Is guided self-help as effective as face-to-face psychotherapy for depression and anxiety disorders? A systematic review and meta-analysis of comparative outcome studies

• Published in: Psychological medicine Vol. 40; no. 12; pp. 1943 - 1957
• Main Authors: Cuijpers, P., Donker, T., van Straten, A., Li, J., Andersson, G.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.12.2010
• Subjects: Anxiety; Anxiety Disorders - therapy; Anxiety-Depression; Behavior therapy. Cognitive therapy; Bibliotherapy; Biological and medical sciences; Clinical outcomes; Comparative studies; depression; Depression - therapy; Dropping out; guided self-help; Humans; Medical sciences; Meta-analysis; Patient Dropouts; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Randomized controlled trials; Randomized Controlled Trials as Topic; SAMHÄLLSVETENSKAP; Self Care; Selfhelp; SOCIAL SCIENCES; Systematic review; Treatment Outcome; Treatments; meta-analysis; Bibliotherapy; depression; guided self-help; Mood disorder; Human; Cognitive therapy; Treatment efficiency; Anxiety disorder; Controlled therapeutic trial; Depression; Review; Individual psychotherapy; Metaanalysis; Treatment; Selfcare; Social interaction; Behavior therapy; Comparative study
• ISSN: 0033-2917; 1469-8978; 1469-8978
• DOI: 10.1017/S0033291710000772

Although guided self-help for depression and anxiety disorders has been examined in many studies, it is not clear whether it is equally effective as face-to-face treatments.MethodWe conducted a meta-analysis of randomized controlled trials in which the effects of guided self-help on depression and anxiety were compared directly with face-to-face psychotherapies for depression and anxiety disorders. A systematic search in bibliographical databases (PubMed, PsycINFO, EMBASE, Cochrane) resulted in 21 studies with 810 participants. The overall effect size indicating the difference between guided self-help and face-to-face psychotherapy at post-test was d=-0.02, in favour of guided self-help. At follow-up (up to 1 year) no significant difference was found either. No significant difference was found between the drop-out rates in the two treatments formats. It seems safe to conclude that guided self-help and face-to-face treatments can have comparable effects. It is time to start thinking about implementation in routine care.