Self-help interventions for psychosis: A meta-analysis

Abstract

Self-help has been shown to be an effective intervention for a wide range of mental health problems. However, there is less evidence on the efficacy of self-help for psychosis and, to date, there has been no systematic review. A search of bibliographic databases identified 24 relevant studies with a total sample size of N = 1816. Ten studies adopted a repeated measures design and 14 an independent group design (including RCTs and quasiexperimental studies). Self-help interventions had, on average, a small-to-medium-sized effect on overall symptoms (d + = 0.33, 95% CI: 0.17 to 0.48). Sub-analyses revealed that selfhelp interventions had a small-to-medium-sized effect on positive symptoms (d + = 0.42, 95% CI: 0.13 to 0.72), a small-to-medium-sized effect on negative symptoms (d + = 0.37, 95% CI: 0.07 to 0.66), and a small-sized effect on outcomes associated with the symptoms of psychosis such as quality of life (d + = 0.13, 95% CI: 0.02 to 0.24). Moderation analysis identified a number of factors that influenced treatment effects including the complexity of the intervention and amount of contact time. Self-help interventions for psychosis have a lot of potential and recommendations for further research are discussed. Word count: 190Key words: Self-help, psychosis, meta-analysis P r e P u b l i c a t i o n C o p y Self-help interventions for psychosis 3 Self-help interventions for psychosis: A meta-analysis "A massive, systematic, and yet largely silent revolution is occurring in mental health today and is gathering steam for tomorrow" (Norcross, 2000, p. 370) In the quote above, Norcross (2000) refers to the proliferation of self-help approaches for mental health conditions, an approach that has gathered momentum with practitioners, researchers, and policy makers placing an increasing emphasis on self-help for treating mental health problems (Lewis et al., 2003). Self-help interventions are defined as those that are "designed to be conducted predominantly independently of professional contact" (Bower, Richards, & Lovell, 2001, p. 839). Self-help interventions can be administered through a variety of mediums such as face-to-face or group meetings, through computers, mobile, and online platforms. Self-help typically involves working independently through a guide that describes the steps to be taken in order to apply a psychological treatment. A slight variation is guided self-help, which is distinguished "by the support that is given by a professional therapist or coach to the patient when working through the standardized treatment" (Cuijpers, Donker, van Straten, & Andersson, 2010, p. 1934. The support offered can range from assisting the person to work through the self-help program to emotional support and can be provided in a range of ways (e.g., face-to-face, telephone, or email). Most self-help interventions are based on standardized psychological treatments, with the most common interventions being those based on cognitive behavioral therapy (CBT: Cuijpers & Schuurmans, 2007). Self-help inter...

Psychological Interventions for Post-traumatic Stress Symptoms in Psychosis: A Systematic Review of Outcomes

“…Although only a single study, and therefore with limited generalisability, it raises questions as to the value of non-therapist led interventions. A recent meta-analysis for example has shown a small to moderate effect size for “self help” interventions within psychosis highlighting this as an area for further utilisation and investigation (Scott et al, 2015). …”

Internet- und mobilbasierte Interventionen bei Schizophrenie

“…Berger et al, 2011;Dear et al, 2015], sodass der Nutzen von Guidance nicht abschließend beurteilt werden kann. Für nicht Internet-basierte Selbsthilfeansätze bei Schizophrenie konnte eine Meta-Analyse aufzeigen, dass diese mittlere bis große Effektstärken bei Positivsymptomatik erzielen (d = 0,78; N = 11 Studien [Scott et al, 2015] [Rotondi et al, 2010]. Die PatientInnen benutzten das Programm deutlich intensiver als die Angehörigen, was im Vorfeld der Programmentwicklung nicht erwartet wurde [Rotondi et al, 2005] und auf großes Interesse aufseiten der Betroffenen hinweist.…”

Cognitive Behavior Therapy for psychosis based Guided Self-help (CBTp-GSH) delivered by frontline mental health professionals: Results of a feasibility study

“…However, research on self-help interventions in Schizophrenia has lagged considerably behind other psychiatric disorders such as depression and anxiety (Lewis et al, 2003). A recently published meta-analysis (Scott et al, 2015) has highlighted the potential for selfhelp interventions, especially the guided self-help for psychosis. This meta-analysis reported self-help interventions using a wide range of interventions, with many approaches ranging from psychoeducation to CBT, using traditional face-to-face, paper, and online formats.…”