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Objective This randomized controlled investigation examined the effectiveness of a self-help bibliotherapy format of the evidence-based mindfulness-based stress reduction (MBSR) intervention. Method College students seeking stress reduction were randomly assigned to a 10-week MBSR bibliotherapy intervention group (n = 47) or a no-treatment control group (n = 45). Self-report measures were collected at baseline and postintervention. Results A total of 25 bibliotherapy and 43 control group participants provided final data following the intervention period. Compared to the control group, bibliotherapy participants reported increased mindfulness following the intervention. Significant decreases on measures of depression, anxiety, stress, perceived stress, and anxiety sensitivity also were reported postintervention as well as increased quality of life in physical health, psychological, and environmental domains. No statistically significant group effects were found for social relationships quality of life domain, worry, and experiential avoidance measures. Conclusion This MBSR workbook may provide an acceptable and effective alternative for motivated individuals seeking to reduce stress, at least for a select group of individuals who are willing and able to sustain participation in the intervention.

Bibliotherapy, reading a self-help book for the treatment of psychological problems, has been shown to be effective as a "stand-alone" treatment for depression. Many practitioners recommend self-help books as an adjunct to treatment. This article offers some guidelines for the use of bibliotherapy as an adjunct to individual psychotherapy with depressed older adults. Two clinical cases demonstrate how bibliotherapy can be used effectively in conjunction with individual psychotherapy.

Although there are numerous self-help books for depression, relatively few have been empirically tested. However, those that have been used in clinical trials have fared well, with an average effect size roughly equivalent to the average effect size obtained in psychotherapy studies. Computer-based treatments are being developed and appear promising as an alternative to bibliotherapy for those interested in self-administered treatments. This article provides a summary of the depression bibliotherapy literature and discusses several remaining questions such as effectiveness versus efficacy, practice applications, ethics, and future research.

There has been increased interest in the use of brief interventions and the delivery of alcohol treatment services through nonspecialist health care settings. One possible resource for reaching untreated individuals is "bibliotherapy," the provision of self-help materials to motivate and guide the process of changing drinking behavior. Research on the effectiveness of self-help materials for problem drinkers has been done for three decades. This report summarizes a meta-analytic review of 22 studies evaluating the effectiveness of such self-help materials. Each study was rated on 12 methodological criteria, and effect sizes of bibliotherapy were computed. The methodological quality of studies was generally high relative to other treatment-outcome studies. Modest support was found for the efficacy of self-help materials in decreasing at-risk and harmful drinking. The weighted mean pre/post-effect size for bibliotherapy was .80 with self-referred individuals seeking help for drinking problems, and .65 for individuals identified through health screening. Between-group comparisons of bibliotherapy with no-intervention controls appear to have a small to medium effect, with a weighted mean effect size of .31 with self-referred drinkers; effect size was more variable in opportunistic interventions based on health screening. Finally, between-group comparisons of effects on drinking of bibliotherapy versus more extensive interventions yielded effect size values near zero. These findings provide support for the cost-effective use of bibliotherapy with problem drinkers seeking such help to reduce their consumption, and to a lesser extent with drinkers who are identified through screening as at risk.

Self-administered psychosocial treatments for child health problems have the potential to circumvent barriers to traditional models of care. They are convenient and inexpensive to families and, for some types of problems, may be as effective as therapist-based care. In a review of past research on child- and parent-facilitated self-administered treatments, it was found that a stronger evidence base exists in support of some formats (manual- and multimedia-based treatments) than for others (inspirational literature and support groups). The practical, ethical, and legal issues associated with self-administered treatments are discussed as well as avenues for future research. How psychologists and health care systems respond to the opportunities associated with self-administered treatments for children will likely affect the face of the profession and the health of children in the future.

Stepped behavioral health care models have begun to receive increased attention. Self-administered treatments deserve consideration as an element in these models for some disorders and for some consumers. Features suggesting inclusion include low cost, wide availability, and evidence-based status. We present a stepped-care model for depression inclusive of a self-administered treatment component. We also discuss cautions such as depression severity and consumer preference. Evaluation of the efficacy and cost effectiveness of this approach to depression treatment is necessary.

First-person narratives may have advantages as adjuncts in psychotherapy. They provide an inside view of mental disorders expressed in the person's own words, emphasize issues that the person deems important, are interesting to read with strong story lines, are less didactic than self-help books, and offer identification with a protagonist. Recent trends in published autobiographies are described. There has been an increase in the number of published autobiographies describing mood disorder relative to schizophrenia, of psychotherapists going public with personal experiences of mental disorder, and of books expressing a positive view of treatment. The article includes case vignettes and a practitioner-recommended list of autobiographies on addictive disorders, death and grieving, and mood disorders.

The first aim is to describe the psychotherapy of 1949 in the light of today's psychotherapies. The old psychotherapy is suited to treating severely ill patients. It does not use free association, but rather is focused on current problems. It uses dreams, yet it also uses homework and bibliotherapy. The second aim is to critique the treatment. Consistent with its era, it does not make use of medications, and there is an absence of references to psychotherapy research, which was then just starting. The treatment relies over-heavily on the authority of the therapist. A third aim is to describe the changes in our field in the past 50 years and examine the predictions for the future. Although the treatment is called objective psychotherapy, it does not make use of the most up-to-date means of measuring accuracy of interpretations, such as the Core Conflictual Relationship Theme (CCRT) method and other methods like it.

Gerald M. Rosen has reminded us of the contributions of two task forces that addressed self-help therapies. The problems with self-administered treatments that were discussed in the recent Journal of Clinical Psychology special section (Volume 59, Number 3) also were discussed by these task forces. One of the primary problems is the lack of quality control and, in particular, the fact that self-help books without empirical support can be marketed to the public. There is not sufficient data available to reach conclusions regarding the overall impact of self-help books. Additional research and empirical support are needed for self-administered treatments; however, requiring such research support prior to publication would be holding self-help books to a higher standard than is currently required for psychologists (and other therapists) providing services. Our belief is that self-administered treatment is at least benign and potentially helpful to most consumers. © 2003 Wiley Periodicals, Inc. J Clin Psychol.

A special series on self-administered therapies was edited by Forrest R. Scogin for the Journal of Clinical Psychology (Volume 59, Number 3). Articles in the edited series failed to mention two task forces on self-help therapies that were sponsored by groups within the American Psychological Association in 1978 and 1990. Consideration of the work by these task forces provides an historical perspective for the issues and recommendations provided in Scogin's series.

The present study investigated the effectiveness of bibliotherapy and minimal therapist-contact interventions in the treatment of panic attacks. Individuals were randomly assigned to one of three conditions: (1) bibliotherapy alone (BT); (2) bibliotherapy plus phone contact (BT+PC); or (3) phone contact alone (PC). Assessment (pre- and post-treatment) and treatment (8 weeks in duration) were conducted via mail and phone. Individuals receiving BT and BT+PC exhibited significant reductions from pre- to post-treatment on panic cognitions and fear of having a panic attack. Individuals receiving BT+PC exhibited significant reductions from pre- to post-treatment on panic symptoms and avoidance. In addition, individuals in the BT and BT+PC groups were more likely to exhibit clinically significant improvement on most dependent measures relative to PC alone. On some measures, individuals in the BT+PC group did clinically better than individuals in the BT group. Results of the present study also suggest that diagnosis may play some role in outcome.

Self-help materials, brief therapies, and treatments involving minimal therapist contact have all been proposed as effective and low-cost interventions for anxiety disorders. However, research also suggests that the therapeutic alliance is a central predictor of therapy outcome. Interestingly, amounts of therapist contact within and across "self-help" interventions vary greatly. It is therefore unclear how much therapist contact is necessary for a positive anxiety disorder treatment outcome. The present article reviews the literature on anxiety disorder treatments using self-help, self-administered, and decreased therapist-contact interventions. Treatment studies are grouped together by anxiety diagnosis as well as amount of therapist contact. It is concluded that self-administered treatments are most effective for motivated clients seeking treatment for simple phobias. Predominantly self-help therapies are efficacious for panic disorder and mixed anxiety samples. On the other hand, minimal-contact therapies have demonstrated efficacy for the greatest variety of anxiety diagnoses.

Self-administered treatments are a cost-effective way to treat a broad spectrum of people. This article focuses on the existing research of self-administered treatments and their effectiveness when integrated with ongoing practice or when implemented alone. Evidence for their effectiveness is mixed; self-help has been proven successful in the treatment of depression, mild alcohol abuse, and anxiety disorders. It has proven less successful for smoking cessation and moderate to severe alcohol abuse. When determining whether self-administered treatment is appropriate, individual characteristics and attitude as well as the nature and severity of the problem should be taken into consideration. In addition, because many self-help treatments have not been evaluated, caution should be exercised when implementing self-administered treatment, and progress should be carefully monitored.

This article describes a systematic and integral method of incorporating self-help books into psychotherapy as a collaborative function. We address the distinctions between self-help and bibliotherapy, consider bibliotherapy as adjunctive or integrative to psychotherapy, and outline the multiple uses of bibliotherapy for clinical purposes. How to apply self-help books in psychotherapy and ways to select books are illustrated by a case example. Indications and contraindications for bibliotherapy in therapy are outlined.

The first aim is to describe the psychotherapy of 1949 in the light of today's psychotherapies. The old psychotherapy is suited to treating severely ill patients. It does not use free association, but rather is focused on current problems. It uses dreams, yet it also uses homework and bibliotherapy. The second aim is to critique the treatment. Consistent with its era, it does not make use of medications, and there is an absence of references to psychotherapy research, which was then just starting. The treatment relies over-heavily on the authority of the therapist. A third aim is to describe the changes in our field in the past 50 years and examine the predictions for the future. Although the treatment is called objective psychotherapy, it does not make use of the most up-to-date means of measuring accuracy of interpretations, such as the Core Conflictual Relationship Theme (CCRT) method and other methods like it. © 2000 John Wiley & Sons, Inc. J Clin Psychol 56: 889–896, 2000.

This brief article introduces the In Session issue devoted to integrating self-help into psychotherapy. The utility of self-help in psychotherapy is discussed, including the potential for enhancing the effectiveness of psychotherapy. Brief descriptions of the seven articles comprising this special issue are provided. These include articles on bibliotherapy, autobiography, films and psychotherapy, Internet self-help resources, focused expressive writing, and a review of the research on self-administered treatments. These articles give practitioners a number of ideas about how to augment their treatments with self-help approaches. © 2003 Wiley Periodicals, Inc. J Clin Psychol/In Session 59: 175–176, 2003.

Evaluated the psychotherapeutic adjunct of bibliotherapy in a maximum security correctional setting with 54 volunteers from a general and segregation population. Results indicated no differences between the treatment methods, but significant increases in self-concept and internal locus of control with an interaction on the dependent measure of Chance locus of control. There were no significant effects on the dependent variables as a result of the level of participation of the volunteers. It was concluded that bibliotherapy may have a facilitative effect on self-concept and internal locus of control, but cannot be differentiated from the effects of therapist intervention.

Evaluated the psychotherapeutic adjunct of bibliotherapy in a maximum security correctional setting with 54 volunteers from a general and segregation population. Results indicated no differences between the treatment methods, but significant increases in self-concept and internal locus of control with an interaction on the dependent measure of Chance locus of control. There were no significant effects on the dependent variables as a result of the level of participation of the volunteers. It was concluded that bibliotherapy may have a facilitative effect on self-concept and internal locus of control, but cannot be differentiated from the effects of therapist intervention.