Attrition and outcome in self-help treatment for bulimia nervosa and binge eating disorder: A constructive replication
ABSTRACT The aim of the study was to assess the efficacy of a 12-week CBT-based pure and guided self-help among 29 patients with full and subthreshold bulimia nervosa, and binge eating disorder. In the intention-to-treat analyses, self-help had a moderately positive and sustained effect on the patients' eating problems. The patients reduced their mean number of objective bulimic episodes and purging behavior by 26% and 22% over the course of treatment. The corresponding reduction levels for the treatment completers (n=21) were 41% and 34%, respectively. As in the previous study, there were no significant differences between the pure and guided self-help mode in terms of outcome, and the results were sustained 6 months after the end of the treatment. The findings are discussed in relation to the shorter duration of the self-help, the lower rate of attrition, and the characteristics of the sample compared to the earlier trial.
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- "The purpose of these meetings is to support the patient's motivation for continuing the selfhelp , and not to provide counselling care. Success rates for guided self-help vary greatly, partly due to completion rates often being low (e.g., Gellatly et al., 2007; Ghaderi, 2006). However, it is generally accepted that self-help can be used successfully compared to waiting list controls (although not always, see Mead et al, 2005) but less so when compared to therapist-led treatment (e.g., Gregory et al., 2004; Menchola et al., 2007). "
ABSTRACT: This study investigated whether an analysis of narrative style (word use and cross-clausal syntax) of patients with symptoms of generalised anxiety and depression disorders can help predict the likelihood of successful participation in guided self-help. Texts by 97 people who had made contact with a primary care mental health service were analysed. Outcome measures were completion of the guided self-help programme, and change in symptoms assessed by a standardised scale (CORE-OM). Regression analyses indicated that some aspects of participants' syntax helped to predict completion of the programme, and that aspects of syntax and word use helped to predict improvement of symptoms. Participants using non-finite complement clauses with above-average frequency were four times more likely to complete the programme (95% confidence interval 1.4 to 11.7) than other participants. Among those who completed, the use of causation words and complex syntax (adverbial clauses) predicted improvement, accounting for 50% of the variation in well-being benefit. These results suggest that the analysis of narrative style can provide useful information for assessing the likelihood of success of individuals participating in a mental health guided self-help programme.Psychiatry Research 09/2010; 179(2):181-6. DOI:10.1016/j.psychres.2010.04.011 · 2.47 Impact Factor
- Kindheit und Entwicklung 07/2009; 18(3):180-190. DOI:10.1026/0942-5403.18.3.180 · 6.00 Impact Factor
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ABSTRACT: Psychological research has emphasized the importance of narrative for a person's sense of self. Building a coherent narrative of past events is one objective of psychotherapy. However, in guided self-help therapy the patient has to develop this narrative autonomously. Identifying patients’ narrative skills in relation to psychological distress could provide useful information about their suitability for self-help. The aim of this study was to explore whether the syntactic integration of clauses into narrative in texts written by prospective psychotherapy patients was related to mild to moderate psychological distress. Cross-clausal syntax of texts by 97 people who had contacted a primary care mental health service was analyzed. Severity of symptoms associated with mental health difficulties was assessed by a standardized scale (Clinical Outcomes in Routine Evaluation outcome measure). Cross-clausal syntactic integration was negatively correlated with the severity of symptoms. A multiple regression analysis confirmed that the use of simple sentences, finite complement clauses, and coordinated clauses was associated with symptoms (R2 = .26). The results suggest that the analysis of cross-clausal syntax can provide information on patients’ narrative skills in relation to distressing events and can therefore provide additional information to support treatment decisions.Applied Psycholinguistics 04/2011; 32(02). DOI:10.1017/S0142716410000408 · 1.39 Impact Factor