Issues and outcomes associated with adult mental health self-help materials: A “second order” review or “qualitative meta-review”

Abstract

Aims: This review evaluates the evidence associated with the effectiveness of self-help materials designed to help individuals suffering with adult mental health (AMH) problems, and explores the methodological status of the field as well as issues associated with self-help delivery.

Methods: An original second-order review perspective was used, where previous individual reviews are systematically retrieved, compared and contrasted qualitatively.

Results: Self-help treatment manuals appear to be effective for several types of anxiety disorder as well as with assertiveness difficulties. There is early support for its use with depression. Less powerful and more variable evidence exists for its use with habit disorders and as a computer-delivered modality. Certain methodological limitations remain within the field including, for instance, compliance/drop-out and generalization issues.

Conclusions: Self-help looks set to be an important component in AMH services. Studies do not seem to have attempted to fully evaluate the “added-value” dimensions which justify the use of self-help materials. Interventions should be offered which are based on a person's presenting difficulties, personal preferences and their individual characteristics. Several themes associated with the individual characteristics which might advantage the self-help modality are explored and some future research guidance is listed.

Keywords:

• Literature review
• adults
• mental health
• mental illness
• self-help techniques
• bibliotherapy

Notes

1 This review focuses upon self-help materials, rather than self-help group treatment programs.

2 From this point, termed “psychotherapy”.

3 Attempts to subsume the key points of the Health Technology Assessment report on CCBT (Kaltenthaler et al., 2002) and the National Institute of Clinical Excellence (NICE) guidance on the use of CCBT (NICE, 2002).