Understanding Low Self-Esteem

Low self-esteem means not holding yourself in high regard. If you have low self-esteem, you might feel shy or anxious around other people, think of yourself as incapable or criticize yourself harshly. Some people with low self-esteem know that they judge themselves too harshly, whereas others hold onto their negative beliefs so strongly that they can feel like facts. Low self-esteem affects many people, and may make you more vulnerable to struggling with other mental health problems. Fortunately, there are helpful psychological approaches for improving your self-esteem. 

The Understanding Low Self-Esteem guide is designed to help clients with low self-esteem to understand more about their condition. As well as a clear description of symptoms and treatments, the guide explores key maintenance factors for low self-esteem including:

• Your core beliefs
• Unhelpful rules for living
• Speaking to yourself in a critical way
• Negative predictions and unhelpful behavior

• Scaffold knowledge. The guides are perfect during early stages of therapy to help your clients understand how their symptoms fit together and make sense.
• Reassure and encourage optimism. Many clients find it hugely reassuring to know there is a name for what they are experiencing, and that there are evidence-based psychological models and treatments specifically designed to help.
• De-mystify the therapy process. To increase your client’s knowledge of the therapy process and the ingredients that it is likely to involve. If you can help your clients to understand why an intervention is important (think exposure!) it can help encourage them to engage.
• Signposting. If you’re just seeing a client briefly for assessment, or you have a curious client who wants to know more, these resources can be a helpful part of guiding them to the right service.
• Waiting time not wasted time. When you’ve assessed someone but their treatment can’t begin right away, psychoeducation can help them learn about how therapy can help while they’re waiting.

• Case examples to help your clients relate to the condition, and to normalize their experiences.
• Jargon-free descriptions of symptoms, and descriptions of how they might affect your thoughts, feelings, and actions.
• A symptom questionnaire for screening assessment.
• An accessible cognitive-behavioral account of what keeps the problem going, or what stops it from getting better.
• A description of evidence-based treatments for that condition, including an overview of the ‘ingredients’ of a good cognitive behavioral approach.

• Silverstone, P. H., & Salsali, M. (2003). Low self-esteem and psychiatric patients: Part I–The relationship between low self-esteem and psychiatric diagnosis. Annals of General Hospital Psychiatry, 2(1), 1-9.
• Kolubinski, D. C., Frings, D., Nikčević, A. V., Lawrence, J. A., & Spada, M. M. (2018). A systematic review and meta-analysis of CBT interventions based on the Fennell model of low self-esteem. Psychiatry Research, 267, 296-305.
• Fennell, M. J. (1997). Low self-esteem: A cognitive perspective. Behavioural and Cognitive Psychotherapy, 25(1), 1-26.
• Padesky, C. A. (1990). Schema as self-prejudice. International Cognitive Therapy Newsletter, 6(1), 6-7.
• Korrelboom, K. (2015). COMET voor negatief zelfbeeld: competitive memory training bij lage zelfwaardeing en negatief zelfbeeld. Bohn Stafleu van Loghum.
• Whelan, A., Haywood, P., & Galloway, S. (2007). Low self‐esteem: group cognitive behaviour therapy. British Journal of Learning Disabilities, 35(2), 125-130.
• Morton, L., Roach, L., Reid, H., & Stewart, S. H. (2012). An evaluation of a CBT group for women with low self-esteem. Behavioural and Cognitive Psychotherapy, 40(2), 221-225.
• Waite, P., McManus, F., & Shafran, R. (2012). Cognitive behaviour therapy for low self-esteem: A preliminary randomized controlled trial in a primary care setting. Journal of Behavior Therapy and Experimental Psychiatry, 43(4), 1049-1057.
• Korrelboom, K., van der Weele, K., Gjaltema, M., & Hoogstraten, C. (2009). Competitive memory training for treating low self-esteem: A pilot study in a routine clinical setting. The Behavior Therapist.
• Korrelboom, K., Maarsingh, M., & Huijbrechts, I. (2012). Competitive Memory Training (COMET) for treating Low Self‐Esteem in Patients with Depressive Disorders: A Randomized Clinical Trial. Depression and anxiety, 29(2), 102-110.
• Korrelboom, K., Marissen, M., & van Assendelft, T. (2011). Competitive memory training (COMET) for low self-esteem in patients with personality disorders: A randomized effectiveness study. Behavioural and Cognitive Psychotherapy, 39(1), 1-19.