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An alarming number of college students suffer from depression, which is often accompanied by struggles with anxiety and feeling inadequate compared to others (i.e., stigma). Seeing a counselor in person is challenging for many students due to wait times or feeling embarrassed or shameful. Using self-help books may be a helpful alternative for depressed students, but these books are not often tested in formal studies, and getting students to use self-help books over time is also difficult. Therefore, this study examined whether self-help books accessed online could help students with depression. We tested two books which use different approaches to treating depression: Acceptance and Commitment Therapy (ACT) and traditional cognitive behavioral therapy (CBT). While some students were randomly given one of these two books, we also allowed some students to choose themselves which book they wanted to use, since we believed this may help students feel more invested in the treatment and use the book more consistently over time. We enrolled 142 students in our study, who all read a self-help book over 10 weeks, while completing online surveys that asked about depression, anxiety, and depression-related stigma. We also asked students questions about how they look at their thoughts and feelings, since changes in these perspectives are often related to positive outcomes. Overall, students were satisfied with the book they used, however over half of them dropped out of the study by the 10-week mark. Over the course of the study, rates of depression, anxiety, and depression-related stigma lowered. There were only small differences in outcomes based on which book a student used. However, we found that students who were randomized to a book improved more than students who chose a book, and also read more of their book, which contradicted our predictions. Our results suggest that distributing online self-help books to college students can help them in managing their depression. The finding that allowing students a choice of book did not lead to them using it more, and in fact led to worse outcomes compared to the students who randomly received a book, suggests that simply providing students with a viable self-help book may be more important than incorporating their individual preferences. Given that we struggled to keep students engaged in our study over time, future research should look into other ways of promoting adherence to self-help treatments for depression.
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