From specialist care to self directed treatment: empower the patient and spare the clinician. (Editorial)

Empower the patient and spare the clinician

We can no longer escape the conclusion that the number of patients who can be helped by treatment that depends on technology is limited by constraints on resources. This applies as much to psychological as to physical treatments. The specialist knowledge, skills, and time required for one to one psychotherapy, for example, are also limited resources. A possible way to resolve this dilemma may be for some patients to use self directed treatment manuals, thereby saving scarce resources for those who need them most. An additional benefit of this approach, in which skill is shared with the users of health care, is that it enables patients to become more actively involved in their own health care.[1] Arguments that such methods increase users' mastery and self esteemm make a virtue out of necessity. The important questions are whether self directed treatment works and for which conditions.

Despite the overwhelming number of books on health problems that have been written specifically for the public, relatively few actually teach users how to deal with their problems. Even fewer of these texts have been tested against other interventions.

One approach of self directed treatment has been to educate people about harmful lifestyles and to …