Cited by 220Digital Mental Health InterventionsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and Access

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Why is self-help neglected in the treatment of emotional disorders? A meta-analysis

DEN BOER, P. C. A. M., WIERSMA, D., VAN DEN BOSCH, R. J.·2004·Psychological Medicine

DOI 10.1017/s003329170300179x

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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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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
DOI: 10.1017/s003329170300179x
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
Licence: www.cambridge.org/core/terms (unspecified, 12 d)
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
Health Sciences › Medicine › Psychiatry and Mental health › 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

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Why is self-help neglected in the treatment of emotional disorders? A meta-analysis

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