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CBT Guided Self-Help Compares Favourably to Gold Standard Therapist-Administered CBT and Shows Unique Benefits Over Traditional Treatment

Published online by Cambridge University Press:  28 November 2013

Margaret Priemer  and
France Talbot
Margaret Priemer
Affiliation:
School of Psychology, Université de Moncton, Moncton, New Brunswick, Canada
France Talbot*
Affiliation:
School of Psychology, Université de Moncton, Moncton, New Brunswick, Canada
*
Address for correspondence: France Talbot, Taillon Building, 18 Antonine-Maillet Avenue, Moncton, NB, CanadaE1A 3E9. E-mail: france.talbot@umoncton.ca
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Abstract

CBT guided self-help (CBTgsh) can produce treatment outcomes comparable to therapist-administered CBT (CBTta) for the treatment of anxiety and depression. The efficacy of CBTgsh compared to gold standard CBTta, however, remains to be examined. The current article addresses this issue, as well as how CBTgsh may have unique benefits over CBTta. It further highlights ways in which CBTgsh may be used for disorders of increasing severity, using eating disorders and personality pathology for illustrative purposes. A literature review of PsycINFO, PsyARTICLES, and PubMED was conducted to identify relevant studies published since 1990. Studies directly comparing CBTgsh to gold standard CBTta for anxiety and depression, as well as bulimia nervosa, revealed no significant differences between the two interventions. Furthermore, CBTgsh may have unique benefits by encouraging continued improvement over time. Innovative eating disorder studies also show that CBTgsh can be used for more severe disorders as a supplementary treatment, and produces treatment outcomes superior to CBTta or treatment as usual alone. Based on these findings, CBTgsh applications to personality pathology are suggested. Traditional stepped care models, as they pertain to CBTgsh, may gain to be broadened both in their focus and methods of delivery.

Keywords

CBTguided self-helpanxietydepressioneating disorderspersonality
Type
Standard Papers
Information
Behaviour Change , Volume 30 , Issue 4 , December 2013 , pp. 227 - 240
Copyright
Copyright © The Author(s), published by Cambridge University Press on behalf of Australian Academic Press Pty Ltd 2013 

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References

Agras, W.S., Crow, S.J., Halmi, K.A., Mitchell, J.E., Wilson, G.T., & Kraemer, H.C. (2000). Outcome predictors for the cognitive behavior treatment of bulimia nervosa: Data from a multisite study. American Journal of Psychiatry, 157, 1302–1308.Google Scholar
Andrews, G., Cuijpers, P., Craske, M.G., McEvoy, P., & Titov, N. (2010). Computer therapy for the anxiety and depressive disorders is effective, acceptable and practical health care: A meta-analysis. PLoS ONE, 5, e13196.Google Scholar
Antony, M.M. & Swinson, R. (1998). When perfect isn't good enough: Strategies for coping with perfectionism. Oakland: New Harbinger Press.Google Scholar
APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61, 271–285.Google Scholar
Bailer, U., de Zwaan, M., Leisch, F., Strnad, A., Lennkh-Wolfsberg, C., El-Giamal, N., & Kasper, S. (2004). Guided self-help versus cognitive-behavioral group therapy in the treatment of bulimia nervosa. International Journal of Eating Disorders, 35, 522–537.Google Scholar
Barlow, D.H., & Craske, M.G. (2000). Mastery of your panic and anxiety: MAP-3. New York: Graywind Publications.Google Scholar
Beck, A.T., Freeman, A., & Davis, D. (2004). Cognitive therapy of personality disorders (2nd ed.). New York: Guilford Press.Google Scholar
Beck, A.T., Rush, J., Shaw, B., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.Google Scholar
Berger, T., Caspar, F., Richardson, R., Kneubühler, B., Sutter, D., & Andersson, G. (2011). Internet-based treatment of social phobia: A randomized controlled trial comparing unguided with two types of guided self-help. Behaviour Research and Therapy, 45, 337–340.Google Scholar
Berger, T., Hohl, E., & Caspar, F. (2009). Internet-based treatment for social phobia: A randomized controlled trial. Journal of Clinical Psychology, 65, 1021–1035.Google Scholar
Burns, D. (1980). Feeling good. New York: New American Library.Google Scholar
Campbell, L.F., & Smith, T.P. (2003). Integrating self-help books into psychotherapy. Journal of Clinical Psychology, 59, 177–186.Google Scholar
Coull, G., & Morris, P.G. (2011). The clinical effectiveness of CBT-based guided self-help interventions for anxiety and depressive disorders: A systematic review. Psychological Medicine, 41, 2239–2252.Google Scholar
Crits-Christoph, P., & Barber, J.P. (2007). Psychological treatments for personality disorders. In Nathan, P.E., & Gorman, J.M., (Eds.), A guide to treatments that works (pp. 641–658). New York: Oxford University Press.Google Scholar
Cuijpers, P., Donker, T., van Straten, A., Li, J., & Andersson, G. (2010). Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders?: A systematic review and meta-analysis of comparative outcome studies. Psychological Medicine, 40, 1943–1957.Google Scholar
Cuijpers, P., & Schuurmans, J. (2007). Self-help interventions for anxiety disorders: An overview. Current Psychiatry Reports 9, 284–290.Google Scholar
Fairburn, C.G., Marcus, M.D., & Wilson, G.T. (1993). Cognitive-behavioral therapy for binge eating and bulimia nervosa: A comprehensive treatment manual. In Fairburn, C.G., & Wilson, G.T., (Eds.), Binge eating: Nature, assessment, and treatment (pp. 361–404). New York: Guilford Press.Google Scholar
Fichter, M., Cebulla, M., Quadflieg, N., & Naab, S. (2008). Guided self-help for binge eating/purging anorexia nervosa before inpatient treatment. Psychotherapy Research, 18, 594–603.Google Scholar
Floyd, M., Scogin, F., McKendree-Smith, N.L., Floyd, D.L., & Rokke, P.D. (2004). Cognitive therapy for depression: A comparison of individual psychotherapy and bibliotherapy for depressed older adults. Behavior Modification, 28, 297–318.Google Scholar
Foroushani, P.S., Schneider, J., & Assareh, N. (2011). Meta-review of the effectiveness of computerised CBT in treating depression. BMC Psychiatry, 11, 131.Google Scholar
Gunderson, J.G., Shea, M.T., Skodol, A.E., McGlashan, T.H., Morey, L.C., . . . Keller, M.B. (2000). The Collaborative longitudinal personality disorders study: Development, aims, design, and sample characteristics. Journal of Personality Disorders, 14, 300–315.Google Scholar
Harwood, T.M., & L'Abate, M. (2010). Self-help in mental health: A critical review. New York: Springer.Google Scholar
Hirai, M., & Clum, G.A. (2006). A meta-analytic study of self-help interventions for anxiety problems. Behavior Therapy, 37, 99–111.CrossRefGoogle ScholarPubMed
Keown, P., Holloway, F., & Kuipers, E. (2002). The prevalence of personality disorders, psychotic disorders and affective disorders amongst patients seen by a community mental health team in London. Social Psychiatry and Psychiatric Epidemiology, 37, 225–229.Google Scholar
Kiropoulos, L., Klein, B, Austin, D.W., Gilson, K., Pier, C., Mitchell, J., & Ciechomski, L. (2008). Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? Journal of Anxiety Disorders, 22, 1273–1284.Google Scholar
Klein, B., Richards, J.C., & Austin, D.W. (2006). Efficacy of internet therapy for panic disorder. Journal of Behavior Therapy and Experimental Psychiatry, 37, 213–238.Google Scholar
Lewis, C., Pearce, J., & Bisson, J.I. (2012). Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: Systematic review. The British Journal of Psychiatry, 200, 15–21.Google Scholar
Linehan, M.M. (1993). Skills training manual for treating borderline personality disorder. New York: Guilford Press.Google Scholar
Linehan, M.M., Comtois, K.A., Murray, A.M., Brown, M.Z., Gallop, R.J., Heard, , & Lindenboim, N. (2006). Two-year randomized trial and follow-up of dialectical behaviour therapy vs. therapy by experts for suicidal behaviours and borderline personality disorder. Archives of General Psychiatry, 63, 757–766.Google Scholar
McGlashan, T.H., Grilo, C.M., Sanislo, C.A., Ralevski, E., Morey, L.C., Gunderson, J.G., Pagano, M. (2005). Two-year prevalence and stability of individual DSM-IV criteria for schizotypal, borderline, avoidant, and obsessive-compulsive personality disorders: Toward a hybrid model of Axis II disorders. American Journal of Psychiatry, 162, 883–889.Google Scholar
Menchola, M., Arkowitz, H.S., & Burke, B.L. (2007). Efficacy of self-administered treatments for depression and anxiety. Professional Psychology: Research and Practice, 38, 421–429.Google Scholar
Mitchell, J.E., Agras, S., Crow, S., Halmi, K., Fairburn, C.G., Bryson, S., & Kraemer, H. (2011). Stepped care and cognitive behavioral therapy for bulimia nervosa: A randomised trial. The British Journal of Psychiatry, 198, 391–397.Google Scholar
National Institute for Health and Clinical Excellence (NICE) (2004). Eating disorders: Core interventions in the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders (Clinical Guideline No. 9). London: Author. Retrieved from http://www.nice.org.uk/nicemedia/live/10932/29218/29218.pdfGoogle Scholar
National Institute for Health and Clinical Excellence (NICE). (2011). Common mental health disorders: Identification and pathways to care (Clinical Guideline No. 123). London: Author. Retrieved from http://www.nice.org.uk/nicemedia/live/13476/54604/54604.pdfGoogle Scholar
Neacsiu, A.D., Risvi, S.L., & Linehan, M. M. (2010). Dilalectic behavior therapy skills use as a mediator and outcome of treatment for borderline personality disorder. Behaviour Research and Therapy, 48, 832–839.Google Scholar
Newman, M.G., Szkodny, L.E., Llera, S.J., & Przeworski, A. (2011). A review of technology-assisted self-help and minimal contact therapies for anxiety and depression: Is human contact necessary for therapeutic efficacy? Clinical Psychology Review, 31, 89–103.CrossRefGoogle Scholar
Perkins, S.S.J., Williams, R.R.M., Schmidt, U.U.S., & Williams, C. (2009). Self help and guided self help for eating disorders. Cochrane Database of Systematic Reviews, Issue 3. Art. No.: CD004191. doi:10.1002/14651858.CD004191Google Scholar
Pleva, J., & Wade, T.D. (2006). Guided self-help versus pure self-help for perfectionism: A randomised controlled trial. Behaviour Research and Therapy, 45, 849–861.Google Scholar
Rapee, R.M. (1998). Overcoming shyness and social phobia: A step-by-step guide. Lanham, MD: Jason Aronson.Google Scholar
Rapee, R.M., Abbott, M.J., Baillie, A.J., & Gaston, J.E. (2007). Treatment of social phobia through pure self-help and therapist-augmented self-help. British Journal of Psychiatry, 191, 246–242.Google Scholar
Rapee, R.M., & Sanderson, W.C. (1998). Social phobia: Clinical applications of evidence-based psychotherapy. Lanham, MD: Jason Aronson.Google Scholar
Schmidt, U.H., & Treasure, J.L. (1993). Getting better bit(e) by bit(e). London: Erlbaum.Google Scholar
Scogin, F., Bynum, J., Stephens, G., & Calhoon, S. (1990). Efficacy of self-administered treatment programs: Meta-analytic review. Professional Psychology: Research and Practice, 21, 42–47.Google Scholar
Shear, K., Brown, T.A., Barlow, D.H., Money, R., Sholomskas, D.E., Woods, S.W., . . . Papp, L.A. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry, 154, 1571–1575.Google Scholar
Skodol, A.E., Clark, L.A., Bender, D.S., Krueger, R.F., Morey, L.C., Verheul, R., Oldham, J.M., (2011). Proposed changes in personality and personality disorder assessment and diagnosis for DSM-5-Part 1: Description and rationale. Personality Disorders: Theory, Research and Treatment, 2, 4–22.Google Scholar
Talbot, F. (2012). Client contact in self-help therapy for anxiety and depression: Necessary but can take a variety of forms beside therapist contact. Behaviour Change, 29, 63–76.Google Scholar
Thiels, C., Schmidt, U., Treasure, J., & Garthe, R. (2003). Four-year follow-up of guided self-change for bulimia nervosa. Eating and Weight Disorders, 8, 212–217.CrossRefGoogle ScholarPubMed
Thiels, C., Schmidt, U., Treasure, J., Garthe, R., & Troop, N. (1998). Guided self-change for bulimia nervosa incorporating use of a self-care manual. American Journal of Psychiatry, 155, 947–953.Google Scholar
van't Hof, E., Cuijpers, P., & Stein, D.J. (2009). Self-help interventions in depression and anxiety disorders: A systematic review of meta-analyses. CNS Sprectrums, 14, 34–40.Google Scholar
Wilson, G.T., & Zandberg, L.J. (2012). Cognitive behavioral guided self-help for eating disorders: Effectiveness and scalability. Clinical Psychology Review, 32, 343–357.Google Scholar
Wood, J. C. (2010). The cognitive behavioral workbook for personality disorders: A step-by-step program. Oakland, CA: New Harbinger Publications.Google Scholar
Woody, S.R., & Sanderson, W.C. (1998). Manuals for empirically supported treatments: 1998 update. The Clinical Psychologist, 51, 17–21.Google Scholar
Young, J.E., & Klosko, J.S. (1993). Reinventing your life: The breakthrough program to end negative behaviour . . . and feel great again. New York: Plume.Google Scholar
Zanarini, M.C., Frankenburg, F.R., Hennen, J., Reich, D.B., & Silk, K.R. (2005). The McLean Study of Adult Development (MSAD): Overview and implications of the first six years of prospective follow-up. Journal of Personality Disorders, 19, 505–523.CrossRefGoogle ScholarPubMed