Self-Help for Anxiety in an International Sample

Since I saw him present on some preliminary results at a conference 6 years ago, I’ve been following with interest University of Albany – SUNY professor John Forsyth’s, PhD, research on his self-help book, The Mindfulness and Acceptance Workbook for Anxiety. (The Workbook was recently published in a 2nd edition but the research is on the 1st edition.)

The Workbook is based on Acceptance and Commitment Therapy (ACT) principles, and it is designed to treat a wide range of anxiety-related problems (it’s “transdiagnostic”).

Self-help books have great potential to help people who don’t have access to or don’t want to pursue psychotherapy. Unfortunately, self-help books are rarely based on well-researched treatments, let alone studied themselves as standalone treatment. Dr. Forsyth and his co-author Dr. Georg Eifert have been working very hard to make their book an exception.

The Most Recent Study

In the most recent published study, Dr. Forsyth’s lab gave out copies of the Workbook to a large (503 people!) international sample—mostly American, with people from the UK, Canada, Australia, New Zealand, and other countries. Participants either received a copy immediately, or they were assigned to a 12-week waiting period before receiving a copy. They completed questionnaires before receiving the book and 12-months later, with follow-up assessment at 6 and 9 months. All waitlist participants received a copy after 12-weeks and completed the same post-treatment and follow-up measures.

Contrary to research studies of self-help books that may include regular phone consultation or other forms of therapist/researcher contact, Dr. Forsyth’s lab deliberately chose to not offer guidance for participants using the Workbook in order to examine how useful it was in the way it would normally be used.

What They Found

The sample included people with generalized anxiety disorder, OCD, major depressive disorder, panic disorder, obsessive-compulsive disorder, social anxiety disorder, and posttraumatic stress disorder, among other conditions.

Participants in both conditions showed improvements in anxiety, depression, worry, quality of life, mindfulness, and self-compassion after using the book, and some continued to show improvement at the 6 and 9-month follow-ups. As a comparison sample, people on the waitlist did not show significant improvement until after receiving and working through the Workbook.

What was really interesting is that some of the improvements in scores on the measures were comparable to studies that involved individual ACT treatment delivered by therapists.


Dr. Forsyth’s recent publication offers further evidence that The Mindfulness and Acceptance Workbook for Anxiety is a helpful, cost effective treatment option for people struggling with a variety of anxiety-related problems. In my work as an anxiety specialist, I recommend this book more than any other because of the strong research support behind it—and because it offers a number of useful worksheets and recordings.

Here’s a link if you want to check out the 2nd edition of The Mindfulness and Acceptance Workbook for Anxiety.

If you or some you know is struggling with anxiety-related problems, please check out the Portland Psychotherapy Anxiety Clinic.

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