Evaluation of a bibliotherapy manual for reducing psychological distress in people with depression: a randomized controlled trial


  • Wallapa Songprakun,

    1. Wallapa Songprakun PhD RN, Associate Dean for Academic Affairs, McCormick Faculty of Nursing, Payap University, Chiang Mai, Thailand
    Search for more papers by this author
  • Terence V. McCann

    1. Terence V. McCann PhD RN, Professor of Nursing Research, School of Nursing and Midwifery, Victoria University, Melbourne, Australia
    Search for more papers by this author

W. Songprakun: e-mail: swallapa@yahoo.com


Aim.  This article reports a study to evaluate the efficacy of a self-help manual in reducing psychological distress in individuals with moderate depression.

Background.  The prevalence of depression in Thailand is increasing markedly (e.g. from 56–197 per 100,000 population between 1997–2007).

Design.  We conducted a randomized controlled trial with 54 outpatients with depression in Chiang Mai Province in Thailand.

Method.  Participants were assigned randomly to an intervention or control group. The intervention group participants were given a self-help manual in addition to standard care and treatment while the control group received standard care and treatment. Psychological distress was measured with the Kessler Psychological Distress Scale. Data were collected between October 2007–April 2008.

Results.  The findings showed statistically significant differences between both groups in their levels of psychological distress (e.g. tiredness, hopelessness, restlessness). At post-test, the distress scores of the intervention group were lower than those in the control group. Between post-test and 1-month follow-up, distress scores continued to decrease steadily in the intervention group but only decreased slightly in the control group.

Conclusion.  The findings affirm the benefits of bibliotherapy or self-help therapy in book form in helping to reduce psychological distress in people with moderate depression. The approach is easy to use and can be incorporated as an adjunct to standard care and treatment. Bibliotherapy can be used by community mental health nurses and other clinicians to reduce psychological distress and promote recovery in people with moderate depression.