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When are self-help programs “helpful”?

February 2, 2017

About the Author

photo of Srini Pillay, MD

Srini Pillay, MD, Contributor

Srini Pillay, M.D. ( is Assistant Professor of Psychiatry (Part-Time) at Harvard Medical School. After graduating as the overall top medical student in South Africa, he completed his residency in psychiatry at McLean Hospital—Harvard’s largest freestanding … See Full Bio
View all posts by Srini Pillay, MD


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Liz Tebb
February 14, 2017

Not everyone is in the frame of mind to implement strategies. N

Alok Varshney
February 11, 2017

Dr Srini

Thanks for the insight I gained on combination of intuition and critical research for designing appropriate and best practices for vocational skilling and employment support for individual marginalised unemployed youth in India . This should help in raising effectiveness of our skill programs in India and other countries .


Alok Varshney

Sara Marshall
February 12, 2017

My problem with the Harvard posts are they usually aim at selling their books and products. I really object to the so-called social support popping up with insurance companies AARP MDX is the worst I’ve seen. They dust off old articles and barrage people with mail that is useless.

John M. Lind
February 10, 2017

Some of us need very serious help in a certain area. The problem is with chemical exposure (OPs + etc.) resulting in neurological and respiratory illness among employees in pesticide manufacturing, agriculture, and airline aircrew members. As an airline risk management professional, a nurse friend and I are seeking ways to reduce the airline health exposure that is causing death, disability and grounding of pilots and flight attendants. Less so among passengers because they do not live in this environment.
I have emails from the neurologically disabled desperately seeking help from alternative sources. They spend huge sums in this haphazard effort.
We will value any direction you can give us!!!!

February 10, 2017

One other essential criterion is not mentioned in this article: weighing the potential benefits against the actual or potential costs. How much, if any, harm will result if the method does not succeed for a given individual? Even if only a small percentage of individuals succeed with a given method, it might still be worth a try if there is little or nothing to lose. On the other hand, a high success rate does not necessarily make a method worth trying if a failed attempt would be physically, financially, or emotionally devastating.

Jay Yudof, MS, Certified Psychiatric Rehabilitation Practitioner
February 10, 2017

Sounds like a good framework to evaluate self-help toolsets. I also encourage folks to consider whether they are looking at the toolset for closing a skills or treatment gap (e.g., upon onset of a condition) versus supporting entertainment (e.g., cueing and reinforcing coping strategies).

For the latter, peer support groups are often a good resource. Good programs do not claim to replace professional psychotherapy or skills training programs, but often help people normalize and strengthen our own learned or innate coping capabilities. Expect a support group to offer 1)practical advice from your peers, 2)a non-judgmental environment, a leader trained in the model, but also trained not to give advice, 4)a sense of empathy, mutual aid, and mutuality, and 5)a chnace to help others (the “helper therapy” effect).

MCE Conferences
February 10, 2017

Good Post… I believe that a combination of the two is most valuable, and critical thinking applied to both “intuition” and “research” will help all of our interventions get better.

February 3, 2017

This article, despite it’s pneumonic, doesn’t offer folks a way to use research but leaves one to judge if a program ‘feels’ right, feels trustworthy and offers little guidance on how to use research nor how to vett expertise. Probably because these are difficult to do for a generic person as you say.

Dr. Pillay, you have highlighted the need for collaboration between practioners and researchers. As a teacher I have a lot of gut instincts, built up over decades of teaching, about which intervention will help which child and family. My instincts would benefit from a researchers careful attention and insights. A researcher would benefit from my more nuanced grouping of the populations being studied and paired with interventions. I suspect many self-help strategies have good and bad mingled. Researchers could begin with self-helpers, teachers, and practioners that they “feel are trustworthy” as “clincial experts” and co-design investigations that probe those instincts to hep caring people separate the best of their services for those they serve.
If you’d like to explore this idea by pairing a research scientist with my innvotive programs for social/language goals, I’d be delighted. -Erica, Learning Seeds Brookline

Srini Pillay
February 4, 2017

Thanks for your perspective, Erica. Yes, this article is not meant to be about how to use research. but rather, about how to think about the self-help that you are receiving. As you imply, research is the cornerstone of traditional medicine, and very valuable indeed. However, as you also point out, intuitive decisions also play a role because controlled trials do not necessarily reliably represent every person and there is no real way to tell if they do. I believe that a combination of the two is most valuable, and critical thinking applied to both “intuition” and “research” will help all of our interventions get better. Mostly, I think that both extremes—a blind overemphasis on the research, and no research at all—can both be problematic. My intention in writing this article was to provoke thinking about this. I have tremendous respect for teachers, and agree that intuition and research go well together in that context as well. I wish you all the best in finding a research scientist for your programs, and if I come across any helpful sources, I’ll mention them here. Thanks again for being a part of this discussion!

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