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particular relationship in question provide explanations for a lack of emotional fortitude in providing help If one s past partners (or current partner) have not been open to accepting help in the past, then the person is likely to be reluctant to offer care A lack of fortitude may also stem from temporary factors When temporarily stressed or in a bad mood, people may not feel that they have the energy to help because they may be especially likely to anticipate that negative outcomes will be associated with helping (Clark & Waddell, 1983) Alerting Partners to Your Needs Next consider skills and fortitudes necessary for eliciting needed support for the self from one s partner In this regard, freely expressing one s own need states to the partner through self-disclosure and emotional expression should be important After all, a partner cannot respond to needs without knowing what they are.

principles This is likely to have considerable advantages for health psychology if the evidence-based practice movement in health care challenges long-standing beliefs in the medical community about the relative value of behavioral versus traditional medical approaches An emphasis on evidence-based practice applied equally to behavioral and medical interventions could in uence policies regarding reimbursement and other aspects of health care resource allocation The criteria for the status of empirically supported therapies distinguish between evidence of ef cacy and effectiveness (Kendall et al, 1999) Paralleling the distinction between internal and external validity, ef cacy refers to evidence of signi cant effects in carefully controlled trials using highly selected patients or participants and speci cally trained therapists or providers In contrast, effectiveness refers to evidence of signi cant treatment effects in the context of actual clinical or applied settings, with unselected recipients and actual health care providers.

Given this, it is not surprising to us that self-disclosure has been found to increase positive affect (Vittengl & Holt, 2000), liking (Collins & Miller, 1994), and satisfaction in dating relationships (Fitzpatrick & Sollie, 1999), marriages (Meeks, Hendrick, & Hendrick, 1998), and sibling relationships (Howe, Aquan-Assee, Bukowski, Rinaldi, & Lenoux, 2000) Of course, one ought also to be able to ask outright for help and accept it when it is offered Perhaps less obviously, possessing the ability to say no to requests from the partner that interfere with one s needs ought to be crucial to the partner s being attentive and responsive to one s needs It should also be important that, over time, one demonstrates that one does not exaggerate needs or constantly seek help when it is not needed (Mills & Clark, 1986).

Structured interview schedules ensure that clinicians in the same or in different settings conduct clinical interviews using standardized questions that maximize the.

The evaluation of ef cacy in health psychology intervention research is quite similar to the context of mental health intervention research (eg, description of sample, random assignment, evaluation of reliability of treatment implementation, etc), with the exception that it involves a very broad array of intervention targets, types of intervention-delivering personnel, and contexts for delivery Table 102 illustrates this range by describing interventions as falling along two dimensions (a) the levels of analysis as described in the biopsychosocial model, as described by Engel (1977) and illustrated in Figure 101; and (b) the particular stage of the health versus disease, from the prevention of risk, to the reduction of risk, and to the management of the impact of established disease Hence, the nature of carefully controlled trials that produce evidence of ef cacy will vary enormously, as will the real-world studies of effectiveness.