How have self help materials assisted people in practice

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• How have self help materials assisted people in
  practice?

Catherine ONeill Services and Awareness Manager
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About Anxiety UK

• User-led anxiety disorders charity
• Established 1970 by sufferer of agoraphobia
• Provides range of support services including 11
  therapies (CBT, clinical hypnotherapy,
  counselling, NLP)
• Membership based organisation
• Supported by DH grant
• Recently delivered 2 high profile projects
• 2008 Children Anxiety
• 2006/7 Toilet Phobia Project

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Self Help information
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Research

• Mansell (2007) investigated the use of CBT based
  self help guides for the treatment of anxiety
  disorders. Primary findings from 11 users
  interviewed suggested
• Users rarely duplicated each others selections,
  suggesting the wide range of self help materials
  available
• Of 11 readers, 9 felt 'No self-help guides are
  perfect, but I can gain something new from each
  one I read', although 6 mentioned 'I am on the
  look-out for a self help guide that will provide
  me with the perfect answer to all of my problems'
  which suggests a mixed pattern of expectation
  into what a self help guide can offer

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What makes a good self help guide? (Mansell,
2007)?

• Positive points
• Easy to Read
• Understanding and compassionate
• Encouraging and optimistic
• Up to date information and style
• Explains why avoidance makes things worse
• Section on assertiveness
• Realistic
• 'Helps me understand myself'
• Author identifies with reader as normal human
  being
• Can easily 'dip in'
• Includes vignettes on Anxiety

• Negative points
• Patronising, impersonal or distant
• Only applied to a small range of anxieties
• Goals for the reader are not relevant
• Too basic
• Too 'spiritual'
• Too much irrelevant information
• Need to be on the road to recovery to find it
  helpful
• Dwells on the symptoms so much I imagine I have
  them
• Unconvincing case examples

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Self Help Survey

• A survey was conducted to ascertain individuals
  experiences of access self help materials
• Users views were requested from individuals
  accessing self help groups, local PCMHS, Anxiety
  UK helpline and volunteers
• 20 individuals were surveyed, with 5 having
  in-depth interviews at follow up

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Self Help Materials in Practice

• Common self help materials used by our members
  included
• Overcoming series
• Overcoming Anxiety (Dr. Chris Williams book)
• Mind over Mood
• Centre for Clinical Interventions resources (see
  www.cci.health.wa.gov.au)
• www.glasgowsteps.com
• www.livinglifetothefull.com
• cCBT packages (Beating the Blues)

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Results of Survey

• Results of survey- the vast majority of
  individuals surveyed had sought additional
  information about their anxiety condition

Have you ever sought additional information with
regard to your anxiety?
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What types of information resources have you
accessed?

• The results suggested that respondents used a
  wide variety of resources when seeking out
  additional information

If yes, what information resources have you
accessed?
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Which of these sources did you find most useful?

• The internet and books were rated as the most
  useful resources when looking for additional
  information

Which of these sources did you find most useful?
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What was your experience of using self help
information?

• I found it helpful that it was structured and
  progressive
• Found the worksheets helpful although did not
  get motivated to work systematically through it
• Found it very helpful
• A very simple and easy to understand guide,
  giving clear explanations and positive guidance

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What did you find helpful/ not so helpful about
the resource?

• You could save the whole course onto your PC and
  work through it in your own time, and could print
  out worksheets, diaries, etc repeatedly
• Found the use of case studies good in both
  resources
• All aspects of it were positive and I found it
  to be extremely useful
• I found the language a bit impersonal at times,
  and case studies were not relevant to my
  particular problem

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How did accessing self help information assist
you?

• The information helped me to analyse my own
  problems and come up with solutions on
  understanding the linkage between the mind and
  physical feelings in the body which had been
  generated by anxiety
• It helped me to identify specific issues which
  were causing me distress/ anxiety and identify
  the steps to address these
• Helped me to recognise how my self critical
  thoughts were affecting me and how to challenge
  these effectively.
• It gave a step by step guide for analyzing your
  problem and techniques for addressing issues
• Helped me feel more normal lots of other
  people had the same issues

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Are there any ways that information could be
adapted that might have improved your experience?

• Some support from another person may have helped
  felt I would have done with someone helping me
  to take a more measured approach
• Help or encouragement when struggling to
  practice techniques perhaps a mentor?
• There were areas of the program that having
  additional support to discuss issues and work
  through these would have been helpful
• Maybe a telephone counselling service could be
  introduced to assess feedback on the information
  and to provide further guidance on the way
  forward

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Key issues

• It would seem that many people seek out self help
  guides to use without the aid of a supporter
  (e.g. Low intensity worker/ GMHW)?
• Issues centre around the language used and style
  of the resource, along with difficulties around
  motivation to complete materials without support
• Accessibility also seemed to be important- self
  help is often a 'first port of call' before
  accessing more structured support
• Guides that seemed 'impersonal or irrelevant' in
  terms of their material were viewed less
  positively, an issue faced by self help materials
  generally

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Key issues (cont)?

• Many people found a structured approach helpful
  breaking down materials into 'bite sized chunks'
  made them easier to complete
• Good goal setting and the identification of
  individual issues seemed to be very important in
  helping people understand their problem
• Case studies were seen as an important way of
  helping the reader relate to the material
• Having worksheets that could be printed out or
  photocopied was also seen as beneficial

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Conclusions

• Small sample size makes it difficult to
  generalise, but findings were similar to Mansell
  (2007) suggesting that there may be common
  experiences of self help information
• Many people do use self help information, but
  would benefit from an easily accessible support
  service when using it
• Experiences with self help materials were
  generally positive, and present an excellent way
  to reach individuals in the early stages of their
  problem

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Contact
Catherine O'Neill Services and Awareness
Manager Anxiety UK 339 Stretford
Road Hulme Manchester M15 4ZY Tel [phone]
774 Fax [phone] email volunteering_at_anxiety
uk.org.uk Web www.anxietyuk.org.uk