A meta-analysis of self-help treatment approaches

Abstract

We conducted a meta-analysis of 40 self-help studies examining 61 treatments which used as control groups no-treatment, wait-list, or placebo comparisons. We found an overall treatment effect size for self-help interventions of 0.76 at posttreatment and an effect size of 0.53 at follow-up. Studies that used a more stringent control group — placebo — had a lower mean effect size than studies utilizing a no-treatment control. No differences were found for unadulterated self-help treatments and those with minimal contact from a therapist or which were in fact therapist-assisted. Some target problems were more amenable to self-help approaches, including skills deficits and diagnostic problems, such as fears, depression, headache, and sleep disturbance. Habit disturbances such as smoking, drinking, and overeating, were less amenable to self-help treatments. Compliance with the treatment regimen was found to improve treatment effects. While effect size was negatively related to duration of treatment, this effect was largely a function of duration being confounded with type of problem. Results were examined from the perspective of problems that are targetable with self-help approaches. Recommendations for improvements in research design for future studies are also made.