Journal of Clinical Psychology in Medical Settings

, Volume 17, Issue 3, pp 258–271 | Cite as

Bibliotherapy as a Treatment for Depression in Primary Care

  • Elizabeth V. Naylor
  • David O. Antonuccio
  • Mark Litt
  • Gary E. Johnson
  • Daniel R. Spogen
  • Richard Williams
  • Catherine McCarthy
  • Marcia M. Lu
  • David C. Fiore
  • Dianne L. Higgins


This study was designed to determine whether a physician-delivered bibliotherapy prescription would compare favorably with the prevailing usual care treatment for depression in primary care (that often involves medication) and potentially offer an alternative. Six family physicians were trained to write and deliver prescriptions for cognitive-behavioral bibliotherapy. Thirty-eight patients were randomly assigned to receive either usual care or a behavioral prescription to read the self-help book, Feeling Good (Burns, D. D. (1999). Feeling good: The new mood therapy. New York: HarperCollins). The treatment groups did not differ in terms of overall outcome variables. Patients in both treatment groups reported statistically significant decreases in depression symptoms, decreases in dysfunctional attitudes, and increases in quality of life. Although not statistically significant, the mean net medical expenses in the behavioral prescription group were substantially less. This study provided empirical evidence that a behavioral prescription for Feeling Good may be as effective as standard care, which commonly involves an antidepressant prescription.


Depression Primary care Bibliotherapy Usual care 


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Elizabeth V. Naylor
    • 1
  • David O. Antonuccio
    • 2
  • Mark Litt
    • 3
  • Gary E. Johnson
    • 1
  • Daniel R. Spogen
    • 1
  • Richard Williams
    • 1
  • Catherine McCarthy
    • 1
  • Marcia M. Lu
    • 1
  • David C. Fiore
    • 1
  • Dianne L. Higgins
    • 4
  1. 1.Department of Family & Community MedicineUniversity of Nevada School of MedicineRenoUSA
  2. 2.Department of Psychiatry and Behavioral SciencesUniversity of Nevada School of MedicineRenoUSA
  3. 3.Division of Behavioral SciencesUniversity of Connecticut Health CenterFarmingtonUSA
  4. 4.Tahoe Forest Multispecialty ClinicsIncline VillageUSA

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