Self Help: The good, the bad, and the ugly. Making good choices
Introduction
I have had a long career in mental health mostly good – at least it kept me off the street.
But suicide topped and tailed my career. I was the one who found someone who had ended their life – the last person to see them alive. The result was my career was marked by flashbacks and had I been more clever I could have used that experience to stop others ending their lives. Now at the near end of my career a young man I had been treating ended his life after completing what was a successful round of therapy. He was found by young boys and I can only imagine their shock.
I was very privileged working with this young man and his lovely family who like many people in the same situation wondered what they could have done differently, and the answer is probably nothing but whether my reassurances replace the guilt is questionable. Similarly, they want his life not to be in vain and so do I. Maybe then, at the very least, I can dissuade similarly suicidal young people by illustrating the impact of suicide on me and on family.
One of the criticisms of my care was that I discharged him with a range of options for self help but did not spend enough time on explaining their functions so that he felt more confident in using them. The critics have a point.
There are so many self help choices out there that it is easy to get lost, as I frequently do, and there needs to be better signposting to those that are credible, research or evidence based and appropriate.
But there are some ways that you can be better assured that what is out there meets the criteria above (maybe there are better criteria to apply). Nice Guidelines for various conditions may help you recognise what approach works for conditions such as anxiety and depression and psychoses etc. This requires that you are clear as to what your symptoms are.
Peter Fonagy and Anthony Roth produced a marvellous book on what type of psychotherapy is best for what condition but is now long out of date (2005) and I am not sure it will be revised which is a shame.
First my definition: Self help is taking action to start or maintain recovery with either minimal help or with some oversight by a helper professional or peer. It may be done as self initiated package or as part of more formal therapy.
Self help can be as small as listening to inspiring words or music when our mood is low or anxiety is high or applying mindfulness or relaxation exercises through to engaging in on line packages with or without a professional guide.
Regardless, lets see whether we can first look at the benefits of self help and then look at the disadvantages of self help.
Benefits of self help
Lets have a list of benefits of self help.
Lets list the disadvantages
Where do we find self help?
I’m a bit of a magpie when it comes to resources, but unlike magpies I share what I find.
Where have you found self help or what have you found that works for you?
The Reading Well Series
https://reading-well.org.uk/books/books-on-prescription/mental-health#self-help
The Reading well series have a range of fabulous books mostly written by experts in the field such as Melanie Fennell and Overcoming Low Self Esteem or Colin Espie and “Getting a Good Nights Sleep”.
One of the best books is David Burns “Feeling Great” Book. So much so that it could be made into a six week Better Mental Health Reading Book Club, if anyone is interested?
Other self help material on line
Some very good self help material can be found here:
https://www.nhs.uk/mental-health/self-help/
https://www.annafreud.org/selfcare/
Books to inspire and console
A great podcast is the “Start the Week” podcast on the 10th January about reading as consolation.
https://www.bbc.co.uk/programmes/m00138fq
Like others, I have found consolation in books as have others.
What books bring you consolation?
Music can have an inspiring and uplifting effect, try Katy Perry “Resilient”
What about Pink
If Apps are your bag!
The apps on here are researched and some professionally reviewed and you click on the label that best fits such as mood disorder or phobias or stress or sleep and it recommends an app.
Some inspiring Podcasts
All in the Mind
https://www.bbc.co.uk/programmes/b006qxx9/episodes/player
Who would have thought nasal breathing especially using your left nostril would be a stress buster:
https://www.bbc.co.uk/sounds/play/m0012scb
Training
Looks like some great training on offer at Bury Adult Learning. As an example:
Self-Care Sanctuary- Starts Tuesday 11 January, 7.00pm-9.00pm for 5 weeks. This course introduces you to the importance of self-care practice for living a healthier, happier and more productive life.
Creative Writing for Wellbeing – Starts Wednesday 12 January, 1.00pm-3.30pm for 5 weeks. This course aims to give you the outlet to be able to express your thoughts and emotions and develop your writing skills to release your creative potential.
Greater Manchester Mental Health Recovery Service has a good download on Mindfulness:
https://www.gmmh.nhs.uk/download.cfm?doc=docm93jijm4n7062.pdf&ver=9600
What about the Creative Living Centre and their Courses
https://www.creativelivingcentre.org.uk/courses.html
Articles/research
Repper and Carter (2011) recommend researching any self help group initiative.
• Repper J, Carter T. (2011). A review of the literature on peer support in mental health services. J Ment Health, 20, 392 – 411
• Kählke, F., Berger, T., Schulz, A., Baumeister, H., Berking, M., Cuijpers, P., Bruffaerts, R., Auerbach, R.P., Kessler, R.C. & Ebert, D.D. 2019, "Efficacy and cost-effectiveness of an unguided, internet-based self-help intervention for social anxiety disorder in university students: Protocol of a randomized controlled trial", BMC psychiatry, vol. 19, no. 1, pp. 1-12.Link
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•
• Riva, G., Bernardelli, L., Castelnuovo, G., Di Lernia, D., Tuena, C., Clementi, A., Pedroli, E., Malighetti, C., Sforza, F., Wiederhold, B.K. & Serino, S. 2021, "A Virtual Reality-Based Self-Help Intervention for Dealing with the Psychological Distress Associated with the COVID-19 Lockdown: An Effectiveness Study with a Two-Week Follow-Up", International journal of environmental research and public health, vol. 18, no. 15, pp. 8188.Link
• Bond, B., Wright, J. & Bacon, A. 2019, "What helps in self-help? A qualitative exploration of interactions within a borderline personality disorder self-help group", Journal of mental health (Abingdon, England), vol. 28, no. 6, pp. 640-646.Link
• Muntingh, A.D.T., Hoogendoorn, A.W., van Schaik, Digna J. F, van Straten, A., Stolk, E.A., van Balkom, Anton J. L. M & Batelaan, N.M. 2019, "Patient preferences for a guided self-help programme to prevent relapse in anxiety or depression: A discrete choice experiment", PloS one, vol. 14, no. 7, pp. e0219588-e0219588.Link
• Zwerenz, R., Baumgarten, C., Becker, J., Tibubos, A., Siepmann, M., Knickenberg, R.J. & Beutel, M.E. 2019, "Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial", Journal of medical Internet research, vol. 21, no. 10, pp. e13655-e13655.Link
• Gaudiano, B.A., Davis, C.H., Miller, I.W. & Uebelacker, L. 2020, "Pilot randomized controlled trial of a video self-help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability", Clinical psychology and psychotherapy, vol. 27, no. 3, pp. 396.Link
• Al-Alawi, M., McCall, R.K., Sultan, A., Balushi, N.A., Al-Mahrouqi, T., Ghailani, A.A., Sabti, H.A., Al-Maniri, A., Panchatcharam, S.M. & Sinawi, H.A. 2021, "Efficacy of a Six-Week-Long Therapist-Guided Online Therapy Versus Self-help Internet-Based Therapy for COVID-19–Induced Anxiety and Depression: Open-label, Pragmatic, Randomized Controlled Trial", JMIR mental health, vol. 8, no. 2.Link
• Cerga-Pashoja, A., Doukani, A., Gega, L., Walke, J. & Araya, R. 2020, "Added value or added burden? A qualitative investigation of blending internet self-help with face-to-face cognitive behaviour therapy for depression", Psychotherapy research, vol. 30, no. 8, pp. 998.Link
• Soucy, I., Provencher, M.D., Fortier, M. & McFadden, T. 2019, "Secondary outcomes of the guided self-help behavioral activation and physical activity for depression trial", Journal of mental health (Abingdon, England), vol. 28, no. 4, pp. 410-418.Link
• Mitsopoulou, T., Kasvikis, Y., Koumantanou, L., Giaglis, G., Skapinakis, P. & Mavreas, V. 2020, "Manualized single-session behavior treatment with self-help manual for panic disorder with or without agoraphobia", Psychotherapy research, vol. 30, no. 6, pp. 776.Link
• Gaudiano, B.A., Davis, C.H., Miller, I.W. & Uebelacker, L.A. 2019, "Development of a Storytelling Video Self-Help Intervention Based on Acceptance and Commitment Therapy for Major Depression: Open Trial Results", Behavior modification, vol. 43, no. 1, pp. 56.Link
• Chang, S., Sambasivam, R., Seow, E., Tan, G.C., Lu, S.H., Assudani, H., Chong, S.A., Subramaniam, M. & Vaingankar, J.A. 2021, "“We Are All Trying to Find a Way to Help Ourselves”: A Look at Self-Help Strategies Among Psychotherapy Clients", Frontiers in psychology, vol. 12, pp. 621085-621085.Link
Introduction I have had a long career in mental health mostly good – at least it kept me off the street. But suicide topped and tailed my career. I was the one who found someone who had ended their life – the last person to see them alive. The result was my career was marked by flashbacks and had I been more clever I could have used that experience to stop others ending their lives. Now at the near end of my career a young man I had been treating ended his life after completing what was a successful round of therapy. He was found by young boys and I can only imagine their shock. I was very privileged working with this young man and his lovely family who like many people in the same situation wondered what they could have done differently, and the answer is probably nothing but whether my reassurances replace the guilt is questionable. Similarly, they want his life not to be in vain and so do I. Maybe then, at the very least, I can dissuade similarly suicidal young people by illustrating the impact of suicide on me and on family. One of the criticisms of my care was that I discharged him with a range of options for self help but did not spend enough time on explaining their functions so that he felt more confident in using them. The critics have a point. There are so many self help choices out there that it is easy to get lost, as I frequently do, and there needs to be better signposting to those that are credible, research or evidence based and appropriate. But there are some ways that you can be better assured that what is out there meets the criteria above (maybe there are better criteria to apply). Nice Guidelines for various conditions may help you recognise what approach works for conditions such as anxiety and depression and psychoses etc. This requires that you are clear as to what your symptoms are. Peter Fonagy and Anthony Roth produced a marvellous book on what type of psychotherapy is best for what condition but is now long out of date (2005) and I am not sure it will be revised which is a shame. First my definition: Self help is taking action to start or maintain recovery with either minimal help or with some oversight by a helper professional or peer. It may be done as self initiated package or as part of more formal therapy. Self help can be as small as listening to inspiring words or music when our mood is low or anxiety is high or applying mindfulness or relaxation exercises through to engaging in on line packages with or without a professional guide. Regardless, lets see whether we can first look at the benefits of self help and then look at the disadvantages of self help. Benefits of self help Lets have a list of benefits of self help. Lets list the disadvantages Where do we find self help? I’m a bit of a magpie when it comes to resources, but unlike magpies I share what I find. Where have you found self help or what have you found that works for you? The Reading Well Series https://reading-well.org.uk/books/books-on-prescription/mental-health#self-help The Reading well series have a range of fabulous books mostly written by experts in the field such as Melanie Fennell and Overcoming Low Self Esteem or Colin Espie and “Getting a Good Nights Sleep”. One of the best books is David Burns “Feeling Great” Book. So much so that it could be made into a six week Better Mental Health Reading Book Club, if anyone is interested? Other self help material on line Some very good self help material can be found here: https://www.nhs.uk/mental-health/self-help/ https://www.annafreud.org/selfcare/ Books to inspire and console A great podcast is the “Start the Week” podcast on the 10th January about reading as consolation. https://www.bbc.co.uk/programmes/m00138fq Like others, I have found consolation in books as have others. What books bring you consolation? Music can have an inspiring and uplifting effect, try Katy Perry “Resilient” What about Pink If Apps are your bag!
App GuideThe apps on here are researched and some professionally reviewed and you click on the label that best fits such as mood disorder or phobias or stress or sleep and it recommends an app.Calm Harm: A Professional ReviewSome inspiring Podcasts All in the Mind https://www.bbc.co.uk/programmes/b006qxx9/episodes/player Who would have thought nasal breathing especially using your left nostril would be a stress buster: https://www.bbc.co.uk/sounds/play/m0012scb Training Looks like some great training on offer at Bury Adult Learning. As an example: Self-Care Sanctuary- Starts Tuesday 11 January, 7.00pm-9.00pm for 5 weeks. This course introduces you to the importance of self-care practice for living a healthier, happier and more productive life. Creative Writing for Wellbeing – Starts Wednesday 12 January, 1.00pm-3.30pm for 5 weeks. This course aims to give you the outlet to be able to express your thoughts and emotions and develop your writing skills to release your creative potential. Greater Manchester Mental Health Recovery Service has a good download on Mindfulness: https://www.gmmh.nhs.uk/download.cfm?doc=docm93jijm4n7062.pdf&ver=9600 What about the Creative Living Centre and their Courses https://www.creativelivingcentre.org.uk/courses.html Articles/research Repper and Carter (2011) recommend researching any self help group initiative. • Repper J, Carter T. (2011). A review of the literature on peer support in mental health services. J Ment Health, 20, 392 – 411 • Kählke, F., Berger, T., Schulz, A., Baumeister, H., Berking, M., Cuijpers, P., Bruffaerts, R., Auerbach, R.P., Kessler, R.C. & Ebert, D.D. 2019, "Efficacy and cost-effectiveness of an unguided, internet-based self-help intervention for social anxiety disorder in university students: Protocol of a randomized controlled trial", BMC psychiatry, vol. 19, no. 1, pp. 1-12.Link • • • Riva, G., Bernardelli, L., Castelnuovo, G., Di Lernia, D., Tuena, C., Clementi, A., Pedroli, E., Malighetti, C., Sforza, F., Wiederhold, B.K. & Serino, S. 2021, "A Virtual Reality-Based Self-Help Intervention for Dealing with the Psychological Distress Associated with the COVID-19 Lockdown: An Effectiveness Study with a Two-Week Follow-Up", International journal of environmental research and public health, vol. 18, no. 15, pp. 8188.Link • Bond, B., Wright, J. & Bacon, A. 2019, "What helps in self-help? A qualitative exploration of interactions within a borderline personality disorder self-help group", Journal of mental health (Abingdon, England), vol. 28, no. 6, pp. 640-646.Link • Muntingh, A.D.T., Hoogendoorn, A.W., van Schaik, Digna J. F, van Straten, A., Stolk, E.A., van Balkom, Anton J. L. M & Batelaan, N.M. 2019, "Patient preferences for a guided self-help programme to prevent relapse in anxiety or depression: A discrete choice experiment", PloS one, vol. 14, no. 7, pp. e0219588-e0219588.Link • Zwerenz, R., Baumgarten, C., Becker, J., Tibubos, A., Siepmann, M., Knickenberg, R.J. & Beutel, M.E. 2019, "Improving the Course of Depressive Symptoms After Inpatient Psychotherapy Using Adjunct Web-Based Self-Help: Follow-Up Results of a Randomized Controlled Trial", Journal of medical Internet research, vol. 21, no. 10, pp. e13655-e13655.Link • Gaudiano, B.A., Davis, C.H., Miller, I.W. & Uebelacker, L. 2020, "Pilot randomized controlled trial of a video self-help intervention for depression based on acceptance and commitment therapy: Feasibility and acceptability", Clinical psychology and psychotherapy, vol. 27, no. 3, pp. 396.Link • Al-Alawi, M., McCall, R.K., Sultan, A., Balushi, N.A., Al-Mahrouqi, T., Ghailani, A.A., Sabti, H.A., Al-Maniri, A., Panchatcharam, S.M. & Sinawi, H.A. 2021, "Efficacy of a Six-Week-Long Therapist-Guided Online Therapy Versus Self-help Internet-Based Therapy for COVID-19–Induced Anxiety and Depression: Open-label, Pragmatic, Randomized Controlled Trial", JMIR mental health, vol. 8, no. 2.Link • Cerga-Pashoja, A., Doukani, A., Gega, L., Walke, J. & Araya, R. 2020, "Added value or added burden? A qualitative investigation of blending internet self-help with face-to-face cognitive behaviour therapy for depression", Psychotherapy research, vol. 30, no. 8, pp. 998.Link • Soucy, I., Provencher, M.D., Fortier, M. & McFadden, T. 2019, "Secondary outcomes of the guided self-help behavioral activation and physical activity for depression trial", Journal of mental health (Abingdon, England), vol. 28, no. 4, pp. 410-418.Link • Mitsopoulou, T., Kasvikis, Y., Koumantanou, L., Giaglis, G., Skapinakis, P. & Mavreas, V. 2020, "Manualized single-session behavior treatment with self-help manual for panic disorder with or without agoraphobia", Psychotherapy research, vol. 30, no. 6, pp. 776.Link • Gaudiano, B.A., Davis, C.H., Miller, I.W. & Uebelacker, L.A. 2019, "Development of a Storytelling Video Self-Help Intervention Based on Acceptance and Commitment Therapy for Major Depression: Open Trial Results", Behavior modification, vol. 43, no. 1, pp. 56.Link • Chang, S., Sambasivam, R., Seow, E., Tan, G.C., Lu, S.H., Assudani, H., Chong, S.A., Subramaniam, M. & Vaingankar, J.A. 2021, "“We Are All Trying to Find a Way to Help Ourselves”: A Look at Self-Help Strategies Among Psychotherapy Clients", Frontiers in psychology, vol. 12, pp. 621085-621085.Link
Mood-Coach 