The right of self-defence is usually presented as an exception to the principle of non-use of force. Conventional wisdom therefore holds that the right of self-defence can only be relied on to justify those measures constituting a threat or use of force. This article rejects that claim. It argues that self-defence is a general right under international law and, as such, can be invoked to justify all measures necessary to repel an armed attack regardless of whether they are forcible or non-forcible in nature. To support this argument, this article examines the genesis of the right of self-defence under customary international law, the text of Article 51 of the United Nations Charter, the structure of the United Nations Charter and State practice on Article 51.

Access to cognitive behaviour therapy for those with psychosis (CBTp) remains poor. The most frequently endorsed barrier to implementation is a lack of resources. To improve access to CBTp, we developed a brief form of CBTp that specifically targets voice-related distress. The results of our pilot trial of guided self-help CBT for voices (GiVE) suggest that the therapy is both acceptable and beneficial. The present study aims to explore the subjective patient experience of accessing GiVE in the context of a trial. We interviewed nine trial participants using the Change Interview and a mixed methods approach. Most participants reported at least one positive change that they attributed to GiVE. We extracted five themes: (1) changes that I have noticed; (2) I am not alone; (3) positive therapy experiences; (4) I want more therapy; and (5) helping myself. The themes indicate that participating in the GiVE trial was generally a positive experience. The main areas in which participants experienced changes were improved self-esteem, and the ability to cope with voices. Positive changes were facilitated by embracing and enacting ‘self-help’ and having support both in and out of the therapy sessions. The findings support the use of self-help materials with those distressed by hearing voices, but that support both within and outside the clinical setting can aid engagement and outcomes. Overall, the findings support the continued investigation of GiVE.

Demands placed on informal caregivers can result in an increased likelihood of experiencing common mental health difficulties that may affect their ability to undertake the caring role. Currently, however, few evidence-based interventions have been specifically developed for informal caregivers and available interventions are difficult to access. The Improving Access to Psychological Therapies (IAPT) programme aims to improve access to evidence-based psychological therapies for all groups and may therefore present an opportunity to meet informal caregiver needs. Located within the MRC Complex Intervention Framework, a Phase II feasibility randomised controlled trial (RCT) examines key methodological, procedural and clinical uncertainties associated with running a definitive Phase III RCT of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors. Recruitment was low despite different recruitment strategies being adopted, highlighting significant challenges moving towards a Phase III RCT until resolved. Difficulties with study recruitment may reflect wider challenges engaging informal caregivers in psychological interventions and may have implications for IAPT services seeking to improve access for this group. Further attempts to develop a successful recruitment protocol to progress to a Phase III RCT examining effectiveness of the adapted CBT self-help intervention should be encouraged.

Though there are effective psychological and drug treatments for obsessive–compulsive disorder (OCD), many patients remain inadequately treated or untreated. Making effective self-treatment guidance available may increase the number of patients being helped. In this review, database and manual literature searches were performed of case studies, open and randomised controlled trials (RCTs) of bibliotherapy, self-help groups, telecare and computer-aided self-help for OCD. We found no RCTs of bibliotherapy or self-help groups for OCD. Three open studies showed the efficacy of brief exposure and ritual prevention (ERP) instructions delivered by a live therapist by phone. A vicarious ERP computer program was effective in a small open study. Fully interactive computer-aided self-help by ERP for OCD was efficacious in two open studies and a large multicentre RCT, and in a small RCT compliance and outcome with that program was enhanced by brief scheduled support from a clinician. Although more research is needed, self-help approaches have the potential to help many more patients who would otherwise remain inadequately treated or untreated. Their dissemination could save resources used by health care providers. We propose a stepped care model for the treatment of OCD.

Selon les recommandations actuelles, les traitements de choix des troubles alimentaires compulsifs type boulimie et hyperphagie boulimique reposent sur plusieurs aspects. Tout d’abord, une prise en charge hygiéno-diététique ayant pour objectif de restructurer les prises alimentaires, modifier les comportements alimentaires en dehors des crises, tester les croyances erronées vis-à-vis des aliments, aider à la gestion des vomissements… Elles sont le plus souvent associées à une prise en charge psychothérapique et/ou médicamenteuse. La psychothérapie de choix est la thérapie cognitivo-comportementale (TCC). Compte tenu de leurs cibles thérapeutiques les TCC sont plutôt à réserver à des patientes euthymiques, ayant de fortes préoccupations pour la minceur. L’alternative psychothérapique peuvent être les thérapies interpersonnelles et éventuellement les thérapies psychanalytiques dans certaines situations. Le traitement médicamenteux de première ligne est la fluoxetine à dose anti-compulsive (60 mg/j). D’autres prises en charge médicamenteuses sont proposées (epitomax, naltrexone…) mais doivent être réservées à des deuxièmes lignes après avis spécialisé. Quelle que soit la prise en charge retenue, il est fondamental dans le cadre de l’hyperphagie boulimique d’expliquer aux patients que ces prises en charge n’auront pas d’effets amaigrissants En complément de ces prises en charge, des techniques de self-help devraient être systématiquement associées. Ces techniques consistent en l’utilisation de différents outils (livres, des sites Internet, CD…) qui seront utilisé par le patient seul ou accompagné par le thérapeute dans le but d’augmenter ses connaissances par rapport sa problématique et lui apporter des compétences et des outils pour diminuer les symptômes voir les faire disparaître. Ces techniques simples et pouvant être facilement utilisées par tous ont été validées scientifiquement dans plus d’une trentaine d’études y compris en population française. Certains de ces supports de self-help, actuellement disponibles en France, seront présentés.

Les programmes de gestion du stress par les thérapies comportementales et cognitives (TCC) ont été étudiés dans de nombreux pays et ont montré une efficacité sur la réduction du stress perçu, les symptômes anxieux et de la qualité de vie des patients. Compte tenu du nombre très important de patients susceptibles d’en bénéficier et ne pouvant y accéder, des programmes en self-help ont été proposés. Présentés au début sous la forme de livres (bibliothérapie) ces programmes se sont ensuite enrichis de supports informatiques et numériques. Hélas autant les programmes de gestion du stress basés sur les TCC en présentiel que ceux sur support numérique ont été très peu évalués dans notre pays. À notre connaissance le programme Seren@ctif est le premier programme self-help de gestion du stress en français proposé sur support numérique. Nous avons mené une étude de faisabilité de ce programme sur 10 patients répondant au diagnostic de trouble de l’adaptation avec anxiété selon les critères du DSM-IV. Le programme comprend 5 séances hebdomadaires que le patient suit dans notre unité à partir d’un site internet. Il bénéficie d’un contact minimal avec un membre du personnel médical avant et après chaque séance. Il est fourni au patient, dès la première séance une clé USB contenant des vidéos, des fichiers audios, un self-help book sous forme de e-guide, des carnets de suivi avec le programme des exercices à réaliser en dehors des 5 séances du module. Le patient est encouragé à pratiquer les exercices 20 minutes quotidiennement 5 à 6 jours par semaine. La faisabilité du programme a été évaluée par une échelle originale de satisfaction. La symptomatologie anxieuse a été mesurée au moyen de la forme état de l’inventaire d’anxiété de Spielberger State Trait Anxiety Inventory – forme Y (STAI-Y STAI-S). Au terme des 5 semaines du programme on retrouve de bons résultats en termes d’acceptabilité et d’attractivité. Les scores moyens au questionnaire de satisfaction sont pour tous les items au moins égal à 4 sur 5. Les scores moyens à la STAI-état ont diminué de 53,4 (ET 8,29) à l’inclusion à 44,2 (ET 7,73) en post-intervention. Le programme Seren@ctif mériterait d’être évalué dans le futur de façon contrôlée chez des patients présentant un trouble de l’adaptation avec anxiété afin de juger de son intérêt.

India's agrarian history has for the most part been cast within colonial and nationalist frameworks or in analyses of modernity and development in the South Asian historiography on both sides of the independence divide. This leaves plenty of space to discuss both the vast engagement of American actors with Indian elite formations and modifications to the agrarian projects contingent upon those interactions. A focus on the Americanist drive for agrarian modernization in India allows for exploring the distinct cultural location of modernization in a long-term perspective and its engagement with colonial “development.” A study of their mutual interaction gives insights into modernization's somewhat distinct itinerary on the subcontinent and provides specificity to the history of the otherwise spatially wider American intervention in global and inter-Asian contexts.

This article examines an Arabic commentary on the American self-help pioneer Dale Carnegie's How to Stop Worrying and Start Living, written by a one-time leading intellectual of the Egyptian Muslim Brotherhood, Muḥammad al-Ghazālī. Ghazālī’s 1956 commentary was perhaps the earliest manifestation of an influential genre of literature within the Islamic world today: “Islamic self-help.” Although scholars treat Islamic self-help as an effect of neoliberalism, this article reorients the study of Islamic self-help beyond neoliberalism by showing first, that Ghazālī’s early version of it emerged through a critical engagement with several ideological forms that relate in complex ways to neoliberalism's antecedent, liberalism; and second, that his Islamic self-help is best understood in terms of an Islamic encounter with American metaphysical religion made possible by Carnegie's text. It argues that Ghazālī’s Islamic self-help constituted a radical reconfiguration of Western self-help, one that replaced the ethics of self-reliance and autonomy with Islamic ethical sensibilities clustered around the notions of human insufficiency and dependence upon God. In doing so, it highlights how scholars of contemporary Islam might fruitfully pose the question of how novel intellectual trends and cultural forms, like self-help, become Islamic, instead of limiting their analysis to how Islam is reshaped by modern Euro-American thought, institutions, and practices.