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User Perspectives of Self-Help and Community Signposting: Borders Self-Help and Toolkit Service

Michael Henderson, Pamela Walker and April Quigley, Psychological Services, NHS Borders

Background

The Borders Self-Help Service was established at the beginning of 2005. The service offers guided self-help for people with mild to moderate psychological distress ( e.g. moderate anxiety, depression, simple grief reaction, relationship difficulties), as well as mild psychosocial problems. Typically, patients will be presenting to their GP with anxiety and or depression and often additional, more practical problems such as housing, employment, debt and so on.

Two part-time self-help coaches, based in local health centres, provide a brief intervention, with a maximum of three appointments. The coaches follow a solution-focused/problem-solving approach. An initial hour-long problem solving based assessment interview is followed by a personalised 'prescription' of self-help materials and signposting to local agencies from the toolkit (a directory of local organisations who liaise with the service). The service aims to inform and empower users to help themselves.

This research project was undertaken to examine how voluntary/statutory agencies are used by the project, promoting good involvement between them and the NHS, and to produce findings that would contribute to better quality self-help materials. A semi-structured interview for service users was developed to add greater depth to the information gathered by questionnaire.

This project adds an in-depth user perspective, and therefore complements the evaluation of clinical outcomes, which is an integral part of the service. Initial outcome data for the service shows significant reductions in psychopathology and high satisfaction ratings as measured by a simple questionnaire.

Methods

A standardised self-report questionnaire was designed to collect comments and opinions about the self-help materials and community signposting. This questionnaire was included in the evaluation pack, which all self-help users are asked to complete at the end of their appointments with the self-help coach. An abbreviated questionnaire was also included with every self-help booklet for the period of the study.

To capture users' experience of the whole service, and to examine in more detail their opinions on the written materials and the signposting, the research worker carried out semi-structured interviews. This format allowed the researcher to include standardised questions and also to capture any other themes concerning the Self-Help Service that became apparent during conversation.

Main findings

Self-help materials

• The overall feedback was positive. The booklet content was seen as helpful, informative and containing helpful, practical tips.
• The layout and look of the booklets were perceived to be clear and friendly.
• The response rate was too low to allow topic specific feedback that might inform further versions of the materials.

Community signposting

• Out of the 14 people interviewed, 10 had been suggested another organisation/service to contact. Four of those signposted had attended the suggested organisation. However, a further five felt that they had information that was a useful resource for future use.
• There was not sufficient information about any one organisation to allow satisfaction and agency use to be examined in greater detail.

Self-help service

• Whilst most users were initially unsure of what to expect of the service, the majority of users described their experience positively and felt they would use the service again.
• The majority of users felt that the Self-Help Service had been of benefit, both with their immediate concerns, and also as a source of advice and information that would be of longer-term benefit.
• The majority of users had managed sustained positive changes in behaviour and attitude.
• There were emerging themes of acquiring new resources and having started a process of recovery.
• The short waiting time for an appointment was seen as a positive.
• The Self-Help Service model was seen as positive, with users not feeling 'fobbed off'.
• There was a general feeling that some further follow up, or option of future contact, would be of benefit.

Further details from:

Michael Henderson
Consultant Clinical Psychologist

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