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Can People Read Self-Help Manuals for Depression? A Challenge for the Stepped Care Model and Book Prescription Schemes

Published online by Cambridge University Press:  18 December 2007

Rebeca Martinez
University of Glasgow, UK
Graeme Whitfield
Consultant Psychiatrist in Psychotherapy, Leicester, UK
Rebecca Dafters
Clinical Psychologist, Ayr, UK
Christopher Williams*
University of Glasgow, UK
Reprint requests to Christopher Williams, Senior Lecturer, Department of Psychological Medicine, University of Glasgow, The Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK. E-mail:


Self help approaches are increasingly being used in healthcare settings through over 100 book prescription schemes in the UK. The use of Cognitive Behavioural Therapy (CBT) self-help materials for depression is advocated as part of stepped care service models. This study assesses how the reading ages of the most recommended self-help books for depression compare to British literacy levels. A cross sectional survey was carried out. The most recommended self-help books for depression were identified; seven CBT based self-help books were included in this study as well as a widely used booklet for depression. Readability scores and reading ages were calculated for a randomly generated selection representing 15% of each selected book using the Readability Studio® software to generate a wide range of key readability and comprehension scores. The reading ages of the selected books were between 12.6 and 15.4. Reading ease varied amongst the texts, and their complexity (percentage of unfamiliar words, range: 14.8% – 22.6%). A significant proportion of the UK population would struggle to use some of the current CBT-based self-help books recommended. For some patient groups, non text based self-help materials as well as shorter and more easily read written materials may be more appropriate. To our knowledge, this is the first study to address this question. Publication of the reading ages of the recommended books within the book prescription schemes may allow for a more accurate match between the book and the reader.

Research Article
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2007

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