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, 6 (6), e21274

Self-guided Psychological Treatment for Depressive Symptoms: A Meta-Analysis


Self-guided Psychological Treatment for Depressive Symptoms: A Meta-Analysis

Pim Cuijpers et al. PLoS One.


Background: A number of trials have examined the effects of self-guided psychological intervention, without any contact between the participants and a therapist or coach. The results and sizes of these trials have been mixed. This is the first quantitative meta-analysis, aimed at organizing and evaluating the literature, and estimating effect size.

Method: We conducted systematic literature searches in PubMed, PsycINFO and Embase up to January 2010, and identified additional studies through earlier meta-analyses, and the references of included studies. We identified seven randomized controlled trials that met our inclusion criteria, with a total of 1,362 respondents. The overall quality of the studies was high. A post-hoc power calculation showed that the studies had sufficient statistical power to detect an effect size of d = 0.19.

Results: The overall mean effect size indicating the difference between self-guided psychological treatment and control groups at post-test was d = 0.28 (p<0.001), which corresponds to a NNT of 6.41. At 4 to 12 months follow-up the effect size was d = 0.23. There was no indication for significant publication bias.

Conclusions: We found evidence that self-guided psychological treatment has a small but significant effect on participants with increased levels of depressive symptomatology.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.


Figure 1
Figure 1. Flowchart of inclusion of studies.
Figure 2
Figure 2. Standardized effect sizes of self-guided psychological treatment for adult depression: Cohen's d.

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    1. Gellatly J, Bower P, Hennessy S, Richards, Gilbody S, et al. What makes self-help interventions effective in the management of depressive symptoms? Meta-analysis and meta-regression. Psychol Med. 2007;37:1217–1228. - PubMed
    1. Gregory R, Canning S, Lee T, Wise J. Cognitive Bibliotherapy for Depression: A Meta-Analysis. Prof Psychol Res Pract. 2004;35:275–280.
    1. Menchola M, Arkowitz HS, Burke BL. Efficacy of self-administered treatments for depression and anxiety. Prof Psychol Res Pract. 2007;38:421–429.
    1. Cuijpers P. Bibliotherapy in unipolar depression. J Behav Ther Exp Psychiatry. 1997;28:139–147. - PubMed
    1. Hirai M, Clum GA. A meta-analytic study of self-help interventions for anxiety problems. Behav Ther. 2006;37:99–111. - PubMed

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