The findings of a large-scale study conducted by the IBR research institute at the University of Twente reveal that a self-help course, where people learn to accept their psychological distress, is effective in reducing mild to moderate depression and anxiety. At the start of the study, 83 percent of participants were suffering from clinically relevant depression symptoms; by the end of the study, just 30 percent.
In the Netherlands, over 2.5 million people suffer from light to moderate depression or anxiety. This group has an increased risk of developing a depressive disorder. Researchers at the University of Twente have now shown that the self-help therapy Voluit Leven (live life to the full) with e-mail support is an effective method for combating mild to moderate depression or anxiety and improving people's mental health. The course incorporates a new form of behaviour therapy in which people learn to accept their negative thoughts and emotions while learning to do the things that are important to them.
A total of 376 people participated in the study. They were divided into three groups: the first group received intensive counselling by e-mail, the second group received minimal e-mail support and the third group, a control group, did not follow the course.
SIGNIFICANT DECREASE
Prior to conducting the study, online questionnaires were distributed to assess the extent to which the participants struggled with depression, anxiety and fatigue. These levels were measured again nine weeks after completing the course.
Before beginning the study, approximately 83 percent of participants were diagnosed with clinically relevant depressive symptoms. After the course, this number had dropped to just 30 percent compared to 70 percent in the control group.
Furthermore, the researchers also noted a greater reduction in anxiety and fatigue and an improvement in mental health in participants who had attended the course.
The researchers found no significant difference between the two groups receiving e-mail support. This led them to conclude that the degree of e-mail counselling is irrelevant. However, no e-mail support is not an option, according to Ernst Bohlmeijer. "Previous research shows that without e-mail support many people lack the motivation to complete the course under their own steam."
VOLUIT LEVEN SELF-HELP COURSE
The study was based on the Dutch self-help course Voluit Leven. Participants were given a book and an audio CD and were asked to read a chapter a week and complete a range of mindfulness exercises. Participants spent a few hours a week on the course. The course is based on Acceptance and Commitment Therapy (ACT) combined with mindfulness exercises. ACT is a new form of behaviour therapy in which people learn to accept their negative thoughts and emotions rather than trying to avoid or control them. The mindfulness strategies teach people to live more in the here and now and to become aware of their automatic response patterns.
STEPPED CARE
The researchers claim that the self-help course would work well within a stepped care model. Bohlmeijer: "People with milder symptoms can be given cheaper and less intensive treatment, such as this self-help course where the therapist spends a limited amount of time with the patient. Those requiring more intensive treatment would be offered face-to-face support."
THE PSYCHOLOGY OF LIVING CONGRESS
The results of this study will be officially presented on 19 November at the Psychology of Living Congress. This congress is aimed at academics and professionals (including psychologists, psychiatrists, social workers, prevention workers, mental health carers and nurses) and managers working in somatic care for adults and the elderly. More information on the conference is available here. The book 'The psychology of living' and 'Storying later life: Issues, investigations and interventions in narrative gerontology' will be presented during the congress.
RESEARCH
The research was carried out by Martine Fledderus, Ernst Bohlmeijer, Marcel Pieterse and Karlein Schreurs in the research group Psychology & Communication of Health & Risk at the University of Twente's IBR, Research Institute for Social Sciences and Technology. The course was developed with financial support provided by the Innovatiefonds health insurance company and the Fonds Psychische Gezondheid (the Netherlands foundation for mental health).
