Self-help for childhood mental health problems holds promise of easy-access, affordable psychological help

A recent review from the UCL Great Ormond Street Institute of Child Health, London, UK shows that self-help methods can be a good alternative for children with different mental health problems.

In the light of several reports that point to increasing numbers of children with mental health problems, it appears obvious that children should be given the best possible treatment as early as possible. In addition, other studies underline that there are major benefits when targeting psychological problems early in life rather than later in aduldhood.

However, when it comes to psychological treatments, such as cognitive behavior therapy (CBT), there are too few trained clinicians, and even if some coutries have made major implementation efforts, such as the IAPT-program in the UK, in order to reach a majority of patients other formats of treatment are needed.

Self-help methods, either in the format of books or via the internet, seem an obvious choice to meet the demand of easy-access, first-line psychological help. Most countries have a long tradition of self-help literature, and there is a huge (however unregulated) market of self-help books and also a growing field of internet-delivered self-help. The problem with the vast supply of self-help is however that there is little available guidance on the quality and effect of the available methods.

The review of Bennett and colleagues summarizes the state of the art of self-help (both books and online format) for childhood mental health problems. For quality reasons only randomized controlled trials (RCTs) were included. The interventions could be pure self-help or guided self-help with support of a clinician.

Fifty studies were reviewed, targeting anxiety, depression and/or disruptive behaviour, with a total of 3396 children receiving self-help.

Overall, the researchers found that self-help is more effective than the control condition (meaning not receiving help at all). On the contrary, self-help was slightly less effective than traditional face-to-face therapy. The authors conclude that:

“Given the efficacy in comparison to no treatment and similar effects to standard face‐to‐face treatment, self‐help may be particularly useful if used in a stepped‐care model where those that do not respond are then offered face‐to‐face treatment.”

You can find the original article here (not open access).

Reference: Bennett, S. D., Cuijpers, P. , Ebert, D. D., McKenzie Smith, M. , Coughtrey, A. E., Heyman, I. , Manzotti, G. and Shafran, R. (2019), Practitioner Review: Unguided and guided self‐help interventions for common mental health disorders in children and adolescents: a systematic review and meta‐analysis. J Child Psychol Psychiatr. doi:10.1111/jcpp.13010

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