A research team from Umeå University in Sweden have published a randomised controlled trial that investigates the importance of pacing when delivering bibliotherapy for people with panic disorder, i.e. should patients be ‘prescribed’ a full book as therapy all at once, or should they be given separate chapters each week?

The small trial randomised 28 participants to either 10 paced chapters or one book with 10 chapters. Short weekly telephone calls were made to all participants to try and increase compliance (M = 17.8 min, SD = 4.2).

Both treatment arms in the study showed promising results, with effects maintained up to 2 years and with within-group effect sizes (Cohen’s d) between 0.95 and 1.11. Pretreatment ratings of credibility were positively correlated with the change scores at both post-test and 2-year follow-up for three panic measures.

The researchers concluded:

Pacing of text material in bibliotherapy for panic disorder is not needed, and all material can be provided at once when the treatment is guided by a therapist.

Carlbring P, Maurin T, Sjömark J, Maurin L, Westling BE, Ekselius L, Cuijpers P, Andersson G. All at Once or One at a Time? A Randomized Controlled Trial Comparing Two Ways to Deliver Bibliotherapy for Panic Disorder. Cogn Behav Ther. 2011 Jun 28. [Epub ahead of print] [PubMed abstract]