A recent study suggests that self-help books prescribed on the NHS and run in conjunction with advisory sessions, help patients have significant lower levels of depression than if they receive usual GP care.
Self-help books ‘treat depression’
Prescribing self-help books on the NHS is an effective treatment for depression, a study suggests.
Patients offered books, plus sessions guiding them in how to use them, had lower levels of depression a year later than those offered usual GP care.
The effect was seen in addition to the benefits of other treatments such as antidepressants, Scottish researchers report in the journal Plos One.
Such an approach may help the NHS tackle demand for therapy, they said.
More than 200 patients who had been diagnosed with depression by their GP took part in the study, half of whom were also on antidepressant drugs.
Some were provided with a self-help guide dealing with different aspects of depression, such as being assertive or overcoming sleep problems.
Patients also had three sessions with an adviser who helped them get the most out of the books and plan what changes to make.
After four months those who had been prescribed the self-help books had significantly lower levels of depression than those who received usual GP care.
Depression saps people’s motivation and makes it hard to believe change is possible”
Prof Christopher Williams
A year later, those in the self-help group were more likely to be keeping on top of their depression.
Study leader Prof Christopher Williams, from the University of Glasgow, who also wrote the books called Overcoming Depression and Low Mood, said the guided sessions were the key to getting people engaged.
The sessions can be delivered in general practice without referral to a specialist, taking pressure off waiting lists.
In Scotland, a telephone support service has now been set up to help support those using the books, which can be freely copied and disseminated, he added.
“We found this had a really significant clinical impact and the findings are very encouraging,” he said.
“Depression saps people’s motivation and makes it hard to believe change is possible.”
The challenge for the NHS, where self-help books are already used in many places, is how to implement this model so people have easy supported access in primary care, he said.
‘Worth investing in’
There has been huge investment in better treatment for depression in the UK in recent years with the Improving Access to Psychological Therapies programme in England set up to widen access.
It has been estimated this approach could save the NHS up to £272m and the wider public sector £700m.
But, says Prof Williams, despite the huge levels of investment, it is just not possible to refer everyone with depression to mental health services.
Dr Paul Blenkiron, consultant in adult psychiatry at Leeds and York Partnership NHS Foundation Trust, said the results showed that guided self-help is effective and is “something the NHS should be investing in”.
He is currently advising on behalf of the Royal College of Psychiatrists, on a National Books On Prescription Scheme, to be rolled out across UK public libraries this year.
Thirty books, including the one used in the study, have been selected.
But Dr Blenkiron said self-help would not be suitable for everyone: “The key thing is that the person is committed to doing some work.”
Thrive Consultants have been working with people affected by depression in this way for a number of years now. The Thrive Workbook is designed to run alongside Thrive sessions, in which a licensed consultant guides the person through the programme. One of the reasons this has been so successful, is the ability of the Thrive consultant to encourage, motivate and gently challenge the person to move forward and change.
We know that people who suffer from depression also have low self-esteem and low confidence in themselves. This coupled with social anxiety (worrying about what someone else thinks about you or something that you have done) and an external locus of control (feeling powerless to do anything about the symptom) means that the sufferer is very unlikely to put into action any of the advice in a self-help book alone. It is very likely that the book would end up at the back of the bookcase! Purely the fact that those suffering from depression don’t feel able to help themselves and have no belief in their abilities to overcome it, means that they look externally for help. By working through the Thrive workbook with a trained consultant, they are able to acknowledge and deal with those three main limiting beliefs (self-esteem, social anxiety and an external locus of control) that underpin their depression.
Thrive consultants also have the knowledge that sufferers of depression think in a negative way. Negative thinking, amongst other things, can prevent the person from taking any action towards their symptom, from a fear of failure or a belief that nothing will change their symptom. The Thrive programme gives the person a cognitive understanding of how they came to experience their symptom and how they are inadvertently maintaining it. By gaining understanding, they gain control over the symptom. Having a Thrive consultant to guide them through the learning process is invaluable; as the trainee can ask any questions they may have and get a greater understanding whilst putting change into action.
A recent research study conducted on Thrive trainees’ pre and post Thrive saw a dramatic reduction in their Locus of Control score. At the beginning of the programme the averaged trainees’ score was 19.625 out of a possible 30. This meant that the trainees’ were feeling powerless in relation to various different things in their life, particularly to do with their direct symptom. After going through a course of Thrive, their Locus of Control score reduced to, on average, 5.567, which meant that they felt much more, or completely in control of their symptom and other areas of their life.
If you would like to find a licensed Thrive Consultant to go through the workbook with, please follow this link: Find a Thrive Consultant. If you would like to find out more about the Thrive book, please click here: Thrive Book.
Thrive Consultant and Blogger