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In
excess of 40 self help book prescription schemes are now in existence
across the UK, with more under development. The majority of these have
adopted the GP prescription model initially developed by Professor Neil Frude for use across Cardiff (Frude, 2004).
A growing number of supported self help
book schemes however are being developed with the self help clinics being
run by graduate mental health workers within England, often based upon the
protocol implemented by Dr Paul Farrand (Farrand, 2005).
Self Help Book Scheme Location
The
following list highlights the areas or
regions we are currently aware that book schemes are in operation. Due to
such schemes being established all the time it is likely that there are
omissions. If you are aware of any others then please
e-mail Dr Paul Farrand who will be pleased update the list.
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The Self Help Book Prescription List
- The original self help book
prescription list was developed by Professor Neil Frude (Frude, 2004) on
the basis of extensive consultation undertaken with mental health
professionals to identify the titles they had used and found useful and
also on the basis of efficacy being shown in research. From these
suggestions an original list of 35 titles written predominantly by
clinical psychologists, psychiatrists and psychotherapists has been
constructed.
- The book list (Wales,
Devon) covers 20
mental health problems with over 80% of the titles employing a cognitive
behavioural approach and many subjected to clinical trial.
- To maintain and update the book list
some areas have established a self help book review panel, consisting of
mental health professionals, public librarians and user representatives.
- Due to updating, minor variations from
the original book list have arisen between different schemes as the book
lists are beginning to respond to local need and demand that exists for
different titles.
The GP Prescriber Model
- Clients presenting to their General
Practitioner (GP) with a mild to moderate mental health problem are
‘prescribed’ a suitable self help title from a standardised list
covering many of the mental health difficulties commonly encountered in
primary care.
- The book prescription is taken to the
local public library where all the self help books are stocked and
clients issued with the specified book in a manner similar to a standard
library book loan.
- No specific further forms of support
are offered once the book has been prescribed.
The Supported Self Help Model
- Clients initially present to their GP
with a mild to moderate mental health problem (click to see protocol).
If self help is considered to be of possible benefit and the client is
presenting with a mild to moderate mental health problem with little or
no risk the client is encouraged to make an appointment at the self help
clinic.
- Waiting time for these clinics vary but
most clients are seen within a week up to a maximum of a fortnight.
- Self help clinics are based upon the
two-plus-one model of service delivery (Richards et al, 2002) which has
been reported to be highly acceptable to clients, efficient in terms of
client throughput and clinically effective (Lovell, Richards & Bower,
2003).
- Clients are initially offered a 30
minute self help orientation consultation, followed by two 15 minute
fortnightly sessions to support their treatment and a final 15 minute
session 3 months later to evaluate progress (Richards et al, 2002).
What Is Included Within the Self Help
Sessions?
- During the initial consultation clients
are provided with an explanation concerning the nature of self help
(Rogers et al, 2004), advice concerning how to use the resources (Sorby,
1991) and are empowered to take control of their mental health
difficulty. If the client wishes to proceed with self help they are
given a prescription for a self help book from the book list.
- Prescriptions can be handed over at
most of the major public libraries in exchange for the self help title
indicated.
- Follow up sessions offer motivational
interviewing, and support for the acquisition of the skills promoted in
the books.
- In the case of a client initially
experiencing difficulties with self help the mental health worker
supporting the clinics is encouraged to use their discretion and offer
additional sessions of support.
Who Runs the Clinics?
In many areas the supported schemes are
run by graduate primary care mental health workers (GMHW) many of whom
have received specific post graduate level training in the skills required
to support self help (Department of Health, 2003). The role of the GMHW
was introduced across England in response to the need to increase the
provision and accessibility of mental health services in primary care
(Department of Health, 1999).
Involvement of the Public Library
Service
- Within participating areas the public
library play a major role in the delivery of the self help schemes,
often helping in the development of the schemes, in many areas
purchasing multiple copies of all the titles on the book list and
involved in auditing and maintaining book stock.
- Books on the list are commonly located
in all the main public libraries in areas involved in the scheme,
libraries closest to the locations where the self help prescriptions are
being supplied and also in many of the smaller branch libraries.
- Books on the list are stocked within
the libraries in the same manner as any other book. The books can
therefore be accessed in a number of ways:
- If the client has obtained a self
help book prescription it can be handed over in exchange for the self
help title. Accessing the books using the prescription can be
beneficial as it can also activate additional library benefits which
may vary between libraries in different regions.
- Additionally however the books can be
accessed in the same manner as any other library book, simply by going
into the library and taking if off the shelf.
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