Predictors of outcome in guided self-help cognitive behavioural therapy for common mental disorders in primary care
Open accessAbstract
Cognitive behavioural therapy (CBT) can effectively treat common mental disorders (CMDs), but access to treatment is insufficient. Guided self-help (GSH) CBT has shown effects comparable to face-to-face CBT and may be a resource-efficient treatment alternative. However, not all patients respond to GSH. Learning more about predictors of outcome may increase knowledge regarding which patients respond to GSH. The aim of this study was to investigate predictors of outcome for GSH CBT for patients with CMDs in primary care. Consecutive patients (N = 396) with a principal disorder of depression, anxiety, insomnia or stress-related disorders were included. All patients received GSH CBT. Outcomes were remission status, reliable change and post-treatment depression ratings. Predictors investigated were clinical, demographic and therapy-related variables. Analyses were conducted using logistic and linear regression. Higher educational level predicted remission, higher quality of life ratings predicted remission and decreased depression, and higher age at onset predicted reliable change. Therapy-related variables, i.e. patient adherence to treatment and patients' and clinicians' estimation of treatment response, were all related to outcome. More large-scale studies are needed, but the present study points at the importance of therapy-related variables such as monitoring and supporting treatment adherence for an increased chance of remission.
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CBT evidence-based, guided self-help treatments have ranged in length from 2 to 12 weeks, and the National Institutes for Clinical Excellence describes guided self-help as including 6 to 8 face-to-face sessions.
“CBT evidence-based, guided self-help treatments have ranged in length from 2 to 12 weeks [31-34], and the National Institutes for Clinical Excellence describes guided self-help as including 6 to 8 face-to-face sessions [35].”
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Chapdelaine, A., Vasiliadis, H., Provencher, M. D., Norton, P. J., & Roberge, P. (2023) · Figshare · doi:10.6084/m9.figshare.23435035
Haubrock, L. S., Azevedo, V., Hillert, J., Briken, P., Letourneau, E. J., Rahm, C., Seto, M. C., Fix, R. L., Gomes, H. S., Joleby, M., et al. (2026) · Criminal Justice and Behavior · doi:10.1177/00938548251407643
Prediction Models for Treatment Response in Stress-Related Disorders (Preprint)Preprint
Föyen, L. F., Sennerstam, V., Kontio, E., Flygare, O., Boman, M., & Lindsäter, E. (2026) · doi:10.2196/preprints.109431
Self-citationThiblin, E., Woodford, J., Berman, A. H., Farrand, P., Leissner, P., Saarijärvi, M., von Essén, L., & Richards, D. A. (2026) · BMJ Open · doi:10.1136/bmjopen-2026-116503
- Authors
- Salomonsson, S., Santoft, F., Lindsäter, E., Ejeby, K., Ingvar, M., Öst, L.-G., Lekander, M., Ljótsson, B., & Hedman-Lagerlöf, E.
- Affiliations
- Karolinska Institutet (SE)
- Karolinska University Hospital (SE)
- Stockholm University (SE)
- Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden
- Corresponding author
- Salomonsson, Sigrid
- ORCID
- Venue
- Cognitive Behaviour Therapy
- Publisher
- Informa UK Limited
- Published
- 2019-10-22
- Volume
- 49
- Issue
- 6
- Pages
- 455-474
- ISSN
- 1650-6073 (ISSN-L)
- 1651-2316
- OpenAlex
- W2981607304
- Cited by
- 20
- References
- 72
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 6 · 2022: 4 · 2021: 2 · 2020: 2
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Cognitive Behaviour Therapy (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- Karolinska Institutet
- Stockholms Läns Landsting
- 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 › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- guided self-help, cognitive behavioral therapy, common mental disorders, predictors of treatment outcome, depression, anxiety, insomnia, stress-related disorders, remission, reliable change, medication adherence, quality of life, age of onset, primary care
- MeSH terms
- Phobia, Social, Burnout, Psychological, Adjustment Disorders, Adult, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Primary Health Care, Prognosis, Quality of Life, Self Care, Cognitive Behavioral Therapy, Panic Disorder, Treatment Outcome
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