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

Cognitive Behaviour Therapy self-help has been recommended in the NICE guidelines for the treatment of anxiety and depression. However, little is known about who benefits from self-help and the potential drawbacks and problems of using this approach.

To address the current gap in knowledge, we contacted accredited BABCP practitioners to examine practitioner use and attitudes to self-help, current trends of use, and to identify possible problems with this therapy.

A 50% random sample of all accredited BABCP practitioners was approached, and the overall response rate for the survey was 57.6%.

Self-help materials were seen positively by therapists and were used by 99.6%, mainly as an adjunct to individual therapy. Only 38.2% had been trained in the use of self-help, with those trained being more likely to recommend self-help. Higher levels of patient motivation, credibility, likely adherence, self-efficacy and a lower degree of hopelessness were the five factors identified by more than 70% of respondents as predicting successful patient outcome with self-help. Non-compliance and a lack of detection of a worsening of the patient's clinical state due to reduced therapist contact were viewed as being the most important problems with self-help by more than 70% of respondents.

Preferable patient characteristics for self-help have been identified, as have potential problems and adverse consequences.