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Written cognitive behavioural self-help interventions are effective in treating mental health conditions

Farrand P,  Woodford J.  Impact of support on the effectiveness of written cognitive behavioural self-help: A systematic review and meta-analysis of randomised controlled trials Clin Psychol Rev. 2013; 33(1):182-95

Review questions

Do different types of support impact the effectiveness of written cognitive behavioural therapy self-help?

Are different types of support more effective for people with different types of mental health conditions?


Cognitive behavioural therapy (CBT) self-help approaches are used for treating mild to moderate mental health problems, such as depression, anxiety, insomnia and eating disorders. Additional support from health care providers can help patients understand how to use written CBT self-help materials (for example books, manuals and other print material) and give them the motivation to do so.

How the review was done

This is a summary of 38 randomized controlled trials. Only studies of moderate to high quality were included in the review. The studies included 3,223 participants aged 16 or older experiencing an affective or common emotional disorder.

Three types of CBT self-help support were assessed: self-administered (no additional support); minimal contact (infrequent ‘check-ins’ with a health care provider); and guided self-help (regular scheduled visits with a health care provider who helps the patient understand and use the self-help materials).

What the researchers found

Overall, written CBT self-help was moderately effective in treating mental health conditions. While the effectiveness of CBT self-help did not vary between the three support types, there was some evidence suggesting levels of support had different effects on people with different types of mental health problems. However, there is not enough evidence at this point to recommend one type of support over another to treat different mental health problems.


Written CBT self-help is effective in treating a variety of mental health conditions. Different types of support do not appear to impact the effectiveness of CBT, although the impacts of support may vary for people with different types of mental health conditions.


Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.

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