Self-help interventions for adjustment disorder problems: a randomized waiting-list controlled study in a sample of burglary victims.
Adjustment disorders (AjD) are among the most frequent mental disorders yet often remain untreated. The high prevalence, comparatively mild symptom impairment, and transient nature make AjD a promising target for low-threshold self-help interventions. Bibliotherapy represents a potential treatment for AjD problems. This study investigates the effectiveness of a cognitive behavioral self-help manual specifically directed at alleviating AjD symptoms in a homogenous sample of burglary victims. Participants with clinical or subclinical AjD symptoms following experience of burglary were randomized to an intervention group (n = 30) or waiting-list control group (n = 24). The new explicit stress response syndrome model for diagnosing AjD was applied. Participants received no therapist support and assessments took place at baseline, after the one-month intervention, and at three-month follow-up. Based on completer analyses, group by time interactions indicated that the intervention group showed more improvement in AjD symptoms of preoccupation and in post-traumatic stress symptoms. Post-intervention between-group effect sizes ranged from Cohen's d = .17 to .67 and the proportion of participants showing reliable change was consistently higher in the intervention group than in the control group. Engagement with the self-help manual was high: 87% of participants had worked through at least half the manual. This is the first published RCT of a bibliotherapeutic self-help intervention for AjD problems. The findings provide evidence that a low-threshold self-help intervention without therapist contact is a feasible and effective treatment for symptoms of AjD.
a Department of Psychology , University of Zurich , Zurich , Switzerland.
Rahel
R
Bachem
a Department of Psychology , University of Zurich , Zurich , Switzerland.
Andreas
A
Maercker
D000275:Adjustment Disorders / Q000209:etiology / Q000628:therapy*; D000328:Adult; D000368:Aged; D001638:Bibliotherapy / Q000379:methods*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D019548:Crime Victims / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000073278:Self-Management / Q000379:methods*; D013800:Theft / Q000523:psychology*; D016896:Treatment Outcome; D014850:Waiting Lists
Self-guided help; adjustment disorder; bibliotherapy; randomized controlled trial (RCT); self-help