Structured self-help programs, which allow participants to give themselves therapy, may work just as well as psychotherapy with a therapist, according to a study published in the journal Administration and Policy in Mental Health and Mental Health Services Research.
The study was a meta-analysis that analyzed data from previous studies of cognitive behavioral therapy (CBT). CBT is a semi-structured approach to therapy that encourages participants to recognize, understand, and correct automatic thoughts that lead to painful feelings and self-defeating habits. Because CBT focuses on addressing and correcting specific thought patterns, it is possible to distill its principles into a self-help program.
The study points to the value of self-help programs for those reluctant to share their experience with a therapist, those who can’t afford therapy, or those who can’t access a local therapist.
Is Do-it-Yourself CBT Just as Good as Therapy?
The analysis gathered data from 15 previous studies of 910 participants. Each study randomized participants to receive either self-help CBT or traditional CBT through a therapist. A total of 723 participants completed the treatment program. Participants used CBT for a variety of mental health issues, including depression, anxiety, and posttraumatic stress (PTSD).
Researchers found no differences in completion rate between self-help and therapist-delivered CBT. Treatment outcomes were also broadly similar. This suggests both self-help and therapist-based programs can offer symptom relief.
Could Self-Help Programs Replace Therapy?
The study’s authors say self-help programs could be a good first line of defense against mental health issues. They don’t advocate an end to therapy. The analysis only examined self-help CBT, so the findings don’t extend to other types of therapy. A therapist can be helpful for exploring different types of treatment options, and some people in therapy may not have the motivation to keep up with a self-help program on their own.
Outcomes varied in both groups. In the self-help group, there was greater variability. The study did not directly assess why this might be, but its authors suggest the therapist may play a key role in standardizing outcomes. The therapeutic relationship could be a valuable tool for counteracting negative emotions in therapy, and this might ensure more standardized outcomes in people seeking therapy from a therapist.
This supports past research that suggests the therapeutic relationship is a key to therapy’s success. However, the study did not find significant differences between therapists. This may mean the competence of an individual therapist is secondary to the therapist’s ability to follow a standardized treatment program and respond to negative emotions.
In terms of access to mental health treatment, the study shows self-help programs may be an effective interim treatment until an appointment with a therapist can be made.
References:
- Brown, M. (2017, August 23). Be your own therapist? Fine – if you’re up to the job. Retrieved from https://www.theguardian.com/commentisfree/2017/aug/23/therapist-self-help-therapy
- King, R. J., Orr, J. A., Poulsen, B., Giacomantonio, S. G., & Haden, C. (2017). Understanding the therapist contribution to psychotherapy outcome: A meta-analytic study. Administration and Policy in Mental Health and Mental Health Services Research.
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