The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: a systematic review

Research output: Contribution to journalArticlepeer-review

Abstract

Background Cognitive-behavioural therapy (CBT)-based guided self-help (GSH) has been suggested to be an effective intervention for mild to moderate anxiety and depression, yet the evidence seems inconclusive, with some studies reporting that GSH is effective and others finding that GSH is ineffective. GSH differs in important respects from other levels of self-help, yet the literature regarding exclusively guided self-help interventions for anxiety and depression has not been reviewed systematically.
Method A literature search for randomized controlled trials (RCTs) examining CBT-based GSH interventions for anxiety and depressive disorders was conducted. Multiple electronic databases were searched; several journals spanning key disciplines were hand-searched; reference lists of included review articles were scanned and relevant first authors were contacted.
Results Thirteen studies met the inclusion criteria. Meta-analysis indicated the effectiveness of GSH at post-treatment, although GSH was found to have limited effectiveness at follow-up or among more clinically representative samples. Studies that reported greater effectiveness of GSH tended to be of lower methodological quality and generally involved participants who were self-selected rather than recruited through clinical referrals.
Conclusions Although there is support for the effectiveness of CBT-based GSH among media-recruited individuals, the finding that the reviewed RCTs had limited effectiveness within routine clinical practice demonstrates that the evidence is not conclusive. Further rigorous evidence based on clinical populations that examines longer-term outcomes is required before CBT-based GSH interventions can be deemed effective for adults accessing primary care services for treatment of anxiety and depression.
Original languageEnglish
Pages (from-to)2239-2252
Number of pages14
JournalPsychological Medicine
Volume41
Issue number11
DOIs
Publication statusPublished - 1 Nov 2011

Keywords

  • Adult
  • Anxiety Disorders
  • Cognitive Therapy
  • Depressive Disorder
  • Humans
  • Self Care
  • Treatment Outcome
  • CBT
  • clinical practice
  • effectiveness
  • review
  • self-help

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