What do patients do before it starts? Coping with mental health problems on a CBT waiting list

Abstract

AbstractData from a patient survey on self-help and coping strategies during waiting time for CBT are reported. Individuals on an outpatient treatment centre waiting list received a short questionnaire assessing problem-related activities carried out in the interval before therapy (mean waiting time 69 days). A total of 306 patients with a wide range of reliably diagnosed mental disorders were assessed. Results showed that the vast majority of patients (~95%) instigated at least one form of coping or self-help activity related to their mental problem. Resource-orientated strategies were most often reported (88%), but ‘seeking information about the problem’ was also highly prevalent. About one third of persons reported additional health-care utilization. Higher rates of symptom distress and depression were associated with additional health-care utilization and with more passive coping strategies such as distraction. Active self-help strategies contributed to poorer depression outcome and were, thus, no indicator of good prognosis. Other coping strategies were not linked to outcome variables. It can be concluded that problem-related processes do start before treatment. A more systematic integration of self-help activities into the case-formulation and more systematic research on the related (motivational) processes are recommended.