Why is self-help neglected in the treatment of emotional disorders? A meta-analysis
Abstract
BACKGROUND: Although the burden of emotional disorders is very high, mental health care is only available to a minority of patients. The literature suggests that self-help strategies, both bibliotherapy and self-help groups alike, are effective for various, less serious complaints but it is unclear whether available data support a role for self-help in treatment protocols for patients with clinically significant emotional disorders. METHOD: We searched the literature with a focus on 'anxiety' and/or 'depressive disorder'. Standardized assessment of diagnosis or symptoms and randomized controlled trials were inclusion criteria for a meta-analysis. RESULTS: The mean effect size of self-help (mainly bibliotherapy) v. control conditions is 0.84, and 0.76 for follow-up; the effect sizes of self-help v. treatment are -0.03 and -0.07 respectively. A longer treatment period is more effective. CONCLUSIONS: Bibliotherapy for clinically significant emotional disorders is more effective than waiting list or no treatment conditions. The dearth of studies on self-help groups for emotional disorders does not permit an evidence-based conclusion concerning the effects of self-help groups. No difference was found between bibliotherapy and psychiatric treatment of relatively short duration.
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Evidence for bibliotherapy is promising.
“Evidence for bibliotherapy is also promising 6 .”
From Self‐Help Plus ( <scp>SH</scp> +): a new <scp>WHO</scp> stress management package (2016) · cites this paper as [6]
Print materials can be effective in improving behaviors and outcomes related to walking and other physical activities, alcohol problems, and emotional disorders.
“Indeed, studies have found print materials to be effective in improving behaviors and outcomes related to walking and other physical activities [16,17], alcohol problems [18], and emotional disorders [19].”
The effectiveness of print materials for changing health behaviors and outcomes is supported in the literature.
“As noted earlier, the effectiveness of print materials for changing health behaviors and outcomes is supported in the literature [16-19].”
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- Authors
- DEN BOER, P. C. A. M., WIERSMA, D., & VAN DEN BOSCH, R. J.
- Affiliations
- University Medical Center Groningen (NL)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2004-08
- Volume
- 34
- Issue
- 6
- Pages
- 959-971
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2149709319
- Cited by
- 220
- References
- 14
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 1 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 5 · 2019: 9 · 2018: 8 · 2017: 12 · 2016: 9 · 2015: 9 · 2014: 9 · 2013: 12 · 2012: 12
- FWCI
- 21.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- self-help, bibliotherapy, self-help groups, anxiety disorders, depressive disorders, emotional disorders, treatment effectiveness, waiting list comparison, psychiatric treatment, treatment duration
- MeSH terms
- Anxiety Disorders, Bibliotherapy, Depressive Disorder, Humans, Self-Help Groups, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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