Smail Dawn, Elison Sarah, Dubrow-Marshall Linda, Thompson Catherine
Ostrich Community, Manchester, United Kingdom.
Breaking Free Group, Manchester, United Kingdom.
JMIR Ment Health. 2017 Apr 10;4(2):e12. doi: 10.2196/mental.6809.
There are increasing concerns about the health and well-being of individuals facing financial troubles. For instance, in the United Kingdom, the relationship between debt and mental health difficulties is becoming more evident due to the economic downturn and welfare reform. Access to debt counseling services is limited and individuals may be reluctant to access services due to stigma. In addition, most of these services may not be appropriately resourced to address the psychological impact of debt. This study describes outcomes from an Internet-based cognitive behavioral therapy (ICBT) program, Ostrich Community (OC), which was developed to provide support to those struggling with debt and associated psychological distress.
The aim of this feasibility study was to assess the suitability and acceptability of the OC program in a nonclinical sample and examine mental health and well-being outcomes from using the program.
A total of 15 participants (who were not suffering from severe financial difficulty) were assisted in working through the 8-week ICBT program. Participants rated usability and satisfaction with the program, and after completion 7 participants took part in a semistructured interview to provide further feedback. Before the first session and after the final session all participants completed questionnaires to measure well-being and levels of depression, stress, and anxiety and pre- and postscores were compared.
Satisfaction was high and themes emerging from the interviews indicate that the program has the potential to promote effective financial behaviors and improve financial and global psychosocial well-being. When postcompletion scores were compared with those taken before the program, significant improvements were identified on psychometric measures of well-being, stress, and anxiety.
The OC program is the first ICBT program that targets poor mental health associated with financial difficulty. This feasibility study indicates that OC may be an effective intervention for increasing financial resilience, supporting individuals to become financially independent, and promoting positive financial and global well-being. Further work with individuals suffering from debt and associated emotional difficulties will help to examine clinical effectiveness more closely.
人们越来越关注面临财务困境的个人的健康和幸福。例如，在英国，由于经济衰退和福利改革，债务与心理健康问题之间的关系日益明显。获得债务咨询服务的机会有限，而且由于污名化，个人可能不愿寻求此类服务。此外，这些服务中的大多数可能没有足够的资源来应对债务的心理影响。本研究描述了一个基于互联网的认知行为疗法（ICBT）项目——鸵鸟社区（OC）的成果，该项目旨在为那些与债务及相关心理困扰作斗争的人提供支持。
这项可行性研究的目的是评估OC项目在非临床样本中的适用性和可接受性，并检验使用该项目后的心理健康和幸福成果。
共有15名参与者（未遭受严重财务困难）在8周的ICBT项目中得到帮助。参与者对该项目的可用性和满意度进行了评分，项目结束后，7名参与者参加了半结构化访谈以提供进一步反馈。在第一节课之前和最后一节课之后，所有参与者都完成了问卷，以测量幸福感以及抑郁、压力和焦虑水平，并比较前后得分。
满意度很高，访谈中出现的主题表明该项目有潜力促进有效的财务行为，并改善财务状况和整体心理社会幸福感。将项目完成后的得分与项目开始前的得分进行比较时，发现幸福感、压力和焦虑的心理测量指标有显著改善。
OC项目是首个针对与财务困难相关的心理健康不佳问题的ICBT项目。这项可行性研究表明，OC可能是一种有效的干预措施，可增强财务复原力，支持个人实现财务独立，并促进积极的财务状况和整体幸福感。对患有债务及相关情绪问题的个人开展进一步研究，将有助于更深入地检验临床效果。
