Efficacy of self-administered treatments for depression and anxiety.

Abstract

Self-administered treatments (SATs) are widely used by the general public and mental health professionals. Previous reviews of the efficacy of SATs have included under this category interventions for nonclinical problems, group interventions, and interventions involving significant amounts of therapist contact. The efficacy of SATs for clinical levels of depression and anxiety with minimal therapeutic contact was examined by meta-analyzing 24 studies. The results show large effects for SATs when compared with no-treatment control groups (d ϭ 1.00). However, unlike previous meta-analyses that found nonsignificant differences between SATs and therapist-administered treatments, in this sample SATs resulted in significantly poorer outcomes (d ϭ -0.31). Some differences in effect size were observed between the clinical targets of depression and anxiety. However, there were high correlations between clinical target, methodological quality of the study, and amount of contact. This makes it impossible to determine whether the observed differences could be explained by the nature of the disorders, methodological quality, or the amount of contact with a member of the research team. The implications of the findings for the clinical use of SATs and for future research are discussed.

Help a Buddy Take a Knee: Creating Persuasive Messages for Military Service Members to Encourage Others to Seek Mental Health Help

“…However, there is no agreed-upon definition of self-help and there is no consensus concerning the appropriate amount of therapist contact for a treatment to be described as "self-help" (Gellatly et al, 2007). Findings have shown that self-help treatments can be effective in treating depression (Gellatly et al, 2007); however, effectiveness can depend, in part, on how serious the patient's depressive symptoms are, because these treatments may be insufficient for patients with more-severe depressive symptoms (Menchola, Arkowitz, and Burke, 2007).…”

“…Self-help treatments, or self-administered treatments, are typically defined as treatments without therapist contact. They usually encompass media-based treatments, such as books, manuals, audiotapes, or some combination (Gellatly et al, 2007;Menchola, Arkowitz, and Burke, 2007). However, there is no agreed-upon definition of self-help and there is no consensus concerning the appropriate amount of therapist contact for a treatment to be described as "self-help" (Gellatly et al, 2007).…”

“…Studies involving patients recruited in nonclinical settings and studies using a guided self-help approach (versus a "pure" self-help approach) had higher effect sizes (Gellatly et al, 2007). Menchola, Arkowitz, and Burke (2007) conducted their review of self-administered treatments because they wanted to control for several confounding factors that were present in previous meta-analyses. They included 11 studies on depression.…”

La eficacia de un tratamiento computarizado aplicado a través de Internet para la fobia a volar: Un estudio controlado

“…En este sentido, se plantea que problemas más sencillos como las FE podrían requerir una menor guía o contacto del terapeuta, mientras que en problemas más graves el apoyo del clínico podría ser de mayor relevancia (Botella et al, 2010;Menchola, Arkowitz, y Burke, 2007 …”

“…Thus, it is also necessary to consider studies indicating that, whereas self-help interventions without therapist contact can be useful to treat simple psychological disorders (i.e, specific phobias), they may be insufficient for more severe mental disorders [44,82]. Although there is recent evidence showing the utility of selfguided Internet Interventions for severe disorders (i.e., depression) [51], this issue remains unclear.…”