Cognitive Behaviour Therapy self-help: who does it help and what are its drawbacks?

Behav Cogn Psychother. 2009 Jan;37(1):61-72. doi: 10.1017/S1352465808005031.

Abstract

Background: Cognitive Behaviour Therapy self-help has been recommended in the NICE guidelines for the treatment of anxiety and depression. However, little is known about who benefits from self-help and the potential drawbacks and problems of using this approach.

Aims: To address the current gap in knowledge, we contacted accredited BABCP practitioners to examine practitioner use and attitudes to self-help, current trends of use, and to identify possible problems with this therapy.

Method: A 50% random sample of all accredited BABCP practitioners was approached, and the overall response rate for the survey was 57.6%.

Results: Self-help materials were seen positively by therapists and were used by 99.6%, mainly as an adjunct to individual therapy. Only 38.2% had been trained in the use of self-help, with those trained being more likely to recommend self-help. Higher levels of patient motivation, credibility, likely adherence, self-efficacy and a lower degree of hopelessness were the five factors identified by more than 70% of respondents as predicting successful patient outcome with self-help. Non-compliance and a lack of detection of a worsening of the patient's clinical state due to reduced therapist contact were viewed as being the most important problems with self-help by more than 70% of respondents.

Conclusions: Preferable patient characteristics for self-help have been identified, as have potential problems and adverse consequences.

MeSH terms

  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Anxiety Disorders / therapy*
  • Attitude of Health Personnel
  • Cognitive Behavioral Therapy / methods*
  • Cognitive Behavioral Therapy / standards*
  • Depressive Disorder / diagnosis
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • Humans
  • Motivation
  • Patient Compliance / statistics & numerical data
  • Patients*
  • Self Efficacy
  • Self-Help Groups*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome