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

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.