title: Peoples' understandings of a primary care-based mental health self-help clinic.
abstract: Self-help programmes are increasingly advocated as a means of managing mental health problems. This qualitative study explored patients' understandings of the use of a UK primary care-based self-help clinic (facilitated by a nurse). As part of a wider evaluation of the clinic, in-depth interviews were conducted with a purposive sub-sample of clinic users. Data indicate that people understand their problem as one of having lost an ability to cope, and that the ethos underlying the clinic is well matched to restore a sense of coping, by motivating patients to re-establish and retain control over their everyday lives. However, some patients experienced a sense of dissonance between prior expectations and actual use of the self-help clinic. Without prior familiarity with self-help, engaging the patient as the mechanism of change may be difficult. Some patients expected formal counselling and were influenced in this by their previous experience of services and discussions with the GP at the point of referral. It takes time and active engagement with self-help materials before patients become aware that they are a crucial mechanism of change. Patients may benefit from information and a referral process, which emphasises the centrality of self-efficacy and the patient as 'change agent' prior to referral.
authors.affiliation: National Primary Care Research and Development Centre, School of Primary Care, University of Manchester, Oxford Road, Manchester M13 9PL, UK. anne.rogers@man.ac.uk
authors.forename: Anne
authors.initials: A
authors.lastname: Rogers
authors.forename: Dianne
authors.initials: D
authors.lastname: Oliver
authors.forename: Peter
authors.initials: P
authors.lastname: Bower
authors.forename: Karina
authors.initials: K
authors.lastname: Lovell
authors.forename: Dave
authors.initials: D
authors.lastname: Richards
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000554:Ambulatory Care Facilities / Q000592:standards*; D001294:Attitude to Health; D015928:Cognitive Behavioral Therapy / Q000592:standards; D003156:Community Mental Health Services / Q000592:standards*; D005260:Female; D006801:Humans; D007389:Internal-External Control; D008297:Male; D008875:Middle Aged; D009042:Motivation; D020380:Needs Assessment; D015403:Nursing Evaluation Research; D015404:Nursing Methodology Research; D011320:Primary Health Care / Q000592:standards*; D011568:Psychiatric Nursing / Q000592:standards; D011614:Psychotherapy, Brief / Q000592:standards; D036301:Qualitative Research; D012648:Self Care / Q000523:psychology / Q000592:standards*; D011795:Surveys and Questionnaires; D006113:United Kingdom