Psychological Self-Help

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Although having minimal contact with a therapist or a teacher
beyond the self-help readings or tapes did not seem to help much in
the above studies, Rosen (1987) provides evidence that people with
certain problems (premature ejaculation and toilet training) are more
likely to persevere and actually complete a treatment method if a
therapist is continuously encouraging them to use the method and
monitoring their progress, than if the "patients" are left entirely on
their own to apply the method. That's hardly surprising. On the other
hand, there is evidence (Journal of the AMA, 1986) showing that 9 out
of 10 people who quit smoking do it on their own, not in a "program."
Smokers in a program--working with a helper--have a 24% success
rate; self-helpers working alone have a 48% success rate. Maybe the
smokers in a program were more addicted than self-helpers working
on their own. In any case, some people, no doubt, need personal
guidance and encouragement from others. A method could be equally
effective if applied by a therapist or by a self-helper alone, but
obviously the method can not do you any good if you won't use it on
your own. Becoming motivated to change is a critical and little
understood part of changing (see step one in chapter 2 and chapter
Why else do I believe self-help can help you? First, self-help
methods are often based on therapy methods which, in general, have
been shown to be fairly effective (Bergin & Lambert, 1978; Bergin &
Garfield, 1994). Specific treatment methods have been shown to work
dependably with 10 or so specific disorders (DeRubeis & Crits-
Christoph, 1998; National Advisory Council, 1995). Second, early
research on self-help suggested that it is more effective and certainly
far more economical than therapy, e.g. with self-reinforcement
(Kazdin, 1975), fears (Barlow & Craske, 1989; Clark, 1973; Marks,
1978), and vocational choice (Graff, 1972). More and more positive
results continue to be reported (Christensen & Jacobson, 1994),
especially when people are encouraged to work on their own towards
self-improvement (Smyrnios & Kirkby, 1993). Third, several college
self-help courses have been considered successful by 70-85% of the
students (Grasha, 1974 ; Berrera and Glasgow, 1973; Ladd, 1973;
Tucker-Ladd, 1994; Rakos and Grodek, 1984; Sherman, 1975). 
It has been my experience with over 3000 students, who varied
greatly in the seriousness of their problems, their motivation to learn
or change, and their ability, that about half of the students in one
semester became (or were already) rather effective self-helpers.
Perhaps 10% to 20% devoted 6-8 hours a week to the course (16
weeks) and made remarkable progress, turning in well documented
and impressive reports of self-improvement. At the other extreme,
10% to 20% did very little and appeared to learn little. Almost all
"claimed" to have self-improved, of course. When I did a follow up 1 to
8 years after the course, 69% remembered making progress during
the course, 5% said they didn't make progress, and 23% said "some
progress, maybe." At that time, 1 to 8 years later, 8% of the problems
worked on had gone away, 71% had definitely gotten better, 6% had
not changed, and 5% had gotten worse. A 79% success rate for self-
help several years later is pretty good, compared to the generally
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