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Abstract Triple P Online (i.e., TPOL; www..tripleponline.net) is an online self-help parent training program aimed at reducing child behavior problems through "positive parenting practices"—available at time of review for $79.95. TPOL is comprised of 8 video-based modules that also incorporate in-session activities and homework. Randomized control trials have shown that TPOL effectively reduces child behavior problems. The program's main strengths include very high-quality content with an abundance of relevant and easily locatable resources, an easy-to-use interface, and a professional look and feel. The program's main weakness lies in its lack of monitoring and adaptation to the user's state (e.g., child's and parent's behaviors), and real-time reminders for desired actions. Altogether, TPOL is an extremely valuable and important resource for families seeking evidence-based treatment for child behavior problems. Highlights • The content, design, and aesthetic features of Triple P Online are of a high quality. • The program lacks monitoring, feedback, and reminders based on the user's current state. • There is an increasing body of evidence backing the program's effectiveness. • This is an important parent training resource for addressing child behavior problems. [ABSTRACT FROM AUTHOR]

Aim To assess the effectiveness of the Healthy School and Drugs (HSD) program for secondary schools on the development of substance use among Dutch early adolescents and to explore whether boys, adolescents of lower educational backgrounds, or adolescents high on personality risk traits, would benefit more from the HSD program than others. Design Randomized clustered trial with two intervention conditions (i.e., lessons and integral) among a general population of adolescents in the Netherlands. Participants A total of 3784 students of 23 Dutch secondary schools. Measurements Structured digital questionnaires were administered pre-intervention and at 8, 20, and 32 months follow-ups. The outcome measure was the rate of change in substance use across follow-ups. Differential effectiveness of the HSD program was examined for sex, educational level, and personality traits. Findings Our results show no HSD intervention effects on the development of substance use. Sex, education level, and personality characteristics of the participants did not moderate the intervention effects. Conclusion The absence of effects of the Healthy School and Drugs program on the development of substance use indicates that the program should be renewed and redeveloped. [ABSTRACT FROM AUTHOR]

Background Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website ( www.moodswings.net.au ). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. Method Participants with Bipolar I or II disorder ( n= 156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence. Results Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months ( p =0.02) but not on the incidence of recurrence. Limitations The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. Conclusion This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement. [ABSTRACT FROM AUTHOR]

Abstract: This study examined the role of psychological flexibility, as a risk factor and as a process of change, in a self-help Acceptance and Commitment Therapy (ACT) intervention for adults with mild to moderate depression and anxiety. Participants were randomized to the self-help programme with e-mail support (n = 250), or to a waiting list control group (n = 126). All participants completed measures before and after the intervention to assess depression, anxiety and psychological flexibility. Participants in the experimental condition also completed these measures during the intervention (after three and six weeks) and at a three-month follow-up. With multilevel modelling, it was shown that the effects of the intervention on psychological distress were stronger for participants with higher levels of psychological flexibility. Furthermore, our study showed that improved psychological flexibility mediated the effects of the ACT intervention. With a cross-lagged panel design, it was shown that especially improvements in psychological flexibility in the last three sessions of the intervention were important for further reductions in anxiety. To conclude, our study showed the importance of targeting psychological flexibility during an ACT intervention for a reduction in depressive and anxiety symptoms. [Copyright &y& Elsevier]

Abstract: Aims: To examine predictors of quality of life gains among people with type 1 diabetes following the Dose Adjustment for Normal Eating (DAFNE) self-management training programme. Methods: Clinical and questionnaire data were collected from 437 patients from 6 hospital centres before, and 18 months post-DAFNE intervention. Glycated haemoglobin (HbA1c), weight, height, and blood pressure levels were recorded by clinicians during clinic appointments. Questionnaires included the Diabetes-Specific Quality of Life Scale (DSQOLS), the Problem Areas in Diabetes Scale (PAID) and the Hospital Anxiety and Depression Scale (HADS). Basic demographics were recorded at baseline. Linear mixed models were fitted to identify predictors of change in quality of life at an 18 month follow-up assessment. Results: Patients with high levels of diabetes-related distress experienced greatest improvement in DSQOLS quality of life scores (p =0.001). Patients with poor glycaemic control (higher levels of HbA1c; p =0.03) and those with high levels of anxiety (p =0.001) experienced the greatest reductions in diabetes-related distress. Conclusions: Patients with higher baseline levels of anxiety, higher levels of diabetes-related distress and higher baseline levels of HbA1c are most likely to experience quality of life gain from participation in self-management programmes such as DAFNE. [Copyright &y& Elsevier]

Abstract: Objective: This study was conducted to evaluate the effectiveness of a cognitive behavioral self-help program (SHP) in combination with pharmacotherapy in patients with primary insomnia in general practice. Participants: Patients were recruited from 31 general practitioners (GPs) in the Hamburg area, who were randomly assigned to the two different study conditions. Eighty patients completed the study. They had suffered from insomnia for several years and showed a high impairment according to the Pittsburgh Sleep Quality Index. Intervention: According to assignment of their GP the patients either received a progressively reduced 4-week pharmacotherapy or a combination of pharmacotherapy and a SHP consisting of six chapters on progressive muscle relaxation, cognitive relaxation, modified stimulus control, thought stopping, and cognitive restructuring. Measures and results: After study enrollment patients had short weekly consultations with their GPs during treatment to receive sleep medication and questionnaires. They completed questionnaires measuring general sleep quality and sleep-disruptive beliefs and also sleep diaries before treatment, during treatment, immediately following treatment, and at a 6-week and 6-month follow-up time point. For collection of changes in mood the Beck Depression Inventory was used. The whole sample showed reductions of sleep onset latency and time awake after sleep onset. Total sleep time increased and mood improved. Patients additionally working with the SHP showed significantly more improvements in sleep quality and negative sleep-related cognitions like ruminating and focusing on sleep. Treatment effects were significant at the end of therapy and remained stable at the six-week and six-month follow-up. Conclusion: This study supports the use of a cognitive-behavioral SHP on primary insomnia in the setting of a general practice and should be investigated in more detail. Also, regular appointments and the utilization of sleep logs seem to have a positive influence on sleep disorders. [Copyright &y& Elsevier]

Objective: Aim was to examine whether a new cognitive-behavioral self-help intervention program was effective in improving depressed mood in people with acquired chronic physical impairments. Methods: Participants were 32 persons with acquired chronic physical impairments and depressive symptoms, who were randomly allocated to the Cognitive-Behavioral Self-help program (CBS) or the Waiting List Control group (WLC). Depression scores were assessed at three measurement moments: at pretest, immediately after completion of the intervention (posttest), and again two months later (follow-up). To evaluate changes in depression scores, Repeated Measures ANCOVA''s were performed. Results: It was shown that respondents who followed the CBS significantly improved compared to the WLC after completion of the program, and that this positive effect remained at 2-months follow-up. Conclusion: A cognitive-behavioral self-help intervention can be an effective tool to reduce depressive symptoms in people with physical impairments. Practice implications: A self-help program may prove to be more cost-effective for individuals and for the health care system as a whole. In addition, because a self-help intervention program can be delivered through mail or internet, a high number of people could be reached while overcoming geographical and social barriers to treatment. [Copyright &y& Elsevier]

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. [Copyright &y& Elsevier]

Abstract: Guided self-help via Internet is a promising way of treating panic disorder (PD). The present study examined the effects of a self-help program via Internet with weekly therapist contact for PD after disseminated to a new country. Predictors of outcome were also examined. The study was an open trial with 27 participants with PD with or without agoraphobia as their primary diagnose. Medium to large effects on PD-symptoms were reported after treatment and at 6months follow-up, with smaller effects on secondary outcome measures, i.e. depression, interpersonal problems, and sleep problem. The attrition rate of 30% in present study was higher than in Swedish studies. Predictor analysis showed that participants with longer duration of PD-symptoms had less improvement on all outcome measurers, whereas higher age predicted more improvement. The guided self-help program remained effective when disseminated to a new country, but the high attrition rate needs to be addressed in future studies. [Copyright &y& Elsevier]

Objective: This review examined the effectiveness of self-management interventions compared to usual care on mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure. Methods: A systematic review was performed. MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched between 1996 and 2009. Randomized controlled trials were selected evaluating self-management interventions designed for patients with chronic heart failure. Outcomes of interest are mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life. Results: Nineteen randomized controlled trials were identified. The effectiveness of heart failure management programs initiating self-management interventions in patients with chronic heart failure indicate a positive effect, although not always significant, on reduction of numbers of all-cause hospital readmitted patients and due to chronic heart failure, decrease in mortality and increasing quality of life. Conclusion: This systematic review found that current available published studies show methodological shortcomings impairing validation of the effectiveness of self-management interventions on mortality, all-cause hospital readmissions, chronic heart failure hospitalization rate and quality of life in patients with chronic heart failure. Practice implications: Further research should determine independent effects of self-management interventions and different combinations of interventions on clinical and patient reported outcomes. [Copyright &y& Elsevier]

Abstract: To examine dynamic changes in drug-use trajectories over time we analyzed episode types and predictors of quitting use over the 10 years following drug-use initiation for 1797 heroin, cocaine, and methamphetamine (meth) users. Most episodes reflected high use and incarceration, however these events occurred more frequently among heroin and meth users. Quitting was predicted by current treatment and self-help participation among meth (RR 2.57, 1.79–3.70; 2.57, 1.80–3.67) and cocaine (RR 2.00, 1.42–2.81; 2.10, 1.63–2.72) users, and by a history of quitting for meth users (RR 1.11, 1.06–1.17). Quitting was less likely among all users under legal supervision (RR 0.55–0.69) and among heroin (RR 0.66, 0.45–0.97) and meth users (RR 0.73, 0.60–0.89) with an early drug-use onset. Relative to cocaine or meth use, heroin use was characterized by persistent use at a high-level which was often only interrupted by incarceration. While quitting drug use can be facilitated by treatment and/or self-help participation, few people had these experiences in the 10 years following first use. [Copyright &y& Elsevier]

Abstract: This study was based on a ten-year follow-up of smokers who had participated in a randomized controlled trial of a behavioral self-help program for smoking cessation. The original sample was made up of 200 smokers assigned at random to two treatment groups. Ten years later 93.5% (n =187) of the sample were successfully located (of the 13 not located, 6 had died), from whom information was obtained about their current state and the evolution of their smoking over the 10-year period. Reported abstinence at this follow-up was confirmed by carbon monoxide in expired air. Significant differences were found in the abstinence rates of the two groups at the follow-ups 1 year (14% vs. 28%) and 2 years (13% vs. 24%) after the end of the treatment. After 10 years 26% (n =52) of the total sample were abstinent. Over the ten-year period, 62.0% tried to give up smoking at some point, the mean figure for attempts being 1.3. According to the results of the 10-year follow-up, low nicotine dependence at pretreatment is a major factor predicting long-term cessation in smokers. [Copyright &y& Elsevier]