Bibliotherapy for depression.

Bibliotherapy can be used to treat mild to moderate depression or subthreshold depressive symptoms, as a sole or supplementary therapy. Bibliotherapy is a form of guided self-help. The patient works through a structured book, independently from the doctor. The role of the doctor is to support and motivate the patient as they continue through the book and to help clarify any questions or concerns the patient may have. Relevant books can be purchased or often borrowed from a library, with limited cost and good accessibility from a patient perspective. Patients need to have a reading age above 12 years and have a positive attitude toward self-help. Bibliotherapy has NHMRC Level 1 evidence of efficacy and no serious adverse effects have been reported. This article forms part of a series on non-drug treatments, which summarise the indications, considerations and the evidence, and where clinicians and patients can find further information.

Aspectos psicosociales del manejo de la disfunción eréctil / Psycosocial features of the management of erectile dysfunction

OBJETIVO: La sexualidad en general y la respuesta eréctil en particular no son ajenas a aspectos psico-socio-culturales y de pareja.Poner de relieve aquellos aspectos psicológicos y de pareja que interfieren en la erección y asimismo señalar las pautas de intervención en terapia de pareja que mejores resultados obtienen en el tratamiento de la disfunción eréctil.MÉTODOS: Se ha hecho una revisión de la literatura en torno a los aspectos psicológicos y sociales según los hábitos de vida actual en relación a la fisiología de la respuesta eréctil, además de revisar los distintos modelos de tratamiento en pareja.RESULTADOS/CONCLUSIONES: La separación del binomio reproducción-placer conseguido en los años 50 ha permitido una reivindicación progresiva por parte de la mujer de su necesidad de ser satisfecha, constituyendo uno de los motivos que han dado lugar al fenómeno de la “ansiedad de ejecución, que junto con otros hábitos tóxicos (tabaco, alcohol, drogas, vida sedentaria, etc.) facilitan la aparición de disfunción eréctil. Cuando los factores psicológicos forman parte importante del problema, la terapia sexual de pareja combinada con inhibidores de la fosfodiesterasa cinco constituye la estrategia terapéutica de elección(AU)

OBJECTIVES: Sexuality on the whole and erectile response particularly are not alien to psychosocial and couple features. We review al psychological and couple features that interfere on erection and also point out the interventional directions of couple therapy that give the best results in the treatment of erectile dysfunction.METHODS: We performed a bibliographic review about the psychological and social features under the current way of life in relation to erectile response physiology, in addition to review different models of couple therapy.RESULTS/CONCLUSIONS: The separation of the couple reproduction-pleasure achieved in the 50`s enabled a progressive claim from women of their need to be satisfied, representing one of the reasons that led to the phenomenon of “performance anxiety” that, altogether with some toxic habits (Tobacco consumption, alcohol, drugs, sedentary life, etc) help the appearance of erectile dysfunction. When psychological factors are an important part of the problem, couple sexual therapy in combination with phosphodiesterase 5 inhibitors is the therapy of choice(AU)

Internet administered guided self-help versus individualized e-mail therapy: A randomized trial of two versions of CBT for major depression.

Internet-delivered psychological treatment of major depression has been investigated in several trials, but the role of personalized treatment is less investigated. Studies suggest that guidance is important and that automated computerized programmes without therapist support are less effective. Individualized e-mail therapy for depression has not been studied in a controlled trial. Eighty-eight individuals with major depression were randomized to two different forms of Internet-delivered cognitive behaviour therapy (CBT), or to a waiting-list control group. One form of Internet treatment consisted of guided self-help, with weekly modules and homework assignments. Standard CBT components were presented and brief support was provided during the treatment. The other group received e-mail therapy, which was tailored and did not use the self-help texts i.e., all e-mails were written for the unique patient. Both treatments lasted for 8 weeks. In the guided self-help 93% completed (27/29) and in the e-mail therapy 96% (29/30) completed the posttreatment assessment. Results showed significant symptom reductions in both treatment groups with moderate to large effect sizes. At posttreatment 34.5% of the guided self-help group and 30% of the e-mail therapy group reached the criteria of high-end-state functioning (Beck Depression Inventory score below 9). At six-month follow-up the corresponding figures were 47.4% and 43.3%. Overall, the difference between guided self-help and e-mail therapy was small, but in favour of the latter. These findings indicate that both guided self-help and individualized e-mail therapy can be effective.

Storybook-based communication intervention for girls with Rett syndrome and their mothers.

PURPOSE: Storybook reading provides a natural language learning context in which to support early symbolic communication. In this study, we explored the impact of (1) resting hand splints, (2) light tech augmentative communication systems such as voice-output devices and symbols, and (3) very basic parent training on the symbolic communication and labelling behaviours of six girls with Rett syndrome. METHOD: Mothers and daughters were videotaped as they read familiar and unfamiliar storybooks in their homes. RESULTS: Group and individual data collected from the six girls indicated that they became more active and successful participants in the interactions during storybook reading. The girls employed a wider range of communication modes and increased the frequency of their labelling. Familiar storybook reading encouraged greater symbolic communication than unfamiliar storybooks in half the girls. CONCLUSION: This study suggests that motivated parents may not require expensive technologies or lengthy training in order to enhance their children's early communication and participation in storybook reading.