Eligible randomised controlled trials (RCTs) evaluated guided self-help therapy versus face-to-face treatment in patients with depression or anxiety and reported outcomes on depression and/or anxiety. Guided self-help therapy was defined as a treatment where procedures were written down or presented in an audio or video document, through which patients had to work more or less independently with limited contact with therapists. Face-to-face therapy had to use the same format and content as the guided self-help therapy, but had to use individual or group treatment sessions to deliver the therapy. Studies where a diagnostic interview was used to establish the presence of depression or anxiety disorder were included. Studies of children and adolescents were excluded, as were studies that evaluated virtual reality treatments.
Most studies recruited adults in general, the remaining studies recruited students or a more specific population (such as older adults or adults with comorbid substance use). Most studies were of patients with depression or panic disorder and other studies were of patients with social phobia, specific phobias or phobias in general. Most face-to-face treatments used an individual treatment format. The number of sessions of face-to-face treatments ranged from four to 16. The guided self-help therapies used a self-help book, a stand-alone computer programme, an Internet-based intervention or an audio recording to deliver the treatment, with a self-help book being the most common. Included studies were conducted in USA, UK, Australia, Sweden and Canada.
The authors did not state how many reviewers assessed studies for inclusion.