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

Psychol Med. 2010 Dec;40(12):1943-57. doi: 10.1017/S0033291710000772. Epub 2010 Apr 21.

Abstract

Background: 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.

Results: 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.

Conclusions: 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.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Anxiety Disorders / therapy*
  • Depression / therapy*
  • Humans
  • Patient Dropouts
  • Psychotherapy*
  • Randomized Controlled Trials as Topic
  • Self Care*
  • Treatment Outcome