Cochrane Summaries

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Self-help for anxiety disorders

Mayo-Wilson E, Montgomery P
Published Online: 
9 September 2013

Anxiety disorders are common. They interfere with normal living, and they tend not to go away without treatment. Effective treatments are available, including cognitive behavioural therapy. These are known to work when delivered in person, but many people cannot access face-to-face treatment. This review examined 101 clinical trials of self-help and statistically analysed 92 of them. In these trials, 8403 people received self-help or were assigned to a control condition. 

Overall, self-help with some support from a professional appears to be more effective than no treatment. Only half of the people who used self-help were better at the end of treatment, but self-help may still be considered effective because people with anxiety do not tend to get better without treatment. Self-help may be less effective than normal face-to-face therapy. Some results were difficult to interpret because the effects of treatments varied and the risk of overestimating the results was serious because of limitations in the study methods. We conclude that self-help is probably better than no treatment, but many people with an anxiety disorder would get better results from treatment provided by a skilled psychologist. Furthermore, most of the self-help materials used in these studies are intended for research and are not available to the public, so the results reported here may not apply to commercially available products.

This record should be cited as: 
Mayo-Wilson E, Montgomery P. Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD005330. DOI: 10.1002/14651858.CD005330.pub4
Assessed as up to date: 
1 January 2013