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Muslim leaders of the UOIF further cement their claim to respectability through an elite project of community-building. This project consists of forming a respectable class of Muslims who embody the petit bourgeois values of hard work, politeness, and individual responsibility. This is concretely enacted through various institutions, starting with private Muslim schools, and implemented through a range of regular activities, such as reading groups, diploma ceremonies, and self-development workshops. This chapter draws on comparisons made with Black elites in the US and upper-class Jews in nineteenth-century Europe to show that French Muslim leaders’ uplift ideology is also scripted into bodies. Physical exercise, hygienic practices, and appropriate outfits comprise the primary medium of perfectionist politics seeking dignity. These politics are articulated using the language of Islamic virtues – the centrality of education is predicated upon the Quranic injunction iqrāʾ (“read”), the search for professional accomplishment is understood as a duty of iḥsān (excellence), and the importance of behavioral exemplarity is reasoned in reference to ādāb (good manners) and akhlāq (ethical conduct). These moral principles, however, are also consistent with neoliberal definitions of social worth and rely on the continuous erection of boundaries against lower-class, “undeserving” coreligionists.
This book challenges the traditional understanding of belligerent reprisals as a mechanism aimed at enforcing the laws of armed conflict. By re-instating reciprocity at the core of belligerent reprisals, it construes them as tools designed to re-calibrate the legal relationship between parties to armed conflict and pursue the belligerents' equality of rights and obligations in both a formal and a substantive sense. It combines an inquiry into the conceptual issues surrounding the notion of belligerent reprisals, with an analysis of State and international practice on their purpose and function. Encompassing international and non-international armed conflicts, it provides a first comprehensive account of the role of reprisals in governing legal interaction during wartime, and offers new grounds to address questions on their applicability, lawfulness, regulation, and desirability. This title is part of the Flip it Open Programme and may also be available Open Access. Check our website Cambridge Core for details.
Providing Mental Health and Psychosocial Support interventions (MHPSS) for forcibly displaced Ukrainians in Central and Eastern Europe poses numerous challenges due to various socio-cultural and infrastructural factors. This qualitative study explored implementation barriers reported by service providers of in-person and digital MHPSS for Ukrainian refugees displaced to Poland, Romania and Slovakia due to the war. In addition, the study aimed to generate recommendations to overcome these barriers. Semi-structured Free List and Key Informant interviews were conducted using the Design, Implementation, Monitoring and Evaluation protocol with 18 and 13 service providers, respectively. For in-person interventions, barriers included stigma, language, shortage of MHPSS providers, lack of financial aid and general lack of trust among refugees. For digital MHPSS, barriers included generational obstacles, lack of therapeutic relationships, trust issues, and lack of awareness. Recommendations included advancing public health strategies, organizational interventions, building technical literacy and support, enhancing the credibility of digital interventions and incorporating MHPSS into usual practice. By implementing the recommendations proposed in this study, policymakers, organizations and service providers can work towards enhancing the delivery of MHPSS and addressing the mental health needs of Ukrainian refugees in host countries, such as Poland, Romania and Slovakia.
This chapter provides an overview of dissemination and implementation science, which focuses on how clinical interventions can be effectively employed with various client populations in various settings. It reviews some of the ways – other than the one-to-one in-person format – that mental health care can be delivered, including in groups, couples, and families. It also describes advances in technology-delivered services, the increasing role of non-specialist providers in delivering mental health care around the world, and community-based efforts to prevent mental health problems. It concludes with a discussion of self-help and complementary integrative techniques, highlighting the broad range of methods available to deliver mental health services and the need to consider a wider range of delivery models to help reduce the global gap between treatment needs and treatment availability.
Little is known about the effectiveness of cognitive behavioral therapy (CBT) specific self-help for psychosis, given that CBT is a highly recommended treatment for psychosis. Thus, research has grown regarding CBT-specific self-help for psychosis, warranting an overall review of the literature. A systematic literature review was conducted, following a published protocol which can be found at: https://www.crd.york.ac.uk/prospero/export_record_pdf.php. A search was conducted across Scopus, PubMed, PsycInfo, and Web of Science to identify relevant literature, exploring CBT-based self-help interventions for individuals experiencing psychosis. The PICO search strategy tool was used to generate search terms. A narrative synthesis was conducted of all papers, and papers were appraised for quality. Ten studies were included in the review. Seven papers found credible evidence to support the effectiveness of CBT-based self-help in reducing features of psychosis. Across the studies, common secondary outcomes included depression, overall psychological well-being, and daily functioning, all of which were also found to significantly improve following self-help intervention, as well as evidence to support its secondary benefit for depression, anxiety, overall well-being, and functioning. Due to methodological shortcomings, long-term outcomes are unclear.
To examine the effectiveness of Self-Help Plus (SH+) as an intervention for alleviating stress levels and mental health problems among healthcare workers.
Methods
This was a prospective, two-arm, unblinded, parallel-designed randomised controlled trial. Participants were recruited at all levels of medical facilities within all municipal districts of Guangzhou. Eligible participants were adult healthcare workers experiencing psychological stress (10-item Perceived Stress Scale scores of ≥15) but without serious mental health problems or active suicidal ideation. A self-help psychological intervention developed by the World Health Organization in alleviating psychological stress and preventing the development of mental health problems. The primary outcome was psychological stress, assessed at the 3-month follow-up. Secondary outcomes were depression symptoms, anxiety symptoms, insomnia, positive affect (PA) and self-kindness assessed at the 3-month follow-up.
Results
Between November 2021 and April 2022, 270 participants were enrolled and randomly assigned to either SH+ (n = 135) or the control group (n = 135). The SH+ group had significantly lower stress at the 3-month follow-up (b = −1.23, 95% CI = −2.36, −0.10, p = 0.033) compared to the control group. The interaction effect indicated that the intervention effect in reducing stress differed over time (b = −0.89, 95% CI = −1.50, −0.27, p = 0.005). Analysis of the secondary outcomes suggested that SH+ led to statistically significant improvements in most of the secondary outcomes, including depression, insomnia, PA and self-kindness.
Conclusions
This is the first known randomised controlled trial ever conducted to improve stress and mental health problems among healthcare workers experiencing psychological stress in a low-resource setting. SH+ was found to be an effective strategy for alleviating psychological stress and reducing symptoms of common mental problems. SH+ has the potential to be scaled-up as a public health strategy to reduce the burden of mental health problems in healthcare workers exposed to high levels of stress.
The right of self-defence is usually presented as an exception to the principle of non-use of force. Conventional wisdom therefore holds that the right of self-defence can only be relied on to justify those measures constituting a threat or use of force. This article rejects that claim. It argues that self-defence is a general right under international law and, as such, can be invoked to justify all measures necessary to repel an armed attack regardless of whether they are forcible or non-forcible in nature. To support this argument, this article examines the genesis of the right of self-defence under customary international law, the text of Article 51 of the United Nations Charter, the structure of the United Nations Charter and State practice on Article 51.
The social media platform Reddit is a contemporary context where we have an opportunity to identify problems experienced by people regarding different aspects of life. The platform is virtually anonymous which might make users discuss their problems more freely. Reddit is divided in subreddits where different subjects are discussed and the discussions are controlled by creators and moderators. I have identified a quite active subreddit targeted towards recovering addicts of benzodiazepines; r/benzorecovery.
Objectives
* To analyze strategies of recovery in user narrative * To identify techniques commonly used and the how they are described * To construct metadata in order to assess how frequent the discussion of a different techniques are
Methods
Technically, what is done in this study, is adding mark-up metadata to different discussion. A rudimentary form of analysis suitable with a larger digital corpus where content metadata is added (Gilliland Swetland 2000). The metadata is constructed through a hermeneutical method in which the researcher analyses the subreddit.
Results
Answering question like: Example: DIY-tapering; different ways to limit drug use by using less. 1) how common are discussion of taperings in relation to other subjects? 2) Is tapering commonly discussed together with other subjects and techniques?
Conclusions
Using a method of categorization and metadata mark-up we could gain a good understanding of the problems among recovering benzodiazepine addicts. We will also have the possibility to identify concepts that addicts themselves discuss and relate these to professional concepts thus creating better possibilities of communication between professionals and clients.
The Majid Society, at the heart of this chapter, aspires to offer development. The development approach has not, however, replaced a religious culture of aid. Instead, the chapter explores how development can be expressed through the language of Islam and financed through Islamic charity. The chapter explores the organization’s training facility, the “productive families” approach, a program tackling illiteracy among mothers, and the use of microcredit schemes, all of which the Majid Society directed at female beneficiaries of aid.
The welfare association was established in 1998 at the initiative of Prince Majid bin ʿAbd al-ʿAziz (1938–2003). This raises the question of how far royal charity organizations can be considered part of Saudi civil society. With a focus on national development and capacity building, the Majid Society resonates strongly with the public discourse of poverty as initiated and moderated by the Saudi state. The chapter critically looks at state approaches to poverty and how the Saudi state has come to dictate the ways poverty is discussed in public. This raises the question of how far charity organizations act in support of the state, complementing state efforts rather than challenging the status quo.
The relation between neutrality and the use of force is better to be kept within the law of armed conflict rather that the law on the use of force between States. This means that the right of self-defence cannot be the indispensable legal basis for the use of force between belligerents and neutrals. On the contrary it appears that neutral due diligence has been relied on as a basis to expand the scope of the right of self-defence. The latter is admissible as the basis for resort to force only in the case of resistance of a neutral State to repel belligerent violation of its territory or by a belligerent that fully complies with its duties under the law of neutrality.
Cyberspace may constitute either the exclusive area of operations or a means of conduct of hostilities in an otherwise conventional armed conflict. The basic text concerning the rules applicable in cyber warfare is the Tallinn Manual 2.0, a 'soft law' text that is not generally followed by the few States that include cyber warfare in their military manuals. However, the relevance and applicability of the law of neutrality in cyber conflict is not disputed. The proposed legal framework is in principle premised on the Hague Conventions V and XIII, though the particularities of cyberspace as a domain have admitted substantive deviations with respect to inviolability of neutral territory and neutral due diligence.
Mutual help programs are popular resources for persons with alcohol use disorder (AUD) and clinical referral to such programs is common. This chapter describes what is currently known about four established mutual help programs in the United States: Alcoholics Anonymous (AA), SMART Recovery, Women for Sobriety (WFS), and LifeRing. Strong correlational research indicates that AA is associated with increased abstinence and that this association arises in part because of increased social support, abstinence self-efficacy, and spiritual practices. There is little support that reductions in anger, selfishness, and depression account for AA-related benefit. Preliminary evidence indicates that persons reporting lower religiosity and higher education are more likely to affiliate with non-AA mutual help programs and that these programs may be efficacious. A series of recommendations are made to advance our knowledge of these mutual help programs, with an emphasis on the need for future investigations of SMART, WFS, and LifeRing.
Are you a picky eater? Do you worry that food will make you vomit or choke? Do you find eating to be a chore? If yes, this book is for you! Your struggles could be caused by Avoidant Restrictive Food Intake Disorder (ARFID); a disorder characterized by eating a limited variety or volume of food. You may have been told that you eat like a child, but ARFID affects people right across the lifespan, and this book is the first specifically written to support adults. Join Drs. Jennifer Thomas, Kendra Becker, and Kamryn Eddy - three ARFID experts at Harvard Medical School - to learn how to beat your ARFID at home and unlock a healthier relationship with food. Real-life examples show that you are not alone, while practical tips, quizzes, worksheets, and structured activities, take you step-by-step through the latest evidence-based treatment techniques to support your recovery.
This chapter explains what avoidant/restrictive food intake disorder (ARFID) is and provides diverse and relatable case examples of each of the three prototypical ARFID presentations, including sensory sensitivity, fear of aversive consequences, and lack of interest in eating or food.
Access to cognitive behaviour therapy for those with psychosis (CBTp) remains poor. The most frequently endorsed barrier to implementation is a lack of resources. To improve access to CBTp, we developed a brief form of CBTp that specifically targets voice-related distress. The results of our pilot trial of guided self-help CBT for voices (GiVE) suggest that the therapy is both acceptable and beneficial. The present study aims to explore the subjective patient experience of accessing GiVE in the context of a trial. We interviewed nine trial participants using the Change Interview and a mixed methods approach. Most participants reported at least one positive change that they attributed to GiVE. We extracted five themes: (1) changes that I have noticed; (2) I am not alone; (3) positive therapy experiences; (4) I want more therapy; and (5) helping myself. The themes indicate that participating in the GiVE trial was generally a positive experience. The main areas in which participants experienced changes were improved self-esteem, and the ability to cope with voices. Positive changes were facilitated by embracing and enacting ‘self-help’ and having support both in and out of the therapy sessions. The findings support the use of self-help materials with those distressed by hearing voices, but that support both within and outside the clinical setting can aid engagement and outcomes. Overall, the findings support the continued investigation of GiVE.
Key learning aims
(1) To explore participants’ experience of accessing GiVE as part of a trial.
(2) To identify what (if any) changes participants noticed over the course of the GiVE trial.
(3) To identify what participants attribute these changes to.
Post-traumatic stress disorder (PTSD) carries a high disease burden worldwide, yet significant barriers exist to providing and accessing treatment for PTSD, particularly in refugee populations and in low- and middle-income countries. There is emerging evidence that self-administered psychological therapies, such as those accessed via online and mobile applications, are efficacious for many mental illnesses and increase access to treatment. Online and mobile applications offering self-help tools for eye movement desensitisation reprocessing (EMDR) therapy, an internationally recommended treatment for PTSD, are already widely distributed to the public.
Aims
To present a commentary evaluating the potential benefits and risks of self-administered EMDR therapy: first, by conducting a search for existing peer-reviewed evidence relating to self-administered EMDR therapy; second, by presenting existing evidence for other self-help psychotherapies and evaluating what additional insight this could provide into the potential efficacy, safety, tolerability and accessibility of self-administered EMDR therapy; and, third, by describing the conflicting views of EMDR experts on the topic.
Method
A search was conducted for articles related to internet, mobile, book or computerised self-help EMDR therapy. The following databases were searched systematically: Medline, PsycInfo, EMBASE, AMED, CINAHL, Psychology and Behavioural Sciences, Cochrane Database and the EMDR Library.
Results
Only one small primary research study was found relating to self-administered EMDR therapy. The results indicated significantly reduced symptoms of PTSD, depression, anxiety, distress and disability between pre-treatment and 3 month follow-up. No serious adverse events were reported. However, substantial methodological issues were discovered.
Conclusions
There is evidence that self-administered psychotherapies, in general, can be safe, effective and highly accessible. However, controversies persist regarding the safety and potential efficacy of self-administered EMDR therapy, and more robust research is needed. It is vital that methods are found to improve worldwide access to effective PTSD treatment, particularly given the current scale of migration to flee civil unrest.
Demands placed on informal caregivers can result in an increased likelihood of experiencing common mental health difficulties that may affect their ability to undertake the caring role. Currently, however, few evidence-based interventions have been specifically developed for informal caregivers and available interventions are difficult to access. The Improving Access to Psychological Therapies (IAPT) programme aims to improve access to evidence-based psychological therapies for all groups and may therefore present an opportunity to meet informal caregiver needs. Located within the MRC Complex Intervention Framework, a Phase II feasibility randomised controlled trial (RCT) examines key methodological, procedural and clinical uncertainties associated with running a definitive Phase III RCT of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors. Recruitment was low despite different recruitment strategies being adopted, highlighting significant challenges moving towards a Phase III RCT until resolved. Difficulties with study recruitment may reflect wider challenges engaging informal caregivers in psychological interventions and may have implications for IAPT services seeking to improve access for this group. Further attempts to develop a successful recruitment protocol to progress to a Phase III RCT examining effectiveness of the adapted CBT self-help intervention should be encouraged.
Key learning aims
After reading this article, readers should be able to:
(1) Consider key feasibility issues with regard to recruitment and attrition when running a randomised controlled trial of an adapted written cognitive behavioural therapy (CBT) self-help intervention for informal caregivers of stroke survivors.
(2) Understand potential barriers experienced by an informal caregiving population to accessing psychological interventions.
(3) Appreciate implications for clinical practice to enhance access to IAPT services and low-intensity CBT working with an informal caregiver population.
Though there are effective psychological and drug treatments for obsessive–compulsive disorder (OCD), many patients remain inadequately treated or untreated. Making effective self-treatment guidance available may increase the number of patients being helped. In this review, database and manual literature searches were performed of case studies, open and randomised controlled trials (RCTs) of bibliotherapy, self-help groups, telecare and computer-aided self-help for OCD. We found no RCTs of bibliotherapy or self-help groups for OCD. Three open studies showed the efficacy of brief exposure and ritual prevention (ERP) instructions delivered by a live therapist by phone. A vicarious ERP computer program was effective in a small open study. Fully interactive computer-aided self-help by ERP for OCD was efficacious in two open studies and a large multicentre RCT, and in a small RCT compliance and outcome with that program was enhanced by brief scheduled support from a clinician. Although more research is needed, self-help approaches have the potential to help many more patients who would otherwise remain inadequately treated or untreated. Their dissemination could save resources used by health care providers. We propose a stepped care model for the treatment of OCD.
Selon les recommandations actuelles, les traitements de choix des troubles alimentaires compulsifs type boulimie et hyperphagie boulimique reposent sur plusieurs aspects. Tout d’abord, une prise en charge hygiéno-diététique ayant pour objectif de restructurer les prises alimentaires, modifier les comportements alimentaires en dehors des crises, tester les croyances erronées vis-à-vis des aliments, aider à la gestion des vomissements… Elles sont le plus souvent associées à une prise en charge psychothérapique et/ou médicamenteuse. La psychothérapie de choix est la thérapie cognitivo-comportementale (TCC). Compte tenu de leurs cibles thérapeutiques les TCC sont plutôt à réserver à des patientes euthymiques, ayant de fortes préoccupations pour la minceur. L’alternative psychothérapique peuvent être les thérapies interpersonnelles et éventuellement les thérapies psychanalytiques dans certaines situations. Le traitement médicamenteux de première ligne est la fluoxetine à dose anti-compulsive (60 mg/j). D’autres prises en charge médicamenteuses sont proposées (epitomax, naltrexone…) mais doivent être réservées à des deuxièmes lignes après avis spécialisé. Quelle que soit la prise en charge retenue, il est fondamental dans le cadre de l’hyperphagie boulimique d’expliquer aux patients que ces prises en charge n’auront pas d’effets amaigrissants En complément de ces prises en charge, des techniques de self-help devraient être systématiquement associées. Ces techniques consistent en l’utilisation de différents outils (livres, des sites Internet, CD…) qui seront utilisé par le patient seul ou accompagné par le thérapeute dans le but d’augmenter ses connaissances par rapport sa problématique et lui apporter des compétences et des outils pour diminuer les symptômes voir les faire disparaître. Ces techniques simples et pouvant être facilement utilisées par tous ont été validées scientifiquement dans plus d’une trentaine d’études y compris en population française. Certains de ces supports de self-help, actuellement disponibles en France, seront présentés.