Self-help can be brilliant for those who are at least part of the way there, but we should be wary of any suggestion that it could replace therapy
Feeling that you are not coping is horrible, like trying to untangle shackles around you that instead pull tighter with every movement. We are supposed to be able to look after ourselves. Our culture lionises fighters; decision takers; people who know their own mind. We are comfortable in the hands of specialists such as hairdressers or driving instructors, yet many of us find the idea of using a therapist, a specialist in distress, to be strange and uncomfortable – an admission that we can’t sort out our own problems. People experiencing mental distress are often desperate for some kind of talking therapy, yet we still maintain a deep cultural ambivalence toward the concept.
This ambivalence is often reflected in research. Does therapy work? Do other cheaper things work better? The website Quartz recently published an article headlined “Researchers say you might as well be your own therapist”, summarising a paper that contrasts self-help therapy with therapist-delivered therapy. The paper, a meta-analysis of 15 studies, contrasted cognitive behavioural therapy (CBT) delivered by a therapist with CBT delivered through self-help activities, such as activities and exercises. CBT is defined by NHS Choices as “a talking therapy that can help you manage your problems by changing the way you think and behave”. It is provided as part of England’s Improving Access to Psychological Therapies programme, which began in 2007 and was recently written up with besotted love by the New York Times. The authors of the paper “found no difference in treatment completion rate and broad equivalence of treatment outcomes for participants treated through self-help and participants treated through a therapist”.
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