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Saturday, October 24, 2020  Spokane, Washington  Est. May 19, 1883
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Dr. Zorba Paster: Guided self-help makes a positive impact on mental health

By Dr. Zorba Paster For The Spokesman-Review

There are a ton of self-help books out there – all you have to do is go into a bookstore, a brick and mortar one, to see the shelves lined with them. In fact, I wrote one years ago, “The Longevity Code: Your Personal Prescription for a Longer, Sweeter Life.”

As for self-help apps, there are tons of them, too, with more and more coming every day.

But the questions I have gotten time and time again are: How much do they work? How good are they? Don’t you need that one-on-one interaction to make a difference?

Now, I grant you it’s true that a personal interaction with a good therapist is an incredible thing to be treasured. It works well. But there are obstacles to this – cost, availability, taking off from work, the list goes on and on. For many people, this challenge is just too much.

So back to the question: Does self-help work?

I think the answer came in a recent issue of the Lancet Global Health journal. A study found guided self-help reduced psychological distress and improved well-being in areas where there was a humanitarian crisis. It helped people cope with adversity and psychological distress and meaningfully improved their function.

This randomized study compared usual care, which wasn’t very much, to guided self-help in 700 Sudanese refugee women living in Uganda. We know one-on-one psychological treatment helps, but in a low-resource environment, this reaches so few people.

The guided meditation was developed by the World Health Organization. It’s called Self-Help Plus; do a Google search to see what it entails.

Researchers were looking at mental health-based support and treatment for large numbers of people in disaster areas that would help them cope with their problems. Self-Help Plus is a five-session, pre-recorded audio course given by nonspecialist facilitators and coupled with a self-help book designed for low-literacy people. The program is given in groups of as many as 30 people at a time.

At three months, the treatment group had significantly less post-traumatic stress disorder, depression and explosive anger and great social well-being. At the start, nearly 85% said they were severely psychologically distressed; at the end, that dropped to 33%.

And the study showed it had staying power. People continued on that positive course for the next three months of follow-up.

So here’s what I pull from this study: First off, clearly this is something that might be used for groups suffering in this country after a disaster such as hurricanes and other natural disasters or shootings and other awful things that affect us in a group way.

We have first responders who work on the physical side of a disaster, but we need to train more first responders for evidence-based intervention for the psychological part of the disaster.

My spin: As I circle back to the original thought I had at the beginning of this column on self-help books and apps, my answer is yes, they do work.

There are some coming out every day in every way. If you’re suffering, you have many from which to choose. If one book, app or YouTube lecture doesn’t work for you, then try another.

It’s clear to me there is help out there – self-help – that doesn’t need an insurance card. Stay well.

Dr. Zorba Paster can be reached at

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