Psychiatric Bulletin (2006) 30: 318-319. doi: 10.1192/pb.30.8.318
© 2006 The Royal College of Psychiatrists
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Psychiatric Bulletin (2006) 30: 318-319
© 2006 The Royal College of Psychiatrists

Reading about self-help books on depression

Graeme Whitfield, Consultant Psychiatrist in Cognitive–Behavioural Therapy

Leicestershire Partnership NHS Trust

Chris Williams, Senior Lecturer in Psychiatry

*University of Glasgow, e-mail: chris.williams{at}clinmed.gla.ac.uk

Declaration of interest

C.W. is author of one of the Overcoming Depression and Living Life to the Full websites.

Self-help resources for depression are widely available in bookshops and via the internet. They are increasingly being recommended for use by healthcare practitioners as part of a stepped care treatment package (Bower & Gilbody, 2005). Such materials provide key information and key skills to help readers tackle mild-to-moderate depression (National Institute for Clinical Excellence, 2004). The recent review of self-help by the National Institute for Mental Health in England confirmed that it is cognitive-behavioural therapy (CBT) self-help that has an evidence base rather than self-help per se (Lewis et al, 2003).

Evidence for the effectiveness of CBT self-help materials varies in quality. Some reviews have been very enthusiastic in recommending the effectiveness of written CBT self-help materials (so-called bibliotherapy). Other more recent and high-quality reviews have been more measured. Although there are a number of self-help books for the treatment of depression there is little direct evidence for the effectiveness of most available books (Anderson et al, 2005).

Books and book prescription schemes

The majority of specialists who treat patients with depression using CBT utilise written self-help materials (Keeley et al, 2002). These are used in a variety of settings to supplement individual or group therapy, for use by those on waiting lists and within book prescription schemes in primary care. It may be that practitioner support for the use of such books is essential and to date no controlled studies of book schemes have been published.

A growing number of book prescription schemes have developed around the UK (Farrand, 2005) and an example is shown in Table 1. A large range of self-help books are included on ‘recommended’ lists, which cover a range of mental health disorders.


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  		Table 1. Self-help books for depression available on the Peninsula book prescription scheme (Farrand, 2005)

The average UK reading age has been quoted as being around 9 years (Alderson, 1994), and it is clear that a proportion of patients will have problems following the content of some or all of the publications. Some books allow photocopying of either part or all of their content by professionals during their treatment of patients (e.g. Greenberger & Padesky, 1995; Williams, 2001).

Leaflets

Sometimes patients prefer or require information in a shorter format. Locally produced leaflets are available in many clinical units and leaflets with a wider circulation are freely available online (Table 2).


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  		Table 2. Sources of commonly used leaflets on depression that are available online


Figure 1
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  		Fig. 1. Rise in ‘hits’ for SELF and HELP and DEPRESSION on Google.com

Other websites

A range of self-help websites and leaflets are increasingly available via the internet (Fig. 1).

Few studies have examined the effectiveness of psychoeducational websites in helping people with depression-however, some studies have found them to be as effective as online CBT (Christensen et al, 2004). Most sites at present provide simple information about depression. Two sites in particular offer information and life skills training for people facing low mood and depresion: Mood Gym (http://moodgym.anu.edu.au/) and Living Life to the Full (www.livinglifetothefull.com).

Conclusion

It is clear that there is an apparently insatiable desire of users and patients to obtain information about depression. This is reflected by the increasing numbers of books and websites that are available. Practitioners are also increasingly offering information leaflets and such approaches are being formalised within clinical services. Such developments may have run ahead of the evidence base and more research in practice is required.

References

  1. ALDERSON, P. (1994) As plainas can be. Health Service Journal, 106, 28-29.
  2. ANDERSON, L., LEWIS, G., ARAYA, R., et al (2005) Self-help books for depression: how canpractitioners and patients make the right choice? British Journal of General Practice, 55, 307 -392.
  3. BOWER, P. & GILBODY, S. (2005) Stepped care in psychological therapies: access, effectiveness and efficiency: narrative literature review. British Journal of Psychiatry, 186, 11-17.[Abstract/Free Full Text]
  4. BURNS, D. (1999) The Feeling Good Handbook. London: Penguin Books.
  5. CHRISTENSEN, H., GRIFFITHS, K. M. & JORM, A. F. (2004) Delivering interventions for depression by using the internet: randomized controlled trial. BMJ, 328, 265.[Abstract/Free Full Text]
  6. FARRAND, P. (2005) Development of a supported self-help book prescription scheme in primary care. Primary Care Mental Health, 3, 61 -66.
  7. GILBERT, P. (2000) Overcoming Depression. London: Constable & Robinson.
  8. GREENBERGER, D. & PADESKY, C. A. (1995) Mind over Mood. New York: Guilford Press.
  9. KEELEY, H.,WILLIAMS, C. J., & SHAPIRO, D. (2002) A United Kingdom survey of accredited cognitive behaviour therapists' attitudes towards and use of structured self-help materials. Behavioural and Cognitive Psychotherapy, 30, 191 -201.
  10. LEWIS, G., ANDERSON, L., ARAYA, R., et al (2003) Self-Help Interventions for Mental Health Problems. http://www.dh.gov.uk/assetRoot/04/12/57/94/04125794.pdf
  11. NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (2004) Depression:The Management of Depression in Primary and Secondary Care. London: NICE.
  12. WILLIAMS, C. J. (2001) Overcoming Depression: A Five Areas Approach. London: Arnold.




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