Acceptance of Online Health Services for Self-Help in the Context of Mental Health: Understanding Young Adults’ Experiences

ABSTRACT

This article explores the understanding of the acceptance of online health services from a self-help perspective in the context of mental health. By examining the experiences of young adults, this article develops a framework to leverage the current understanding of the factors that would support the acceptance and use of these types of services. To this end, a multidisciplinary perspective incorporating knowledge from the service marketing, health, and information systems literature is used. The results suggest that the production of online services that are meant for self-help purposes necessitates a focus on the acceptance of technology and, more importantly, instrumental value creation, as the purpose of using these types of services should be better understood and supported by technological solutions. This study also identifies several technological features supporting both the acceptance of technology and users’ ability to achieve well-being. Furthermore, when developing services for health self-help purposes, the issue of branding to increase acceptance should be assessed. From a user perspective, there appears to be a difference regarding whether the services are positioned as health services or as wellness services.     

A Comprehensive Review and a Meta-Analysis of the Effectiveness of Internet-Based Psychotherapeutic Interventions

ABSTRACT

Internet-based psychotherapeutic interventions have been used for more than a decade, but no comprehensive review and no extensive meta-analysis of their effectiveness have been conducted. We have collected all of the empirical articles published up to March 2006 (n = 64) that examine the effectiveness of online therapy of different forms and performed a meta-analysis of all the studies reported in them (n = 92). These studies involved a total of 9,764 clients who were treated through various Internet-based psychological interventions for a variety of problems, whose effectiveness was assessed by different types of measures. The overall mean weighted effect size was found to be 0.53 (medium effect), which is quite similar to the average effect size of traditional, face-to-face therapy. Next, we examined interacting effects of various possible relevant moderators of the effects of online therapy, including type of therapy (self-help web-based therapy versus online communication-based etherapy), type of outcome measure, time of measurement of outcome (post-therapy or follow-up), type of problem treated, therapeutic approach, and communication modality, among others. A comparison between face-to-face and Internet intervention as reported on in 14 of the studies revealed no differences in effectiveness. The findings of this meta-analysis, and review of additional Internet therapy studies not included in the meta-analysis, provide strong support for the adoption of online psychological interventions as a legitimate therapeutic activity and suggest several insights in regard to its application. Limitations of the findings and recommendations concerning Internet-based therapy and future research are discussed.     

Does self-help increase rates of help seeking for student mental health problems by minimizing stigma as a barrier?

Objective: This study examined whether self-help (books, websites, mobile apps) increases help seeking for mental health problems among college students by minimizing stigma as a barrier. Participants and Methods: A survey was conducted with 200 college students reporting elevated distress from February to April 2017. Results: Intentions to use self-help were low, but a significant portion of students unwilling to see mental health professionals intended to use self-help. Greater self-stigma related to lower intentions to seek professional help, but was unrelated to seeking self-help. Similarly, students who only used self-help in the past reported higher self-stigma than those who sought professional treatment in the past. Although stigma was not a barrier for self-help, alternate barriers were identified. Conclusions: Offering self-help may increase rates of students receiving help for mental health problems, possibly by offering an alternative for students unwilling to seek in-person therapy due to stigma concerns.     

A Population-Wide Screening and Tailored Intervention Platform for Eating Disorders on College Campuses: The Healthy Body Image Program

Abstract

Objectives: This article presents a new approach to intervention for eating disorders and body image concerns on college campuses, using a model of integrated eating disorder screening and intervention. Formative data on implementation feasibility are presented. Participants: College students enrolled at 2 universities between 2011 and 2012. Methods: The Healthy Body Image program is an evidence-based screening and intervention platform, enacted via community and online resources. An online screen was used to identify students at varying levels of risk or eating disorder symptom status; responses were used to direct students to universal or targeted online interventions or further evaluation. Universal prevention programs to improve healthy weight regulation and body image culture were offered to all students. Results: Formative data from 1,551 students illustrates the application of this model. Conclusions: The Healthy Body Image program is feasible to deliver and provides a comprehensive system of screening, evidence-based intervention, and community culture change.     

Collaborative Self-Help Community Development

ABSTRACT

Collaborative self-help as an approach to community development predominated the field for a number of years. This paper revisits the consensus strategy, discusses the contrasts with more recent approaches, delineates the conditions under which it is still an appropriate model for community betterment, and outlines considerations for implementing community development.     

Organizing Self-Help Groups for Empowerment and Social Change

Abstract

Empirical research has shown that self-help groups are not purely about individual change and intra-personal empowerment, but also about policy change and collective empowerment. In North America and Europe, such groups have been in the forefront of social change, and self-help represents a new political potential. However, findings of this study of self-help groups in Hong Kong indicate that social change has never been their common objective. In addition, members of the Hong Kong groups feel unable to impact social policies that affect their lives, despite wanting to do so. It is contended in this paper that this feeling of powerlessness among members might be related to the nature, size and length of existence of the self-help groups. It is further argued that self-help groups should form coalitions and seek professional assistance in order to effect social change and to strengthen and broaden their power base.     

Health Education as a Component of Campus Bulimia Treatment Programs

Abstract

College students experience stressful life events and little research exists on the role the Internet may play in students’ coping. Objective: The purpose of the present study was to examine associations among perceived stress, time spent on the Internet, underlying motives for utilizing the Internet, problematic Internet use, and traditional approaches to coping. Participants: Data were collected from 267 college seniors during March of 2011. Methods: Participants completed an online survey containing measures of coping, motives for utilizing the Internet, problematic online behavior, perceived stress, and background information. Results: Being female, avoidant-emotional coping, and online motive to cope were positively associated with perceived stress and months since most stressful life event and online motive to enhance were negatively associated with stress. Conclusions: Professionals working with college students will benefit from using a nuanced approach to assessing students’ online behavior, including an assessment of underlying motives for use.     

Prevention of shape and weight concerns among college students: An examination of education status variables

Objective: The current study examined whether overlooked aspects of the postsecondary student experience predicted individuals’ body-related concerns, beyond the influence of demographic factors that have upheld explanatory power in past research. Participants: Undergraduate and graduate students (n?=?3,259) took part in the multi-institute Healthy Bodies Study during the 2015 academic year. Method: Participants completed an online survey that assessed their undergraduate/graduate statuses, academic majors, extracurricular involvements, and body-related concerns. Hierarchical multiple regression analyses were run to answer primary study questions. Results: Gender, body mass index (BMI), undergraduate/graduate student status, being a male graduate student, major, and extracurricular activities predicted shape concern (SC), weight concern (WC), and whether these concerns increased since students began at their universities. The addition of the student-specific variables uniquely contributed to the variance in body-related concerns. Conclusions: Further research on the body-related discontent of the identified student groups should be conducted to elucidate potential campus-based treatment targets.     

Internet-Based Clinical Services: Virtual Support Groups for Family Caregivers

ABSTRACT

Objectives: An internet-based psychotherapeutic support group intervention for family caregivers of persons with neurodegenerative diseases was developed in a series of pilot studies and subsequently evaluated in a feasibility study with 34 participants. The aim was to duplicate online group interactions typical of face-to-face support groups. Methods: A user-friendly web site was developed according to usability criteria for older adult users. Unique features of the web site included video conferencing in two formats, one-on-one and a group format with up to 6 participants and a facilitator. Following ten professionally facilitated sessions, each group evolved into a web-based self-help support group facilitated online by a group member. Results: Qualitative analyses of early, middle and late group video conferencing sessions yielded themes congruent with face-to-face group process. Follow up interviews six months following the initiation of the online groups showed overall positive participant responses in each of the following areas: learning to use computers, negotiating the web site links, obtaining disease-specific information from the website, using technology to communicate, bonding with group members, providing mutual guidance and support, and benefiting in terms of coping with the stresses of caregiving.     

Participation and partnerships in research: Listening to the ideas and experiences of a parent-carer

This paper discusses the aims and compromises that ensued in the design of a project investigating the obstacles faced by migrants in professional occupations when they move between countries in the European Union. A qualitative approach was selected because of the virtual absence of statistical and empirical data on the mobility and barriers to skilled/qualified migrants in the EU, in specific professions. Central to the research design was a series of guided interviews with regulatory bodies, employers' representatives and native workers, and 60 semi-structured interviews with women migrants.     

The Diversity Functions of Organizations That Confront Oppression

ABSTRACT

The twentieth century history of three identity movements is reviewed with reference to their approach toward their oppressors. The African American movement, the Women's Movement, and the Lesbian-Gay-Bisexual Movement appear to follow similar paths from accommodation-assimilation, to normative confrontation, disruptive confrontation, separatism, introspective self-help, and pluralistic integration. It is hypothesized and demonstrated that these paths are evolutionary, as each stance appears to encourage conditions for the next stage. The paths are not linear, however, and it is the movement as a whole, not any one organization that is evolutionary. Social workers have distinct roles to play in each stage.     

Online Education in Social Work,Effectiveness, Benefits,and Challenges: A Scoping Review

ABSTRACT

Online education has long been a controversial issue within the Australian social work community. Although technological advances have improved the quality of teaching substantially, scepticism and disbelief continue to exist. Despite the growing evidence base as to the effectiveness of online teaching, this tends to be overlooked. A scoping review of the literature was conducted to synthesise research conducted on online social work education to identify its effectiveness, potential, and challenges and to show whether online social work education will effectively prepare qualified social workers. This revealed that online education enhanced diversity and equity among social work students and students’ performances and satisfaction were similar for both online and on-campus students. Nevertheless, communication and engagement continue to be a challenge.

IMPLICATIONS

• Decisions on online education should be based on evidence of effectiveness rather than on the assumption that face-to-face teaching is superior.

• Further research is needed to explore effectiveness of online education for different groups of students.

• Employers’ experiences with social work graduates from online courses need further research.

• Academics require support to tailor courses interactively and suitably for online education.

     

Relationship Help-Seeking: A Review of the Efficacy and Reach

ABSTRACT

Formal and informal relationship help-seeking is becoming increasingly common. This article discusses seven forms of relationship help-seeking: couple therapy, couple relationship education, self-help books, internet resources, other media sources, talking with clergy, and talking with friends and family. The purpose of this literature review is to organize the relationship help-seeking research, bring to light some of the less accessible research, and offer recommendations to researchers and practitioners regarding the efficacy and reach of relationship help-seeking. In addition, differences in relationship help-seeking based on gender are explored and current relationship help-seeking trends are discussed.     

Youth-Adult Partnership in Community Organizing

Abstract

This paper presents a case study of a campaign developed around sexuality education policy by a national youth-focused organization, Advocates for Youth, and its network of youth activists. The paper provides an overview of the national sexuality education debate and the specific strategies youth and adults use in partnership to advocate for a comprehensive approach to the education. The case study of the My Voice Counts!Campaign provides insight into the creation and evolution of a youth-adult partnership approach to community organizing, beginning with an online activism campaign and resulting in local youth-led projects to improve sex education policies and curricula. Following an analysis of the Campaign's accomplishments, the paper lays out recommendations for action and research to demonstrate the positive effects of this form of community practice.     

Natural Recovery from Substance Dependency

Abstract

The literature on cessation of drug and alcohol dependency without benefit of treatment or participation in self-help groups spans nearly forty years. While this literature is substantial and analyses of the processes of natural recovery well-developed, discussions directed at treatment providers around the value of these analyses for practice has been sparse. Drawing on our study as well as the research of others, this paper explores two dimensions of natural recovery that hold important implications for treatment providers who work with substance dependent clients. These include the common strategies used by remitters and the concept of recovery capital as a way to capture the embeddedness of these natural recovery strategies within a unique structural context of personal attributes and social environments.     

The Need for Web-Based Cognitive Behavior Therapy Among University Students

ABSTRACT

This study investigates students' need for a web-based cognitive-behavior therapy (CBT) intervention program for preventing depression, the mental health status of those who felt a need for such a program, and underlying factors of the intention to use web-based self-help. A conceptual model for explaining intention to use web-based self-help is proposed. Nearly half of the participants reported a need for help with psychological problems, but only a third of these actually sought help from traditional mental health services. In conclusion, there is a need for web-based self-help, and web-based CBT has the potential to attract a group of students who, so far, have not been reached by traditional mental health services.     

Tanning benefits,seasonal effects,and concerns about sunscreen: Measuring health beliefs about UV among college students

Abstract

Objective: To develop and validate a scale measuring health beliefs about UV in cloudy climates that may impact UV exposure behaviors. Participants: Students at a large university in Oregon completed pilot (N?=?115) and final (N?=?335) scales online March–July, 2016. Five participants underwent cognitive interviews. Methods: Expert feedback, cognitive interviews, and pilot data guided item development and refinement. We conducted factor analysis and invariance testing. Results: The final four-factor model fit well (χ²?=?37.97, df?=?37, RMSEA?=?0.000, CFI?=?1.000). HBAU subscales are Sunscreen Toxicity, Seasonal Effects, Health Benefits of Tanning, and Tanning Through the Winter. Invariance testing supported strong invariance across sex and tanning status. Conclusion: The HBAU measures beliefs that encourage UV exposure and discourage protection (eg, the belief that sunscreen ingredients are toxic). This scale will enable more comprehensive measurement of cognitive predictors of UV exposure for student health, clinical, and research purposes.     

Cultivating a Research Tool Kit for Social Work Doctoral Education

ABSTRACT

Social work doctoral education can prepare students to become research scholars whose work has impact by providing and promoting the development of an appropriately sophisticated and diverse research methods tool kit. Students can cultivate their tool kits through course work, mentored research experience, and specialized workshops. The tool kit is best grounded in guided reading of methodological texts—that is, reading methodological texts while conferring with advanced peers, faculty, and research supervisors—which provides essential teaching and experiences to enhance understanding and use. This article lays out a rationale for guided reading and provides an example of primer text and recommended readings to support guided reading for one set of related research methods: randomized experimentation and finite mixture modeling.     

EDITORIAL

Abstract

Hope is a key construct for successful community adjustment among those with severe mental illnesses, particularly given the strengths-based recovery model increasingly prevalent in mental health services and in social work. Consumer-run mental health self-help agencies (SHAs) are well suited to fostering hope via their supportive program environments. This study examines factors associated with hope among members of four self-help agencies via a two-stage least squares regression model (N =310). Findings provide evidence of both individual and program-level associations with hope. These findings mirror social work ethical values of focusing on consumer strengths and self-determination, which are primary goals of SHAs.