“Handbook of self-help therapies” summary — Patti Lou Watkins

Introduction

You often face psychological challenges without having immediate access to traditional face-to-face professional care due to high costs or long waiting lists. Patti Lou Watkins examines media-based self-help and instructional manuals as practical alternatives that deliver empirically supported psychological interventions.

This book explores the history of self-help, the mechanisms of self-regulation, and specific applications for anxiety, depression, childhood issues, eating disorders, sexual dysfunctions, insomnia, addictions, and primary care integration.

You might wonder about the effectiveness of these tools:

How do self-help interventions compare to therapist-directed treatments?
What psychological mechanisms drive successful self-regulation?
Which conditions respond best to bibliotherapy and computer-guided programs?
How can primary care settings integrate self-administered therapies effectively?

1. Foundations and History of Self-Help

The American self-help movement is rooted in the Protestant ethic and human plasticity, while modern media-based self-help utilizes instructional materials independently of intensive professional contact.

Definition and Scope

Media-based self-help includes various instructional materials delivered independently of intensive professional contact. Gould and Clum defined media-based self-help as materials such as books, manuals, audiotapes, videotapes, or computer programs used largely independently by an individual. Bibliotherapy specifically refers to written forms, which historically represent the largest category of media-based self-help.

You find that women constitute the vast majority of self-help consumers, historically targeted with advice on relationships, health, and weight loss. Approximately 80% of the self-help readership consists of women.

The Boston Women's Health Collective published Our Bodies, Ourselves in 1973 to empower women as informed participants in their healthcare. The 2005 eighth edition of Our Bodies, Ourselves includes 32 chapters.

Historical Roots

The American self-help movement is deeply rooted in the Protestant ethic, emphasizing individual responsibility and human plasticity. Unlike historical European views of implasticity, early American settlers held a dogma of human plasticity, believing individuals can transform themselves through personal effort and hard work. This cultural focus on personal control fueled the explosive growth of the self-help industry.

Well-intentioned self-help materials can fail to translate into effective do-it-yourself formats and may produce harmful side effects. Research demonstrates that interventions highly successful when administered by a therapist often fail when attempted completely independently without professional guidance, sometimes leading to user frustration, increased problem behaviors, or worsened symptoms.

Matson and Ollendick found that 4 of 5 mothers succeeded in toilet training children using a book with a therapist, whereas only 1 of 5 succeeded in a self-administered condition, with failures leading to increased child problem behaviors. In a phobia study, 0% of subjects followed instructions after a self-reward contracting module was added.

Advancing the field of self-help requires replacing the individualistic author model with a collaborative, team-based public health approach. Because individual authors rarely empirically validate their commercial products across varied settings, future progress depends on institutional and multi-site team efforts involving researchers, educators, and healthcare professionals who continuously update and evaluate programs. 2050 is projected as a milestone year to assess whether instructional materials have truly advanced.

2. Effectiveness and Self-Regulation Theory

Self-administered treatments yield moderate effect sizes compared to control groups, often closely mirroring therapist-directed treatments for similar problems.

Meta-analytic summaries show overall effect sizes for self-administered treatments versus wait-list or no-treatment controls ranging from .57 to .87. Direct comparisons sometimes show therapist-directed treatments are more effective for specific disorders like phobias, but self-administered treatments prove equally effective for others like panic disorder and premature ejaculation.

Hirai and Clum evaluated anxiety comparisons showing therapist-directed treatments were more effective for specific phobias, social anxiety, PTSD, and OCD, but similar outcomes were found for panic disorder and test anxiety.

Studies evaluating self-administered treatments show that participants tolerate the approach well. Gould and Clum reported a dropout rate of 9.7% for self-administered treatments and 8.6% for controls across 40 studies, while Hirai and Clum found an anxiety self-administered treatment dropout rate of 12.3%, which compares favorably to traditional psychotherapy dropouts.

Self-Regulation Models

Psychological theories of self-regulation adapt basic cybernetic principles, operating like a home heating thermostat through standards, sensors, comparators, and activators.

Human behavior is regulated by identifying goals or standards, initiating behaviors, monitoring accomplishments, comparing actual levels to goals, and adjusting actions when discrepancies are found. Carver and Scheier use strict control theory, while Bandura and Kanfer incorporate cognitive, learning, and self-efficacy elements.

Kanfer and Bandura view self-regulation as proceeding through three distinct stages:

self-monitoring or self-observation;
self-evaluation or self-reflection;
self-reinforcement or self-reaction.

Self-monitoring provides information to establish realistic goals and direct behavior. Self-evaluation compares current behavior against standards related to your current concern. Self-reinforcement involves rewarding or punishing yourself based on performance to maintain motivation.

Febbraro and Clum's meta-analysis found that self-monitoring alone yielded a small effect size compared to no treatment, whereas combining components produced larger effects. Adding goal-setting to self-monitoring yielded a moderate effect size, and adding feedback produced a large effect size.

3. Anxiety Disorders and Depression

Cognitive-behavioral bibliotherapy and computer-guided programs provide empirically supported treatments for panic disorder, obsessive-compulsive disorder, and depression.

Randomized controlled trials evaluating cognitive-behavioral self-help books and online programs for panic disorder demonstrate significant reductions in physical and cognitive panic symptoms. Four out of five direct comparison studies show effects equivalent to therapist-directed treatment.

Gould and Clum found reading Coping With Panic plus minimal therapist contact significantly reduced panic attacks, with 73% and 83% of participants having zero panic attacks posttreatment in respective trials by Gould and Lidren. Research covers 13 randomized, controlled self-help intervention studies for panic disorder. These programs have an 8.4 weeks average duration of self-help treatment and a 16.8% average dropout rate across self-help groups. Other utilized texts include Living With Fear and Mastery of Your Anxiety and Panic.

Self-administered interventions are also effective for treating specific phobias, though they often yield inferior outcomes compared to direct therapist-led exposure. Studies targeting subclinical and clinical phobias using self-directed exposure, computer-aided programs, and audiotapes show significant symptom reduction and sustained gains. Specific phobia affects 11% of people in their lives, across 10 controlled treatment studies. These interventions have a 5.8 weeks average duration, an 8.6% average dropout rate during treatment, and 94.2% female participants.

Hellström and Öst tested therapist-directed exposure versus home or clinic manual-based treatments. They found 90% of the therapist group could hold a spider posttreatment, compared to 50% for tailored book reading in the clinic and 10% at home.

Anxiety and Phobias

Most self-directed treatments for social anxiety instruct you to expose yourself to feared social situations, whereas therapist-directed interventions frequently utilize active exposure within group or contrived contexts. Self-help interventions are as effective as therapist-directed interventions for subclinical social anxiety, but individuals with diagnosed social phobia are more effectively treated by therapist-directed interventions. Abbott et al. found that bibliotherapy produced moderate reductions in social phobia symptoms, while therapist-directed interventions produced 50 to 100 percent greater reductions on clinician-rated symptom severity at posttreatment. Social phobia self-help treatments average 5.6 weeks in duration with a 12.6 percent average dropout rate.

Computer-guided behavior therapy with minimal clinician contact is effective for treating obsessive-compulsive disorder. It can produce outcomes similar to therapist-directed behavior therapy on several measures. Obsessive-compulsive disorder treatments rely on repetitive exposure and response prevention. Computer- and telephone-guided programs like BT STEPS guide you through education, assessment, and ritual prevention exercises.

Complete three steps for education and assessment
Complete six treatment steps for practicing self-exposure and ritual prevention

Greist et al. compared computer-guided telephone-based behavior therapy with therapist-directed behavior therapy and relaxation training. BT STEPS yielded outcomes similar to therapist-directed treatment on time spent on rituals, depression, and social adjustment. Patients had 10 weeks allowed to complete treatment in this study, while Kenwright et al. evaluated BT STEPS over 17 weeks with 1.25 hours total time of nine scheduled support calls.

Online and manual-based self-help programs utilizing cognitive-behavioral writing exposure can significantly reduce trauma-related symptoms and depression in trauma victims. Programs that guide you to write about your traumatic events and apply positive cognitive reappraisal or mastery approaches decrease avoidance and intrusive symptoms.

Progress from the least anxiety-provoking component to the most anxiety-generating component like exposure
Test mastery of material using online questionnaires before proceeding to the next module

Hirai and Clum developed an 8-week online self-help program consisting of four cognitive-behavioral modules that decreased avoidance behavior, intrusive symptoms, state anxiety, and depressive symptoms compared to a wait-list control. Schlenger et al. noted that 11.2 percent of residents in New York City developed PTSD after the 9/11 attack, and Galea et al. found 20 percent of those living close to the World Trade Center received a PTSD diagnosis. Interapy online programs used a 5-week treatment period.

Bibliotherapy for Depression

Cognitive and behavioral bibliotherapy programs are empirically supported, highly effective treatments for mild to moderate depression across general adult, older adult, and adolescent populations.

Meta-analyses demonstrate that bibliotherapy produces robust effect sizes comparable to traditional psychotherapy modalities for depression, with treatment gains sustained over long-term follow-ups up to two to three years. Cuijpers reported an overall effect size of 0.83 for bibliotherapy, while Gould and Clum found an effect size of 0.74, and Robinson et al. noted an effect size of 0.73 in a review of traditional psychotherapies.

Scogin et al. evaluated cognitive bibliotherapy based on Feeling Good compared to wait-list and attention control conditions, finding significantly greater improvement in older adults. Client characteristics such as initial depression severity, reading level, concentration ability, and treatment expectations moderate the effectiveness of self-administered treatments. Individuals with high symptom severity, severe concentration problems, active suicidality, or comorbid disorders are generally better served through more intensive, traditional therapeutic courses rather than pure self-help. McKendree-Smith found that higher initial levels of depression correlated with less improvement, and that the percentage of pages read was directly correlated with treatment outcome.

Assess the client's treatment preferences and attitudes toward self-administered treatment before recommending it
Explain the rationale behind self-help including cost-effectiveness and empirical support
Monitor the individual's progress regularly using objective depression inventories right from the start
Create a maintenance program if the depression improves to address potential future relapses

4. Childhood and Eating Disorders

Epidemiological studies indicate that 15 to 25 percent of children in the general population suffer from a psychological disorder. Despite this prevalence, fewer than one in five children with diagnosable symptoms have contact with a mental health provider.

Self-help and parent-facilitated interventions offer a practical alternative for children's behavioral and emotional disorders by circumventing severe access barriers, high costs, and treatment stigmas.

Childhood Behavioral Disorders

Parent training using structured instructional tools allows caregivers to manage problematic behaviors at home with minimal therapist contact. Phelan's 1-2-3 Magic technique was evaluated for managing children's disruptive behaviors and sleep problems.

Digital delivery methods such as CD-ROMs, computer programs, and video formats disseminate psychological strategies to families inexpensively while maintaining treatment efficacy. Evaluations of programs like Smart Fit and multimedia tools assessed improvements in children with conditions such as cystic fibrosis across 40 families over a 3-month follow-up.

Use the 1-2-3 Magic technique for managing difficult child behaviors

Eating Disorders

Combining self-help manuals with minimal therapist contact helps patients lower symptom frequency, although long-term weight and shape attitudes remain challenging to alter. Carter et al. found that approximately 54 percent of participants in CBT self-help and 50 percent in attention-placebo control reported at least a 50 percent reduction in binge eating or purging, compared to 31 percent in a wait-list control.

Studies across North America and Europe demonstrate that structured cognitive-behavioral therapy manuals spanning 8 to 20 weeks help reduce binge eating and purging. Improvement rates vary between 22 percent and 88 percent. Cooper and colleagues used a CBT manual called Bulimia Nervosa and Binge Eating: A Guide to Recovery with supervision from a social worker, achieving an 85 percent decrease in binge eating and an 88 percent reduction in vomiting.

Assisted and guided self-help programs for bulimia nervosa and binge eating disorder significantly reduce binge eating and purging frequencies.

The Internet-delivered Student Bodies program effectively prevents eating disorders and reduces weight and shape concerns in young women through 8 sessions. Taylor and colleagues tracked 481 female undergraduate students for up to 3 years and found a significant reduction in weight and shape concerns as well as a reduced time to onset of eating disorders for at-risk participants.

Complete psychoeducational readings made available at the beginning of each session week
Monitor events triggering body image dissatisfaction using the body image journal
Post reactions and provide emotional support in the moderated asynchronous electronic discussion group

Clinicians can recommend self-help books like Fairburn's Overcoming Binge Eating as the first step in a stepped-care approach for eating disorders. Professionally delivered interventions produce a 40 to 70 percent recovery rate over the long term.

Recommend self-help books as the first step in care
Maintain oversight over patient treatment and adherence
Follow up in 2 months to determine if the intervention is helpful
Advance the patient to a more intensive treatment if self-help fails

5. Sexual Dysfunctions and Insomnia

Structured self-help tools, sensate focus therapy, and cognitive-behavioral techniques effectively address sexual dysfunctions and chronic insomnia.

Jack Annon's PLISSIT model matches the depth of sexual intervention to the complexity of the problem. You sequence interventions from least to most intensive, minimizing unnecessary deep psychotherapy.

Provide Permission to alleviate normal worries
Deliver Limited Information regarding anatomy and physiology
Offer Specific Suggestions like masturbation techniques, lubricants, or the squeeze technique
Administer Intensive Treatment for complex or deeply rooted problems

Giving a woman experiencing difficulty having an orgasm permission to masturbate often resolves the problem without formal therapy. Sensate focus therapy uses nondemanding touching exercises to help couples build positive experiences and reduce performance anxiety. Rooted in Masters and Johnson's work, sensate focus establishes a relational frame, bans intercourse initially, and uses structured touching exercises.

Lie on a soft surface in the nude with one partner taking an active role and the other a receptive role
Enjoy receiving pleasurable touches without needing to perform or become sexually excited
Express unpleasant touches clearly, specifically, and gently
Do not touch erogenous zones including penis, breasts, vagina, and anus during the initial phase
Explore various touching styles such as light strokes, long slow strokes, or massaging
Change roles and places after the agreed time has passed

Couples engage in nongenital pleasuring exercises where one partner strokes the other's backside without touching erogenous zones while remaining free from demands for sexual arousal. You can start pleasuring exercises with a duration of 5 minutes. Binik et al. developed Sexpert, a computerized expert system where couples sit before a microcomputer to answer multiple-choice and quantitative questions during a one-hour session. A user acceptance pilot study involved 15 patient and non-patient couples. van Lankveld et al. evaluated 81 applicants in a pilot study offering e-mail-only sex therapy, enrolling 39 participants with an average of 4 hours of therapist time spent per treated participant. At posttreatment, 66 percent of participants indicated their problem was improved or much improved.

Insomnia Management

While sleep medications remain widely used for short-term relief, cognitive-behavioral treatment is the established preferred long-term intervention for chronic insomnia. More than 50 clinical trials involving over 2,000 patients demonstrate the efficacy of CBT, helping 75 percent of insomnia patients and successfully weaning 50 to 84 percent off hypnotic medications. You can achieve a 50 percent average decrease in time to fall asleep and wake time after sleep onset.

Research criteria rely on specific quantitative thresholds. You assess whether it takes more than 30 minutes to fall asleep at least three times per week.

Assess whether it takes more than 30 minutes to fall asleep at least three times per week
Check for nocturnal awakenings or early morning awakenings occurring three or more times weekly
Verify that sleep difficulties cause significant daytime distress or functional impairment and have lasted for more than one month

Lichstein et al. provided empirical support for defining research-grade insomnia using specific latency and duration criteria, recommending a 6 months duration specifier for chronic sleep problems. Behavioral management utilizes stimulus control and sleep restriction.

Avoid daytime napping and go to bed only when feeling sleepy
Use the bedroom exclusively for sleep and sexual activity, establishing a consistent nightly presleep routine
Get out of bed immediately if unable to fall asleep within approximately 20 minutes, repeating as necessary through the night
Reduce total time in bed to match baseline total sleep time, ensuring a sleep window of no less than 5 hours
Increase the sleep window in 15- to 30-minute increments weekly until reaching 85% sleep efficiency

Researchers note that insomniacs must execute stimulus control rules consistently throughout the night, which may require leaving the bed three or four times during severe sleeplessness. You must also target physiological and cognitive hyperarousal.

Practice progressive muscle relaxation by systematically tensing and relaxing different muscle groups in the body
Use imagery training, meditation, or self-hypnosis scripts before bedtime to facilitate sleep onset
Challenge maladaptive beliefs about sleep requirements and decatastrophize thoughts regarding the consequences of a poor night's sleep

Clinicians recommending self-help books must ensure materials include specific evidence-based elements.

Include a screening test or detailed information to distinguish insomnia from sleep apnea
Provide detailed stimulus control guidelines kept separate from general sleep hygiene advice
Provide a progressive muscle or imagery relaxation script
Offer recommendations for lifestyle changes conducive to good sleep
Include a sleep diary tracking time to bed, time out of bed, sleep onset latency, total sleep time, awakenings, wake time after sleep onset, sleep quality, and medication use
Provide information designed to correct faulty beliefs about sleep and medications

You must actively monitor compliance with stimulus control.

Have clients self-monitor sleep with a log and check it every session to maintain a regular rising time regardless of sleep duration or quality
Emphasize the need to get out of bed when unable to fall asleep
Ask clients if they leave the bedroom every time sleep onset is delayed as directed by stimulus control
Problem-solve around adherence to stimulus control by suggesting preplanned activities after leaving the bed
Integrate insomnia management principles with other CBT interventions to consolidate general learning

6. Addictive Behaviors and Smoking Cessation

Self-help manuals incorporating motivational interviewing and cognitive-behavioral strategies assist in reducing problem drinking and quitting cigarette smoking.

Many motivationally based self-help programs for problem drinking rely on the FRAMES framework to structure their guidance and feedback. The FRAMES acronym guides the delivery of self-help interventions by emphasizing specific therapeutic components tailored to the communication medium, particularly for mail or Internet delivery.

Generate Feedback based on a detailed assessment
Emphasize the client's Responsibility for changes
Provide clear Advice to reduce drinking
Offer a Menu of strategies for accomplishing goals
Adopt an Empathic style
Promote Self-efficacy

Comprehensive self-help books such as "Saying When" and "So You Want to Cut Down Your Drinking" utilize cognitive-behavioral therapy, motivational interviewing, and relapse prevention principles. They feature tools like self-monitoring forms, diaries to record previous drinking, and guidelines on managing cravings and drink refusal.

Cunningham and colleagues used the self-help book "Saying When" which presents a five-step process including taking stock, coping with temptation, goal-setting, developing strategies to meet goals, and maintaining progress.

Heather and colleagues used a 56-page manual titled So You Want to Cut Down Your Drinking. The maximum outcome follow-up period examined across the reviewed studies is 12 months.

Smoking Cessation

Nicotine replacement therapies substitute tobacco-derived nicotine to prevent withdrawal while quitting, and their quit rates double when combined with behavioral support. Over-the-counter and prescription replacement options—such as gum, patches, nasal sprays, and inhalers—help stabilize nicotine levels while users break daily smoking routines. Combining these products with psychotherapy significantly enhances success rates.

Schwartz found that using nicotine gum alone yielded a median abstinence rate of 11%, whereas combining it with behavior therapy increased the median abstinence rate to 29%.

Replace nicotine formally obtained from tobacco while stopping smoking behavior
Maintain nicotine levels initially and then slowly reduce them
Seek adjunctive psychotherapy to improve usage compliance

A structured, daily self-directed smoking cessation program with minimal contact significantly reduces nicotine consumption and dependence. The IQ* program requires daily exercises completed in under ten minutes over eight weeks, using nicotine fading, self-monitoring, and cue sensitization.

Thirteen adults with a mean smoking history of 36 years participated in the IQ* program, where 8 completers showed significant decreases in nicotine dependence. Participants had a mean age of smoking onset of 15 years and a current daily smoking range of 15 to 30 cigarettes with an average of 20.85. Completers achieved an average reduction in initial smoking rates of 81.54 percent at termination and 75.42 percent at follow-up, alongside a 50 percent abstinence rate.

Engage in a brief daily exercise to be completed in 10 minutes or less.
Graph past and current levels of smoking on the third day of every week.
Read, follow, and complete the activities within the manual daily in sequential order.

7. Dieting, Weight Management, and Primary Care

Popular diets fall into Low-Cho, Low-Fat, and Bal categories. Researchers like Dansinger et al. and Gardner et al. compared diets such as Atkins, Zone, Ornish, Weight Watchers, and LEARN in 12-month trials. The Atkins diet produced an average weight loss of 4.7 kg after one year in Gardner et al.'s study. Long-term use of the Ornish diet yielded a 32 percent decrease in serum cholesterol concentrations. Conversely, long-term Atkins diet use produced a 25 percent increase in serum cholesterol values.

Nondieting wellness interventions and Internet-based programs prevent weight gain, while primary care settings successfully integrate self-administered therapies into stepped-care models.

Bacon et al. (2002) randomly assigned obese women to either a dieting or nondieting condition attending 24 weekly sessions. The nondieting group achieved superior psychological improvements, lower body image avoidance, significantly fewer attributions of personal failure, and much lower dropout rates. The dieting group experienced a 33 to 41 percent dropout rate at mid- and posttreatment. The nondieting group experienced an 8 percent dropout rate at mid-treatment with no further dropouts. 38 and 35 percent of the dieting group endorsed the failure item at mid-treatment and 12 months. Only 5 and 7 percent of the nondieting group endorsed the failure item at the same junctures.

Weight Management

The Guide to Health (GTH) program combines individualized content, step-count pedometer goals, physical activity planners, and fast-food meal planners. In a randomized trial involving 14 churches with 834 participants, control participants gained an average of 1.34 lbs, while GTH-only participants lost an average of 0.29 lbs, and GTH-plus participants lost an average of 0.88 lbs at post-test. Participants had a mean age of 52.2 years and a mean BMI of 29.0.

Calculate baseline mean steps per day using a provided pedometer.
Increase baseline step counts gradually by 3000 steps per day for 5 days per week in increments of 500 steps per week.
Use the physical activity planner to assist in increasing step counts.
Use the fast-food meal planner to plan lower calorie and lower fat meals in restaurants.

Primary Care Integration

Proudfoot and colleagues (2004) randomly assigned 274 primary care patients with depressive or anxiety disorders to Beating the Blues or treatment as usual, finding significant improvements in depression, anxiety, work and leisure impairment, and aversive attributions. Prochaska et al. (2000) evaluated PACE+ with 224 adolescents and 281 adults across 12 clinics, finding high satisfaction and that it required only 5 to 8 minutes of provider discussion time.

Screen for multiple behaviors including physical activity level and dietary behaviors regarding fat, fruit, and vegetable intake.
Identify patients at risk for disturbed eating practices.
Encourage patients not meeting guidelines who are ready for change to select one physical activity and one dietary behavior to target.
Encourage patients who already meet health guidelines to create plans for relapse prevention.
Identify the benefits of change, specific goals, strategies to reduce barriers, and support persons in action and relapse-prevention plans.

Conclusion

Self-administered psychological treatments and instructional manuals offer empirically supported, cost-effective interventions for a wide range of mental health and behavioral challenges when integrated within a stepped-care model. These tools function within an ecological framework where individual self-regulation interacts with broader social, environmental, and healthcare systems. You can successfully navigate self-help options by evaluating their empirical backing and matching specific formats to your unique psychological needs.

Assess your specific symptoms and functional impairment to determine if a self-help format matches your clinical needs.
Select instructional books or computer programs that feature empirical support and transparent evaluation data.
Establish a structured schedule for reviewing written assignments, monitoring target behaviors, and tracking symptom reduction.
Supplement independent work with professional consultation if your progress stalls or safety concerns emerge.

10 Key Ideas

Media-based self-help includes instructional materials delivered independently of intensive professional contact, with bibliotherapy historically representing the largest category.
Self-administered treatments yield moderate effect sizes ranging from .57 to .87 compared to control groups, often closely mirroring therapist-directed treatments.
Human behavior is regulated through cybernetic principles involving standards, sensors, comparators, activators, and stages of self-monitoring, self-evaluation, and self-reinforcement.
Cognitive-behavioral bibliotherapy and computer-guided programs provide empirically supported treatments for panic disorder, obsessive-compulsive disorder, and depression.
Parent training using structured instructional tools allows caregivers to manage problematic behaviors at home with minimal therapist contact and circumvent severe access barriers.
Assisted and guided self-help programs for bulimia nervosa and binge eating disorder significantly reduce binge eating and purging frequencies.
Structured self-help tools, sensate focus therapy, and cognitive-behavioral techniques effectively address sexual dysfunctions and chronic insomnia.
Cognitive-behavioral treatment is the established preferred long-term intervention for chronic insomnia, helping patients achieve a 50 percent average decrease in sleep onset latency.
Self-help manuals incorporating motivational interviewing and cognitive-behavioral strategies assist in reducing problem drinking and quitting cigarette smoking.
Nondieting wellness interventions and Internet-based programs prevent weight gain, while primary care settings successfully integrate self-administered therapies into stepped-care models.

Book summary “Handbook of self-help therapies”: summary

Summary text