Cognitive Behaviour Therapy self-help: who does it help and what are its drawbacks?

Area of Science:

• Psychiatry
• Clinical Psychology
• Therapeutic Interventions

Background:

• National Institute for Health and Care Excellence (NICE) guidelines recommend Cognitive Behaviour Therapy (CBT) self-help for anxiety and depression.
• Limited understanding exists regarding patient benefits, drawbacks, and challenges associated with CBT self-help.

Purpose of the Study:

• Investigate practitioner use and attitudes towards CBT self-help.
• Identify current trends and potential problems associated with self-help therapy.

Main Methods:

• Survey of a 50% random sample of accredited British Association for Behavioural and Cognitive Psychotherapies (BABCP) practitioners.
• Achieved an overall response rate of 57.6%.

Main Results:

• 99.6% of therapists utilize self-help materials, primarily as an adjunct to individual therapy.
• Only 38.2% of therapists received specific training in recommending self-help.
• Key predictors of successful outcomes include patient motivation, credibility, adherence, self-efficacy, and low hopelessness.
• Major concerns identified were patient non-compliance and the risk of undetected clinical worsening due to reduced therapist contact.

Conclusions:

• Identified patient characteristics that favor successful self-help outcomes.
• Highlighted potential problems and adverse consequences of using CBT self-help, emphasizing the need for careful patient selection and monitoring.