Self-directed Cognitive Behavioral Therapy
In the beginning of the DOC Project, the only resource that I had for my patients to deal with the stress of pain was the Feeling Good book. Inadvertently, I discovered that patients would notice significant improvement within a few weeks. Historically, I could not get a consultative visit with a psychologist within that period of time. David Burn’s book has been the cornerstone of the DOC project from the beginning. In response to a debate regarding an orthopedist’s role in dealing with mental health issues David Burns wrote me this letter. I have seen consistent and profound results with just having my patients use his book in addition to the free writing of thoughts. It is self-directed by the patients. My role has been making my patients accountable to fully engage in using his tools. Whenever possible I do work with a pain psychologist who has added a wonderful dimension to my patient’s care.
David Burn’s Letter
Thanks so much. There is evidence based on quite a bit of research that reading Feeling Good: The New Mood Therapy can have significant antidepressant effects. Dr. Forrest Scogin has reported (based on numerous controlled outcome studies published in Journal of Consulting and Clinical Psychology and other journals) that approximately 2/3rds of individuals seeking treatment for a major depressive episodes will be substantially improved or recovered within four weeks if they are given a copy of Feeling Good, with no other treatment offered during this time. Those patients did not need any further treatment, and maintained their gains during 3-year follow-up studies.
It is certainly not a panacea or cure-all, but does seem to help many people who are struggling with depression and anxiety. Some, of course, will need more than just a self-help book.
There are many techniques and ideas in Feeling Good, and there has not been much research on what the effective therapeutic “ingredients” might be. Research indicates that this is not a placebo effect, since a placebo book was not effective in a controlled study.
In my own research in clinical settings, we have seen that doing psychotherapy “homework” (such as reading Feeling Good between sessions, recording automatic negative thoughts, and so forth) does seem to have profound antidepressant effects.
All the best,
David D. Burns, M.D.
Adjunct Clinical Professor,
Department of Psychiatry and Behavioral Sciences,
Stanford University School of Medicine