Abnormal Psychology

Foundations of Treatment 141

Bibliotherapy

The use of self-help materials as part of therapy.

Prevention programs

Programs that are designed to prevent or

inhibit the development or progression of

psychological problems or disorders.

Much self-help does not take place in groups, but instead often relies on an

individual’s reading a book, listening to audio materials, or visiting Web sites.

The number and variety of self-help books and materials have vastly expanded

in recent years. These publications provide help for a wide variety of problems—

such as depression, panic disorder, attention-defi cit/hyperactivity disorder, and

eating disorders—and many of the publications incorporate the theories and

techniques described in this chapter. Research reveals that self-help materials are

most likely to help people with depression and anxiety (Cuijpers, 1997), head-

ache, sleep disturbances, and fears (Gould & Clum, 1993), and anxiety (Finch,

Lambert, & Brown, 2000; Hirai & Clum, 2006; Scogin et al., 1990). In contrast,

self-help materials have not been as successful in helping people change habits

such as smoking, drinking, or overeating (Cuijpers, 1997). As you might expect,

self-help materials are more likely to be helpful when people closely follow the rec-

ommended techniques (Gould & Clum, 1983).

Using self-help materials as part of therapy is sometimes called bibliotherapy,

and therapists often advise patients to read relevant books (Campbell & Smith,

2003, Starker, 1988) in order to understand better the possible causes of their symp-

toms and ways to treat the disorder.

The Internet also provides a variety of self-help opportunities, including

educational materials, chat rooms that serve as support groups (which may or may

not be led by someone claiming to be a therapist), and interactive self-help treat-

ments (Andersson et al., 2006; Carlbring et al., 2006). However, information can

be posted online by anyone for any purpose, so online resources may not be ac-

curate. Like some “therapists” who engage in cybertherapy, people in an online

support group may be lying about their identity, may not provide accurate diag-

noses, and may recommend inappropriate courses of treatment (Finn & Banach,

2000; Waldron, Lavitt, & Kelley, 2000).

Using the Internet or computer software, people can also benefi t from interactive

self-help programs that automatically adapt to the user’s responses. These interac-

tive programs may be more complex than a self-help book or video, but they are

unlikely to surpass live therapy in terms of patient satisfaction and quality of treat-

ment (Jacobs et al., 2001). As with cybertherapy, some online interactive self-help

programs that use a cognitive-behavioral approach result in a better outcome than

engaging in no treatment at all (Carlbring et al., 2006). Further research is needed,

however, to assess the effi cacy of these programs in comparison with live treatment.

Prevention Programs

Prevention programs are designed to prevent or inhibit the development or

progression of psychological problems or disorders (Mrazek & Haggerty, 1994).

The specifi c techniques in a prevention program might target any or all neurop-

sychosocial factors, but the creation of such programs relies crucially on social

factors. One such program is the Big Brother/Big Sister program, which targets both

psychological and social factors in children deemed at risk of developing problems

because they don’t have regular positive contact with an adult family member; the

Big Brother or Big Sister provides such contact with an adult who serves as a mentor.

Prevention programs have also been created to address suicide and drug abuse, to

provide counseling for rape victims, and to provide early intervention for people

who have been identifi ed as having an elevated risk of a particular psychological

disorder. This last group includes:

• those with a family history of a particular disorder,


• those who have experienced a traumatic event, and


• children whose parents have divorced.

Any treatment technique and theoretical orientation may be employed in a preven-

tion program.

For many people, self-administered treatment

programs available through books and other

media appear to be more effective than no

treatment at all (Bilch et al., 2008; Hirai & Clum,

2006, 2008).

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