Evidence-based group psychotherapy: using AGPA's practice guidelines to enhance clinical effectiveness

Dutch Design: Practice Guidelines for Group Treatment in the Netherlands

The American Group Psychotherapy Association (AGPA) Practice Guidelines helped inspire the Dutch Group Therapy Association (NVGP) to develop the Dutch Practice Guidelines for Group Treatment. In this article, we provide a short review of the history of Dutch group psychotherapy. We discuss socioeconomic developments in the Netherlands and their consequences for health care in general and group psychotherapy in particular. After that, we introduce the procedures of the NVGP Dutch Task Force in developing their Practice Guidelines including their process to reach expert consensus. We then elaborate on the similarities and differences between the American and the Dutch Practice Guidelines. We end by presenting future directions and thoughts on international cooperation in the development of evidence-based practice guidelines for group treatment.

Factors Contributing to the Status of Group Programming at Psychology Internship Sites

Previous research has explored administrative factors that may predict the health of group programs in college counseling centers. The current study seeks to extend this research to a more diverse set of mental health agencies. Directors of training (N = 171) at mental health agencies that host doctoral interns in psychology completed a survey about their site's group offerings, attitudes about group, and training opportunities for interns. Results were largely consistent with the previous study and suggested that efforts to foster expertise may predict better group program outcomes. While attitudes toward group were positive, sites could be doing more to cultivate their group programs, such as offering more regular trainings in group and allowing group coordinators to have hours to administer the programs.

Factor structure of a standards-based inventory of competencies in social work with groups

PURPOSES

This study extends previous findings on a measure of competencies based on Standards for Social Work Practice with Groups. The Inventory of Competencies in Social Work with Groups (ICSWG) measures confidence in performing the Standards. This study examines the latent structure of the Inventory, while illuminating the underlying structure of the Standards.

METHODS

A multinational sample of 586 persons completed the ICSWG. Exploratory factor analysis (EFA), reliability estimates, standard error of measurement estimates, and a range of validity tests were conducted.

RESULTS

The EFA yielded a six-factor solution consisting of core values, mutuality/connectivity, collaboration, and three phases of group development (planning, beginnings/middles, endings). The alphas were .98 for the scale and ranged from .85 to .95 for the subscales. Correlations between the subscales and validators supported evidence of construct validity.

DISCUSSION

The findings suggest key group work domains that should be taught and practiced in social work with groups.

Teens Engaged in Collaborative Health: The Feasibility and Acceptability of an Online Skill-Building Intervention for Adolescents at Risk for Depression

BACKGROUND

There is an ongoing need for effective and accessible preventive interventions for adolescent depression and substance abuse. This paper reports on a field trial of an online indicated preventive intervention, ProjectTECH, which is based on cognitive-behavioral therapy (CBT) techniques. The study aims to gather information about the feasibility and acceptability of this program. Secondary aims of this study were to examine the impact of the program on depression symptoms, perceived stress, positive affect, and substance use and to compare differences between groups that were led by a peer versus those that were led by a licensed clinician.

METHODS

High school students (n = 39) were recruited primarily through social media advertisements, and assigned to four groups of 8-12 individuals to collaboratively participate in an 8 week peer network-based online preventive intervention which were led by a trained peer guide or a licensed clinician. Participants were provided with didactic lessons, CBT-based mood management tools, and peer networking features, and completed quantitative and qualitative feedback at baseline, midpoint, end of intervention, and 1 month follow up.

RESULTS

The program attracted and retained users primarily from social media and was used frequently by many of the participants (system login M = 25.62, SD = 16.58). Participants rated the program as usable, and offered several suggestions for improving the program, including allowing for further personalization by the individual user, and including more prompts to engage with the social network. From baseline to end of intervention, significant decreases were observed in depressive symptoms and perceived stress (p's < .05). Significant increases in positive affect were observed from baseline to midpoint (p < .05) and no changes were observed in substance use, although the rate of substance use was low in this sample. While this study had low power to detect group differences, no consistent differences were observed between participants in a peer-led group and those in a clinician-led group.

CONCLUSIONS

Results of this study indicates that ProjectTECH, an indicated preventive intervention for high school-aged adolescents, demonstrates both feasibility, acceptability, and short-term, longitudinal psychological benefits for participants. Future iterations of the program may benefit from close attention to user interface design and the continued use of trained peer support guides.

Group Therapy and Dialectical Behavior Therapy: An Integrative Response to a Clinical Case

This response to a clinical group case originates from a dialectical behavior therapy (DBT) informed perspective. The article will first summarize the contributions of DBT to the treatment and understanding of borderline personality disorder (BPD) and multi-disordered clients with BPD or emotional dysregulation disorders. The place of group work in DBT will be described and then integrated with psychodynamic group therapy. This model will then be applied to the clinical vignette under discussion.

Group Psychotherapy in Canada

Canada is a relatively young country, spanning a vast geographical area; yet, it has matured quickly, becoming a diverse, prosperous, and proud nation. The development of group psychotherapy in this country has followed a similar path: its roots can be traced back to fairly recent times, but it has given rise to a rich fabric of practice, teaching, and research traditions. This article provides a brief synopsis of how group therapy is provided, taught, and studied in Canada. Given the growing emphasis on providing group therapy, we recommend that Canadian mental health services invest in continuing education in group therapy; accrediting bodies require that foundational knowledge in group principles be taught to all trainees; and institutions encourage researchers to engage clinicians in practice-based research.

Group process as a mechanism of change in the group treatment of anger and aggression

Angry reactions can present unique challenges to the process of conducting group therapy, especially when providing group treatment to participants who have histories of angry or aggressive behavior. This article briefly reviews relevant literature and describes a group-based violence reduction training program (VRTP). The VRTP conceptualizes anger and aggression from a frustration-aggression framework and employs treatment derived from research in the area of social problem-solving. An emphasis is placed on how fostering group experiences consistent with Irving Yalom's classic work on the theory and practice of group therapy can reinforce skill acquisition and general treatment responsiveness. Management of the group process is a plausible mechanism of change in group treatment of anger. We highlight the challenges and benefits of dealing with anger-infused communication while ensuring the integrity of the overall group process. Case examples are provided for illustration of VRTP. Future research can answer important questions about group process and mechanisms of change in group-based treatments for anger and aggression.

A developmental approach to gifts in long-term group psychotherapy extending from an anniversary ritual

Therapists have been quietly receiving gifts from patients for many years, but only recently have they been acknowledging and reporting such transactions. Most of the literature on the subject, which has been sparse, has been limited to the individual psychotherapy setting. In this article, we take up the issue within the group psychotherapeutic setting, surveying the literature, and describing our own experience with what became a gift-giving ritual in our long-term open-ended therapy group. We offer a group developmental perspective for informing therapeutic responses to gifts, and suggestions for the technical management of this kind of transaction.

Can the Clinician–Researcher Gap be Bridged? Experiences from a Randomized Clinical Trial in Analytic/Dynamic Group Psychotherapy

This article describes how four seasoned clinicians and group analysts working in public mental health services, experience their participation in a randomized trial of short-term versus long-term analytic group psychotherapy (20 or 80 sessions). The design makes it possible to integrate the research with regular clinical practice, and participation gives the institutions the opportunity to fulfil obligations of doing research, that are imposed on the Community Mental Health Centres. The experiences are mainly described from the clinicians’ position, but some comments from the research director are included. The collaboration across approximately five years is found to be interesting and rewarding. Based on the assumption that further steps are made to strengthen and develop the qualitative aspects of such projects, the clinicians recommend such collaboration as a feasible and useful way to build and maintain a bridge across the gap that too often seems to separate researchers and clinicians. This is assumed to be profitable for everyone involved, not least the patients.

Overcoming our resistances to "doing" evidence-based group practice: a commentary

This commentary focuses on how the articles in the group therapy issue of the Journal of Clinical Psychology: In Session can address the resistances that many group practitioners exhibit to "doing" evidence-based practice (EBP). The articles attempt to overcome the resistances to practicing evidence-based group therapy through a process of education and skills training. A major issue cutting across the articles is the narrow focus of incorporating empirical findings only from studies specifically examining psychotherapy groups. The author argues that incorporating research from the whole field of group dynamics research can increase the empirical basis for evidence-based practice.