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  1. Peer support offers promise for reducing depression symptoms February 15, 2011Media Contact: Ian Demsky Peer to Peer support showed better outcomes for depression than traditional care and similar results as cognitive behavioral therapy, study finds Peer support offers promise as an effective, low-cost tool for fighting depression, a new study by the VA Ann Arbor Healthcare System and University of Michigan Health System finds. Programs in which patients and volunteers share information were found to reduce symptoms of depression better than traditional care alone and were about as effective as cognitive behavioral therapy, researchers found after analyzing 10 randomized trials of peer support interventions for depression dating from 1987 to 2009. The analysis was the first of its kind to look at peer support specifically for depression, says lead author Paul Pfeiffer, M.D., M.S.,an assistant professor of psychiatry at the University of Michigan Medical School and researcher at the VA Ann Arbor Healthcare System. “Peer to Peer support is much less likely to be incorporated into the treatment of depression than for other conditions such as alcohol or substance abuse,” Pfeiffer says. “Our study combined data from small randomized trials and found peer support seems to be as effective for treating depression as some of the more established treatments.” The findings were recently published online ahead of print publication in General Hospital Psychiatry. Peer support has been found to decrease isolation, reduce stress, increase the sharing of health information and provide role models, the study points out. Since peer support programs often use volunteers and nonprofessionals – and can be done over the phone or Internet as well as in person – they have the potential to be widely available at relatively low cost, Pfeiffer says. The need for additional coping options is important when one considers that one third of patients taking anti-depressants for major depressive disorder still experience significant symptoms after trying four medicines, and more than half of people who achieve remission of their symptoms relapse within a year, he adds. “As a field, we should be looking at how to integrate peer support components into primary care and specialty treatment of depression,” Pfeiffer says, noting that additional, larger studies could also provide more insight. Funding: This research was supported by VA Health Services Research and Development Service, Michigan Diabetes Research and Training Center and the Michigan Institute for Clinical and Health Research. Additional U-M authors: Michele Heisler, M.D., John D. Piette, Ph.D., Mary A.M. Rogers, Ph.D., Marcia Valenstein, M.D. Heisler, Piette and Valenstein have VA appointments. Reference: “Efficacy of peer support interventions for depression: a meta-analysis,” General Hospital Psychiatry. doi:10.1016/j.genhosppsych.2010.10.002 Source: http://www.uofmhealth.org/News/peer_psychiatry_0215
  2. What if you could get what a psychologist offers without actually having to see one? James Cartreine, PhD Posted November 04, 2015, 12:10 pm , Updated November 04, 2015, 9:50 am James Cartreine, PhD, Contributing Editor Many people enjoy the warm, caring relationship provided by a mental health clinician, but others simply want to get better. Many people would rather not open up to another person about their problems — at least, not in person. Plus, seeing a mental health clinician can be inconvenient and expensive — and there might not even be any nearby. One of the new frontiers in psychotherapy is using the Internet to deliver cognitive behavioral therapy (CBT) for depression, anxiety, and other behavioral health problems in a way that reduces — or sometimes eliminates — the amount of time spent with clinicians in person. This novel delivery method allows treatments that have traditionally been provided one-on-one to be scaled up so they can reach far more people. After all, it doesn’t matter if a good treatment exists if people don’t have access to it. What are these online therapies? The field is new, so the data about these online programs are sparse — but a team of British researchers recently conducted a review of the available literature. For the review, they scoured medical journals looking for “John Henry” studies — that is, comparisons of live cognitive behavioral therapy against websites or computer programs that deliver treatments for anxiety or depression. What did the researchers find? They used a high bar of scientific rigor and found only five online mental health interventions that had been directly compared with live clinicians providing the same treatment, for working-age adults. Two of the interventions were Australian and three were Swedish, and all of them were for social anxiety or panic disorder. Most online interventions studied by the researchers were divided into sessions, mirroring the way in-person CBT is delivered on a weekly basis. All of the online therapies delivered treatment via written content, also known as “bibliotherapy.” This was combined with communication with a mental health clinician, usually a psychologist, over email or private messaging systems. In one study, psychologists were limited to spending only 10 minutes per week on each participant. Some programs added text messaging and discussion forums, and most included homework — things that participants did between sessions — just as in-person CBT involves between-session practice. All treatment groups, for both in-person and online CBT, significantly improved in symptoms. One study found better outcomes for the online treatment, and the others found equal results between the two types. The online treatments required much less clinician time, making them more cost-effective. The downside? All of the online treatment participants needed to do a lot of reading, which can be a limiting factor for some people. Also, written interaction with a psychologist or other clinician was part of every online intervention in this review. This means that to some extent, the effectiveness of the intervention still depends on the clinician who’s on the other end. Plus, requiring clinicians to be involved at all creates a hurdle to scaling up treatments to reach massive numbers of people. The newest innovations in a very new field New online programs and mobile apps are emerging that minimize the amount of reading, use video and audio to deliver treatments, and require no clinician involvement at all. These simulate live CBT but can be delivered to huge numbers of people. Head-to-head comparisons of these newer programs against traditional therapy (the kind of comparison that would meet the criteria of the British team) have not yet been published. So stay tuned for developments in this next generation of treatment delivery. Related Information: Understanding Depression health.harvard.edu
  3. So, it's only a little step, and I hope this belongs here. Part of my issue has been personal hygiene. As long as I've been in as my dad calls it a "funk" with my depression and anxiety I had pretty much stopped bathing more than once or twice every couple weeks. Basically when I couldn't stand how my skin felt anymore etc. the thought of the shower was just...daunting. Besides that I had simply stopped brushing my teeth more than a few times a month, except for a brief period after going to the dentist about a year ago when they found two "areas to watch" and I had gingivitis. I kept up pretty good for about two months and then it just went back down hill after some major medical craziness. Anyways, I finally got some help earlier this year (like...January) from a fantastic cognitive behavioral therapist, his brother happens to be one of my Major professors and is in charge of my program and uses behavioral psychology with our classroom management, so it's good for me because he doesn't just fiddle with things, he explains what he's doing and how things work and what the retraining process is and put falls and what not. So when I mentioned my big issues with my personal hygiene his first question was how important it was. I said it was very important, I mean, I'm a 23 year old girl going into music education. I spend my days not only around people, but in close proximity with kids. If something looks or smells weird or off, kids are perceptive and can be mean on purpose in some cases or just...candid in others, depending on the age. Besides, if I decide I want to perform, I can't do that looking like a greasy ball of mess. So he told me to set an alarm on my phone. One that wouldn't interfere with anything I have to do. Every night, regardless of what I am doing, I have to stop everything an get in the shower at that point. I can do it earlier, and obviously if something lets me out late and I'm in the car I can do it later, but basically I go straight there when I walk in the door. This was Saturday. I have showered every single day and brushed my teeth twice a day since Friday. (Friday I was feeling that icky thing, but it doesn't entirely count towards the habit because it was part of the old pattern is what we talked about) We're not worried about flossing right now, because my gums are so messed up that it would just tear them up. I haven't mustered up the guts to make a dentist appointment but I'm hoping that by the time the habit is formed (most CBT agree it takes 14 days to form one 21 to really solidify it) I will feel comfortable doing it. The third day is the hardest. So, for those who have issues with showering and what not. It's okay. You aren't alone. Talk to your therapist, try something like this, it's all about habit. Think about it, it took you years to build it as a child and probably only a few days/weeks to break it as an adult with a disease that affects your whole being. You can do it. Today I was looking forward to my shower. I had gone out that Saturday and smelled all the soft soap body washed that were on sale (didn't want to buy fancy stuff yet, don't want to waste it!) and picked out two and a nice scrub for days when I have time and want a full on spa day. Find things to make it even better. If you have a S.O. That is a support system and you can't stand shopping alone, take them with you! You can do it! It feels so good the first time you want to get in that shower. I sleep so much better now.
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