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Cognitive Behaviour Therapy Self-Help: Who Does it Help and What are its Drawbacks?

Published online by Cambridge University Press:  23 December 2008

Melanie MacLeod
Gartnavel Royal Hospital, Glasgow, UK
Rebeca Martinez
Gartnavel Royal Hospital, Glasgow, UK
Chris Williams*
Gartnavel Royal Hospital, Glasgow, UK
Reprint requests to Christopher Williams, Psychological Medicine, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK. E-mail:


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.

Research Article
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2008

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Bebbington, P. (2000). The need for psychiatric treatment in the general population. In Andrews, G. and Henderson, S. (Eds.), Unmet Need in Psychiatry. Cambridge: Cambridge University Press.Google Scholar
Department of Health (2005). Improving Access to Psychological Therapies Programme. London: DoH.Google Scholar
Gellatly, J., Bower, P., Hennessy, S., Richards, D., Gilbody, S. and Lovell, K. (2007). What makes self-help interventions effective in the management of depressive symptoms? Meta analysis and meta regression. Psychological Medicine. doi:10.1017/S0033291707000062CrossRefGoogle Scholar
Holdsworth, N., Paxton, R., Seidel, S., Thomson, D. and Shrub, S. (1996). Parallel evaluations of new guidance materials for anxiety and depression in primary care. Journal of Mental Health, 5, 195207.Google Scholar
Kaltenthaler, E., Sutcliffe, P., Parry, G., Beverley, C., Rees, A. and Ferriter, M. (2008). The acceptability to patients of computerised cognitive behaviour therapy for depression: a systematic review. Psychological Medicine. doi:10.1017/S0033291707002607CrossRefGoogle ScholarPubMed
Keeley, H., Williams, C.J. and Shapiro, D. (2002). A United Kingdom survey of accredited cognitive behaviour therapists' attitudes towards and use of structured self-help materials. Behavioural and Cognitive Psychotherapy, 30, 193203.CrossRefGoogle Scholar
Lewis, G., Anderson, L., Araya, R., Elgie, R., Harison, G., Proudfoot, J., Schmidt, U., Sharp, D., Weightman, A. and Williams, C. (2003). Self-Help Interventions for Mental Health Problems; report to the Department of Health RandD Programme. London: DoH.Google Scholar
Mahalik, J. R. and Kivlighan, D. Jr. (1988). Self-help treatment for depression: who succeeds? Journal of Counselling Psychology, 35, 237342.CrossRefGoogle Scholar
National Statistics (2000). Scholar
National Institute for Clinical Excellence (NICE) (2004a). Anxiety: management of anxiety (panic disorder, with or without agoraphobia, and generalised anxiety disorder) in adults in primary, secondary and community care: NICE Guideline CG22. London: National Institute for Clinical Excellence ( Scholar
National Institute for Clinical Excellence (NICE) (2004b). Depression: management of depression in primary and secondary care: NICE Guideline CG23. London: National Institute for Clinical Excellence ( Scholar
National Institute for Clinical Excellence (NICE) (2006). Computerised Cognitive Behaviour Therapy for Depression and Anxiety: Technology Appraisal, 97.Google Scholar
Whitfield, G. and Williams, C. (2004). If the evidence is so good, why doesn't anyone use them? A national survey of the use of Computerized Cognitive Behaviour Therapy. Behavioural and Cognitive Psychotherapy, 32, 5765.CrossRefGoogle Scholar
Williams, C. and Whitfield, G. (2001). Written and computer-based self-help treatments for depression. British Medical Bulletin, 57, 133–44.Google Scholar
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