Self‐help and minimal‐contact therapies for anxiety disorders: Is human contact necessary for therapeutic efficacy?
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Self-help materials, brief therapies, and treatments involving minimal therapist contact have all been proposed as effective and low-cost interventions for anxiety disorders. However, research also suggests that the therapeutic alliance is a central predictor of therapy outcome. Interestingly, amounts of therapist contact within and across "self-help" interventions vary greatly. It is therefore unclear how much therapist contact is necessary for a positive anxiety disorder treatment outcome. The present article reviews the literature on anxiety disorder treatments using self-help, self-administered, and decreased therapist-contact interventions. Treatment studies are grouped together by anxiety diagnosis as well as amount of therapist contact. It is concluded that self-administered treatments are most effective for motivated clients seeking treatment for simple phobias. Predominantly self-help therapies are efficacious for panic disorder and mixed anxiety samples. On the other hand, minimal-contact therapies have demonstrated efficacy for the greatest variety of anxiety diagnoses.
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Bibliotherapy has been found to be efficacious by several systematic reviews or meta-analyses in the treatment of emotional, physical, and mental health problems among adults.
“Bibliotherapy has been found to be efficacious by several systematic reviews or meta-analyses in the treatment of emotional, physical, and mental health problems among adults.22,28–32”
Newman et al. reviewed bibliotherapy for anxiety disorders and concluded that bibliotherapy demonstrated efficacy for the greatest variety of anxiety diagnoses.
“Newman et al30 reviewed bibliotherapy for anxiety disorders and concluded that bibliotherapy demonstrated efficacy for the greatest variety of anxiety diagnoses.”
Minimal phone contact with a therapist is vital in encouraging higher rates of program completion.
“Researchers have suggested that minimal phone contact with a therapist is vital in encouraging higher rates of program completion.30”
In bibliotherapy studies of anxiety disorders in other populations, predictors of positive treatment outcome have included participants' motivation for treatment, compliance with program materials, and less complex/severe initial presentations.
“These experiences were consistent with the findings from bibliotherapy studies of anxiety disorders in other populations, where predictors of positive treatment outcome have included participants’ motivation for treatment, compliance with program materials, and less complex/severe initial presentations.27,30,44”
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- Authors
- Newman, M. G., Erickson, T., Przeworski, A., & Dzus, E.
- Affiliations
- Pennsylvania State University (US)
- Seattle Pacific University (US)
- Corresponding author
- Newman, Michelle G.
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2003-02-10
- Volume
- 59
- Issue
- 3
- Pages
- 251-274
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2169583035
- Cited by
- 206
- References
- 89
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 2 · 2019: 7 · 2018: 13 · 2017: 6 · 2016: 6 · 2015: 11 · 2014: 16 · 2013: 14 · 2012: 13
- FWCI
- 1.89
- Type
- journal article
- Language
- en
- Open access
- green
- papers.ssrn.com
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- SSRN Electronic Journal (submittedVersion)
- Funders
- National Institute of Mental Health (MH-58593, R01MH058593)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- anxiety disorders, self-help intervention, therapist contact, therapeutic relationship, self-administered therapy, panic disorder, specific phobia, treatment efficacy, brief psychotherapy
- MeSH terms
- Anxiety Disorders, Humans, Motivation, Patient Education as Topic, Professional-Patient Relations, Self Care, Self-Help Groups, Treatment Outcome
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