Though there are effective psychological and drug treatments for obsessive–compulsive disorder (OCD), many patients remain inadequately treated or untreated. Making effective self-treatment guidance available may increase the number of patients being helped. In this review, database and manual literature searches were performed of case studies, open and randomised controlled trials (RCTs) of bibliotherapy, self-help groups, telecare and computer-aided self-help for OCD. We found no RCTs of bibliotherapy or self-help groups for OCD. Three open studies showed the efficacy of brief exposure and ritual prevention (ERP) instructions delivered by a live therapist by phone. A vicarious ERP computer program was effective in a small open study. Fully interactive computer-aided self-help by ERP for OCD was efficacious in two open studies and a large multicentre RCT, and in a small RCT compliance and outcome with that program was enhanced by brief scheduled support from a clinician. Although more research is needed, self-help approaches have the potential to help many more patients who would otherwise remain inadequately treated or untreated. Their dissemination could save resources used by health care providers. We propose a stepped care model for the treatment of OCD.

Background: Depression is an extremely common mental health disorder, with prevalence rates rising. Low-intensity interventions are frequently used to help meet the demand for treatment. Bibliotherapy, for example, is often prescribed via books on prescription schemes (for example ‘Reading Well’ in England) to those with mild to moderate symptomology. Bibliotherapy can effectively reduce symptoms of depression (Naylor et al., 2010). However, the majority of self-help books are based on cognitive behavioural therapy (CBT), which may not be suitable for all patients. Research supports the use of positive psychology interventions for the reduction of depression symptoms (Bolier et al., 2013) and as such self-help books from this perspective should be empirically tested. Aims: This study aimed to test the efficacy of ‘Positive Psychology for Overcoming Depression’ (Akhtar, 2012), a self-help book for depression that is based on the principles of positive psychology, in comparison with a CBT self-help book that is currently prescribed in England as part of the Reading Well books on prescription scheme. Method: Participants (n = 115) who were not receiving treatment, but had symptoms of depression, read the positive psychology or the CBT self-help book for 8 weeks. Depression and well-being were measured at baseline, post-test and 1-month follow-up. Results: Results suggest that both groups experienced a reduction in depression and an increase in well-being, with no differences noted between the two books. Conclusions: Future directions are discussed in terms of dissemination, to those with mild to moderate symptoms of depression, via books on prescription schemes.

An important goal of inclusive education is to create an environment in which individual differences are appreciated, and where all children are valued. Books are an important way in which children learn about themselves, others and the world around them. Children's literature can potentially promote awareness of individual differences and similarities, acceptance of self and others, and information that counteracts ignorance, misperceptions and stereotypes about disability. This awareness, acceptance and knowledge should ultimately contribute to greater understanding, empathy and respect for diversity. In this article, we review over 50 children's books that may be of value for assisting children of different ages to understand and appreciate individual differences and disabilities. Most of the reviews were contributed by postgraduate psychology students who were enrolled in a disability unit at Queensland University of Technology.

Background: The use of Cognitive Behavioural Therapy (CBT) self-help materials for depression is increasingly recommended as part of stepped care service models. Such resources can be delivered by both new specialist workers (such as the IAPT services in England), or by introducing this style of working into an existing workforce as described in the current paper. The Structured Psychosocial InteRventions in Teams (SPIRIT) course consists of 38.5 hours of workshops, and 5 hours of clinical supervision in the use of CBT self-help (CBSH). Method: This study describes an evaluation of the effectiveness of the course when offered to community and inpatient mental health staff from a wide range of adult and older adult mental health teams in NHS Greater Glasgow Mental Health Division. Results: Training resulted in both subjective and objective knowledge and skills gains at the end of training that were largely sustained 3 months later. At that time point, 40% of staff still reported use of CBSH in the last week. Satisfaction with the training is high, using validated rating scales. Conclusions: The SPIRIT training has gone some way to increasing access to CBSH for use in everyday clinical practice.

Background: In the UK, bibliotherapy schemes have become a widespread source of support for people with common mental health disorders such as depression. However, the current evidence suggests that bibliotherapy schemes that are offered without guidance are not effective. It may be possible to improve the effectiveness of self-help books by incorporating into them some of the “common factors” that operate in personal therapeutic encounters, for example therapist responsiveness. Aim: The aim was to test whether and to what extent authors have incorporated common factors into self-help books. Method: A model of how common factors might be incorporated into CBT-based self-help books was developed and a sample of three books were examined against the model criteria. Results: The sampled self-help books were found to have common factors to a greater or lesser extent, but some types of common factors were more prevalent than others. Factors addressing the development and maintenance of the therapeutic alliance were less often apparent. Conclusions: Self-help books have the potential to provide a valuable service to people with depression, but further work is necessary to develop them. It is suggested that future generations of self-help books should pay explicit attention to the use of common factors, in particular developing and investigating how factors such as flexibility, responsiveness and alliance-rupture repair can be woven into the text.

Aims: The present study aims to determine whether cognitive-behavioural minimal contact bibliotherapy is acceptable to participants suffering from DSM-IV-TR hypochondriasis, and whether this intervention is able to reduce hypochondriacal complaints, as well as comorbid depressive complaints and trait anxiety. Method: Participants were assigned to either an immediate treatment condition, or subsequently to a waiting list condition. Participants were sent a book, Doctor, I Hope it's Nothing Serious?, containing cognitive behavioural theory and exercises. Measures were taken pre, post and at follow-up (after 3 months). Those in the waiting list group received a second pre-assessment, and were then enrolled in the bibliotherapy. Results: Results showed that participants were accepting of the cognitive-behavioural theory. Furthermore, results showed beneficial effects of the intervention: all effect measures decreased significantly over time, with the largest effect at post-assessment. However, a large amount of questionnaires were not returned. Conclusion: It is concluded that bibliotherapy may be an efficient aid in reducing hypochondriacal and comorbid complaints, but due to data attrition and methodological flaws should first be studied further.

The delivery of cognitive behaviour therapy (CBT) in the UK has moved through two phases. In the first phase specialist practitioners delivered bespoke CBT to individuals often experiencing complex and longer-lasting problems. This phase has been characterized by waiting lists and a high quality service delivered to a few. In the second phase of service delivery CBT has begun to be delivered in all sorts of different formats, including CBT self-help/guided CBT, behavioural activation, computerized CBT and group based CBT that aim to increase access to CBT delivered in these ways. It remains unclear how these varying models – “high intensity” (phase 1) and “low intensity” (phase 2) should relate – and even who does best with each. There are implicit assumptions by practitioners reflected in language such as “stepping up/down” that assumes high intensity working is superior in some way to low intensity. Few studies have however examined this in depth and what studies there are suggest these beliefs may be incorrect for many. How these new ways of working will be introduced, evaluated and integrated into existing services currently remains a challenge. A helpful way of resolving some of these issues is to view CBT using a learning/teaching paradigm. In this the focus is primarily on how the client wishes to learn to tackle their problems. This provides a helpful way for both introducing different and new ways of working, and also maintaining a focus on the client's needs at the centre of service development. Crucially, phase two CBT working does not replace phase one. How the two approaches complement each other and compare will be two of the interesting questions to be addressed over the next few years.

Self help approaches are increasingly being used in healthcare settings through over 100 book prescription schemes in the UK. The use of Cognitive Behavioural Therapy (CBT) self-help materials for depression is advocated as part of stepped care service models. This study assesses how the reading ages of the most recommended self-help books for depression compare to British literacy levels. A cross sectional survey was carried out. The most recommended self-help books for depression were identified; seven CBT based self-help books were included in this study as well as a widely used booklet for depression. Readability scores and reading ages were calculated for a randomly generated selection representing 15% of each selected book using the Readability Studio® software to generate a wide range of key readability and comprehension scores. The reading ages of the selected books were between 12.6 and 15.4. Reading ease varied amongst the texts, and their complexity (percentage of unfamiliar words, range: 14.8% – 22.6%). A significant proportion of the UK population would struggle to use some of the current CBT-based self-help books recommended. For some patient groups, non text based self-help materials as well as shorter and more easily read written materials may be more appropriate. To our knowledge, this is the first study to address this question. Publication of the reading ages of the recommended books within the book prescription schemes may allow for a more accurate match between the book and the reader.

Early intervention in depression is important for many reasons including expeditious alleviation of suffering, assisting parenthood, suicide prevention and helping the economy. The fact that people with depression frequently employ maladaptive coping strategies, notably alcohol misuse, suggests the need for evidence-based self-help for sufferers. Self-help can be viewed as a philosophy of patient empowerment and as “a health technology solution to volume and demand”. Bibliotherapy (self-help using written materials) provides information and encourages the reader to make changes leading to improved self-management. Enthusiasm for the use of bibliotherapy in depression should be tempered by pursuit of a sound evidence base.