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.
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.
Cuijpers
P
P
Department of Clinical Psychology, VU University Amsterdam, The Netherlands. p.cuijpers@psy.vu.nl
Donker
T
T
van Straten
A
A
Li
J
J
Andersson
G
G
D001008:Anxiety Disorders / Q000628:therapy*; D003863:Depression / Q000628:therapy*; D006801:Humans; D010352:Patient Dropouts; D011613:Psychotherapy; D016032:Randomized Controlled Trials as Topic; D012648:Self Care; D016896:Treatment Outcome