Limitations included the lack of a «pure»
bibliotherapy condition, the low number of families who satisfactorily implemented the program in the email and client - initiated conditions, and lack of control / comparison groups able to be evaluated at follow - up.
That study showed improvement over a 12 - month follow - up for all three treatment
conditions, no advantage overall for the therapist - led groups compared to
bibliotherapy, and no difference in services delivered by nurses versus psychologists.