Table 3

Content of the consensus questionnaire

1. Given the evidence (or lack or it) could you indicate the maximum and minimum number of guided self-help sessions you feel would be appropriate?

2. Given the lack of evidence could you indicate maximum/minimum session duration?

3. Could you indicate the time period the sessions should be delivered over?

4. What methods could we use to ensure that patients are familiarised to the treatment model, to communicate that they are expected to be the principal agent of change?

5. To what extent should we build in choices (face to face, telephone, email) in terms of how the guidance is provided to patients?

6. How can facilitators and materials reconcile the tension for patients between regaining control over their emotional wellbeing whilst accepting the need for help?

7. Should we ensure that the facilitation and materials in the self-help process include a theme of remoralisation (experience of improvement not the end point)? If so, how?

8. In the self-help process, to what extent should we explore the causal origins of a person's depression as opposed to its maintenance?

9. Are there factors which you think impact the development and maintenance of a therapeutic relationship within a guided self-help model? If so, which ones?

10. Whilst we cannot provide computer delivered materials, to what extent should we produce the material in a range of alternative media?

11. In choosing the self-help material we have determined that the material must be CBT based. However we are less certain about whether the material should also have the following attributes and would welcome your views.

How important are the following factors in your opinion

a. Material reflects patients' lay definitions of mental health problems

b. Material reflects patients' previous coping strategies (e.g. distraction)

c. Material contains information on recognition and relapse strategies

d. Material contains information on pharmacological interventions

e. Material contains information of aspects of living with depression that are not explicitly addressed by the intervention e.g. stigma, material support

f. Material contains information on a return to social functioning rather than symptom relief

12. Are there any other attributes that you believe are essential, if so which ones?

13. What specific interpersonal competencies should the facilitator possess in order to develop a therapeutic relationship/alliance with the patient?

14. What specific therapeutic competencies should the facilitator possess in order to engage the patient to 'self manage?'

15. Should we assume existing training (professional or other) leads to these facilitator (both interpersonal and therapeutic) core competencies? If yes, what type of and level of core training should facilitators have already undergone to select them? If no, what education and training should be provided?

16. What group of health-care workers, if any, would be best suited to deliver guided self-help?

Lovell et al. BMC Psychiatry 2008 8:91   doi:10.1186/1471-244X-8-91

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