on July 12, 2001
Self-help is big business. According to Gerald Rosen (1993) as many as 2000 self-help books are published each year. However, only a very few have been evaluated empirically. This sad state of affairs is a poor response to the appeal made by Rosen (1987) that self-help books should first be evaluated empirically before being sold to the general public. Additionally, the little research that has been done on do-it-yourself treatment books sometimes demonstrates major limitations in their usefulness. Yet psychologists continue to develop and market new programs with increasingly exaggerated claims. This is potentially a problem. Especially as psychologists often use self-help books as adjuncts to their clinical practice (Starker, 1988). The good news from research (e.g. Gould & Clum, 1993) is that certain self-help programs can be quite effective. Fairburn's Binge Eating Disorder treatment (Carter & Fairburn, 1998) and the Albany protocol for Panic Disorder (Barlow & Craske, 1994) are two good examples. In Gould and Clum's (1993) meta-analysis, fears, depression, headaches, and sleep disturbances were especially amenable to self-help approaches. Sometimes with effect sizes as large as for therapist assisted treatments.
How can busy clinicians keep up with the flood of new self-help books, and know which to recommend? Guilford Press offers a solution. In an attempt to help the clinicians a guide to self-help resources in mental health has been published. It includes ratings and reviews of more than 600 self-help books, autobiographies and popular films. It also includes hundreds of Internet sites, and listings of online support groups. The book addresses 28 prevalent clinical disorders and life challenges - from Schizophrenia, Anxiety and Mood Disorders to Career Development, Stress Management and Relaxation.
To determine the usefulness of the self-help resources a series of national studies have been conducted over the past 7 years. The methodology consisted of a lengthy survey mailed to clinical and counselling psychologists residing throughout the USA. A total of 2,500 psychologists contributed with their expertise and judgement in evaluating the books, movies, and Internet sites. The self-help resources were rated on a 5-point scale (-2 to +2). These data were converted into a one to five star rating (negative ratings were given a dagger). On this basis, 19% of the self-help books were rated as "very helpful" and fortunately only 1% as "very harmful" [e.g. the assertiveness training book Winning Through Intimidation by Ringer (1973) and the weight management book the Beverly Hills Diet by Mazel (1981). Interestingly, many of the books by Scientologist guru L Ron Hubbard are categorized as extremely bad].
When looking more closely at a specific disorder, let us say for example panic disorder, there are some good books that I feel are missing. This is probably because of the rating criteria. In order for a book to be included in this self-help guide the psychologists used as referees had to know about the book beforehand. It was their rating of previously read books that mattered. Hence, if there were good books out there that had not been read by many referees [like the Australian panic disorder workbook by Franklin (1996)], they would automatically receive a lower rating. Thus, a low rating does not necessarily mean that a book is less helpful than a higher rated book - only that it has not reached a wide audience. For example, an excellent book, An End to Panic (Zuercher-White, 1998), previously recommended in a review article (Carlbring, Westling, & Andersson, 2000) was described as "highly regarded by the psychologists in our national studies but not well known, leading to a 3-star rating." (p. 79). Another thing that disturbed me was that this particular author's name was misspelled. Instead of Zuercher the surname appeared as Luerchen. No wonder the book was "not well known"! One wonders how many other errors this survey included.
In a perfect world all self-help books would be scrutinized in the same manner as other treatments. However, as a majority of the published books still have not been evaluated, this new guide to self-help is a step in the right direction. Despite questionable inclusion criteria and a few errors I thoroughly recommend this excellent guide to self-help.
Barlow, D. H., & Craske, M. G. (1994). Mastery of your anxiety and panic II. San Antonio, TX: The Psychological Corporation.
Carlbring, P., Westling, B. E., & Andersson, G. (2000). A review of published self-help books for panic disorder. Scandinavian Journal of Behaviour Therapy, 29, 5-13.
Carter, J. C., & Fairburn, C. G. (1998). Cognitive-behavioral self-help for binge eating disorder: A controlled effectiveness study. Journal of Consulting and Clinical Psychology, 66, 616-623.
Franklin, J. A. (1996). Overcoming panic: A complete nine week home based treatment program for panic disorder. Carlton, VIC, Australia: Australian Psychological Society Ltd.
Gould, R. A., & Clum, G. A. (1993). A meta-analysis of self-help treatment approaches. Clinical Psychology Review, 13, 169-186.
Mazel, J. (1981). The Beverly Hills Diet. New York: Macmillan.
Ringer, R. (1973). Winning through Intimidation. Berverly Hills, CA: Los Angeles Book Company.
Rosen, G. M. (1987). Self help treatment books and the commercialization of psychotherapy. American Psychologist, 42, 46-51.
Rosen, G. M. (1993). Self-Help or Hype? Comments on Psychology's Failure to Advance Self-Care. Professional Psychology: Research and Practice, 24, 340-345.
Starker, S. (1988). Psychologists and self help books: Attitudes and prescriptive practices of clinicians. American Journal of Psychotherapy, 42, 448-455.
Zuercher-White, E. (1998). An end to panic: Breakthrough techniques for overcoming panic disorder (2 ed.). Oakland, CA, USA: New Harbinger Publications, Inc.