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Gryesten JR, Poulsen S, Moltu C, Biering EB, Møller K, Arnfred SM. Patients' and Therapists' Experiences of Standardized Group Cognitive Behavioral Therapy: Needs for a Personalized Approach. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:617-633. [PMID: 37740814 DOI: 10.1007/s10488-023-01301-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 09/25/2023]
Abstract
Personalizing psychotherapy can be challenging within standardized group Cognitive Behavioral Therapy (CBT), in which sessions are structured according to a protocol and must accommodate the needs and preferences of multiple patients. In the current study, we aimed to examine patients' and therapists' experiences of standardized group CBT and identify their perceptions of different patient needs. Furthermore, we explored how these needs can inform possible content of add-on interventions for patients who are not improving as expected during group CBT.We conducted 21 individual in-depth interviews with patients with depression and their therapists about their experiences during group CBT with Routine Outcome Monitoring (ROM) and feedback. Interviews were analyzed by using a hermeneutic-phenomenological thematic analysis. Five themes, representing different patient needs, were identified: (1) Individual attention, (2) Psychological exploration, (3) A focus on the patient's life outside of therapy, (4) Extended assessment, and (5) Agreement on therapeutic tasks.The study supports that "one size does not fit all" when it comes to psychotherapy. Patients have varying needs when they are not making progress in therapy, and these needs, when unmet, can negatively impact the overall experience of group CBT. By acknowledging the unique needs of each patient and providing additional individual sessions as necessary, we can move towards a more personalized approach that maximizes the benefits of group psychotherapy.
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Affiliation(s)
- Jasmin Rejaye Gryesten
- Psychiatric Research Unit, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark.
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
| | - Stig Poulsen
- Department of Psychology, Faculty of Social Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Moltu
- Department of Psychiatry, District General Hospital of Førde, Førde, Norway
- Department of Health and Caring sciences, Western Norway University of Applied Science, Førde, Norway
| | - Elisabeth Belmudez Biering
- Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark
| | - Kirsten Møller
- Mental Health Centre Ballerup, Mental Health Services of the Capital Region of Denmark, Ballerup, Denmark
| | - Sidse Marie Arnfred
- Psychiatric Research Unit, Copenhagen University Hospital - Psychiatry Region Zealand, Slagelse, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Ramondo N, Pestell CF, Byrne SM, Gignac GE. Cognitive Behavioral Therapy and Hypnosis in the Treatment of Major Depressive Disorder: A Randomized Control Trial. Int J Clin Exp Hypn 2024; 72:229-253. [PMID: 38861252 DOI: 10.1080/00207144.2024.2354722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/09/2024] [Indexed: 06/12/2024]
Abstract
We investigated whether adding hypnosis to CBT (CBTH) improved treatment outcomes for MDD with a two-armed, parallel-treated, randomized-controlled trial using anonymous self-report and clinician-blinded assessments. Expectancy, credibility, and attitude to hypnosis were also examined. Participants (n = 66) were randomly allocated to 10-weekly sessions of group-based CBT or CBTH. LMM analyses of ITT and Completer data at post-treatment, six-month and 12-month follow-up showed that both treatments were probably efficacious but we did not find significant differences between them. Analyses of remission and response to treatment data revealed that the CBTH Completer group significantly outperformed CBT at 12-month follow-up (p = .011). CBTH also displayed significantly higher associations between credibility, expectancy and mood outcomes up to 12-month follow-up (all p < .05 or better), while attitude to hypnosis showed one significant association (r = -0.57, p < .05). These results suggest that hypnosis shows promise as an adjunct in the treatment of MDD but a larger sample size is required to fully test its merits.
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Affiliation(s)
- Nicolino Ramondo
- School of Psychological Science, University of Western Australia, Perth
- Douro House, West Perth, Western Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth
| | | | - Gilles E Gignac
- School of Psychological Science, University of Western Australia, Perth
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3
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Olisaeloka L, Udokanma E, Ashraf A. Psychosocial interventions for depression among young people in Sub-Saharan Africa: a systematic review and meta-analysis. Int J Ment Health Syst 2024; 18:24. [PMID: 38909254 PMCID: PMC11193191 DOI: 10.1186/s13033-024-00642-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/12/2024] [Indexed: 06/24/2024] Open
Abstract
BACKGROUND Depression among young people is a global health problem due to its rising prevalence and negative physical and social outcomes. The prevalence of depression and the treatment gap among young people in Sub-Saharan Africa (SSA) is higher than global estimates. Most psychosocial interventions for adolescent and youth depression were developed in high-income countries and less is known about their effectiveness in SSA. Due to contextual differences, findings from High-Income Countries (HICs) are less applicable to SSA. Yet, no systematic review of psychosocial interventions for depression among young people in SSA has been conducted. METHODS A systematic literature search of four databases (Medline, Web of Science, PsycInfo, and Cochrane library) was conducted. Experimental studies published before May 2024 that evaluated the effect of psychosocial interventions on depressive symptoms among young people (aged 10-24 years) in SSA were included in the systematic review. Effect sizes (Hedge's g (g)) indicating differences between intervention and control groups were calculated using a random effects model. RESULTS Twenty-two eligible studies were identified for the systematic review, of which eighteen randomized control trials (RCTs) involving 2338 participants were included in the meta-analysis. The findings revealed that psychosocial interventions significantly reduced depressive symptoms (g = -1.55, 95% CI -2.48, -0.63), although heterogeneity was high (I2 = 98.8%). Subgroup analysis revealed that efficacy differed significantly by intervention type, with Cognitive Behavioural Therapy (9 studies) showing the strongest effect (g = -2.84, 95% CI -4.29; -1.38). While Wise Interventions (a form of positive psychology interventions; 2 studies) had a moderate effect (g = -0.46, 95% C.I -0.53, -0.39), Interpersonal Psychotherapy (2 studies; g = -0.08, 95% CI -1.05, 0.88) and Creative Psychological Interventions (3 studies; g = -0.29, 95% CI -1.38, 0.79) showed smaller, non-significant effects. Sensitivity analysis excluding studies at high risk of bias strengthened the effect size. Few studies assessed factors affecting intervention efficacy and showed mixed effects of age, gender, and adherence levels. CONCLUSION Psychosocial interventions, particularly CBT, significantly reduced depressive symptoms among young people in SSA. However, it is crucial to acknowledge the high heterogeneity which likely stems from variations in study populations and intervention delivery modalities. This highlights the need for further research to identify the specific intervention components and delivery methods that work best for distinct subpopulations. Future research should also explore how long intervention effects are maintained and factors affecting efficacy.
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Affiliation(s)
| | - Echezona Udokanma
- School of Nursing, Midwifery, and Health, Coventry University, Coventry, UK
| | - Asma Ashraf
- Department of Nursing, City University of London, London, UK
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4
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Ghasemi F, Herman KC, Reinke WM. A cognitive-behavioral approach to teacher burnout: A randomized controlled trial of a group therapy program. ANXIETY, STRESS, AND COPING 2023; 36:533-541. [PMID: 35943958 DOI: 10.1080/10615806.2022.2103118] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 07/09/2022] [Accepted: 07/13/2022] [Indexed: 05/24/2023]
Abstract
BACKGROUND AND OBJECTIVES As a well-known phenomenon with significant social, biological, and psychological impacts, burnout syndrome has been viewed and treated from different therapeutic perspectives. However, few studies have evaluated interventions to prevent and alleviate teacher burnout. DESIGN This study comprised a randomized controlled trial (RCT) of a group-based cognitive-behavioral therapy (CBT) program for teacher burnout, with assessments at pre-treatment, post-treatment, and 6-month follow-up. METHODS The Maslach Burnout Inventory-Educators Survey (MBI-ES) was administered to 242 English language teachers with diverse professional profiles in Iran. Of these, 62 teachers with burnout symptoms were randomly assigned to either a group-based eight-week CBT treatment program or a waiting list control condition. RESULTS The results of a series of mixed factorial ANOVAs demonstrated significantly greater improvements for the treatment compared to the control condition on the total score and three subscales of the MBI-ES (teachers' emotional exhaustion, depersonalization, and reduced personal accomplishment) at post-treatment, with treatment effects maintained at 6-month follow-up. CONCLUSIONS This CBT intervention has promise for supporting teachers in stressful occupational conditions and reducing their burnout.
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Affiliation(s)
- Farshad Ghasemi
- University of Missouri, Missouri Prevention Science Institute, United States
| | - Keith C Herman
- University of Missouri, Missouri Prevention Science Institute, United States
| | - Wendy M Reinke
- University of Missouri, Missouri Prevention Science Institute, United States
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Clinkscales N, Golds L, Berlouis K, MacBeth A. The effectiveness of psychological interventions for anxiety in the perinatal period: A systematic review and meta-analysis. Psychol Psychother 2023; 96:296-327. [PMID: 36504355 DOI: 10.1111/papt.12441] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Anxiety disorders are relatively common during pregnancy and the postnatal period. Despite their potential acceptability to users, psychological interventions research for this population is still in its infancy. The meta-analysis aimed to comprehensively evaluate the evidence of the effectiveness of psychological interventions for reducing perinatal anxiety. METHOD The review followed PRISMA guidelines. A total of 26 studies published between 2004 and 2022 fulfilled inclusion criteria of which 22 were included in the meta-analysis. RESULTS Results indicated that psychological interventions were more effective than control conditions in reducing symptoms of perinatal anxiety (equivalent to a medium post treatment effect size). Effect sizes were robust for cognitive, behavioural and mindfulness-based interventions. Targeting anxiety also appeared to impact on depression symptoms. There was substantial evidence of methodological heterogeneity. CONCLUSIONS This review demonstrates that psychological interventions are effective in reducing symptoms of both anxiety and comorbid anxiety and depression in both the antenatal and postnatal periods. Further research on longer-term effects, infant outcomes, treatment approach and modality are required.
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Affiliation(s)
- Natalie Clinkscales
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, Scotland, UK
- Maternity and Neonatal Psychological Interventions Team, NHSGGC, Glasgow, Scotland, UK
| | - Lisa Golds
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - Katherine Berlouis
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, Scotland, UK
- National Cleft Surgical Service for Scotland, Glasgow, Scotland, UK
| | - Angus MacBeth
- School of Health and Social Sciences, University of Edinburgh, Edinburgh, Scotland, UK
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6
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Ogawa S, Hayashida M, Tayama J, Saigo T, Nakaya N, Sone T, Kobayashi M, Bernick P, Takeoka A, Shirabe S. Preventive Effects of Group Cognitive Behavioral Therapy in First-Year University Students at Risk for Depression: A Non-Randomized Controlled Trial. Percept Mot Skills 2023; 130:790-807. [PMID: 36720673 DOI: 10.1177/00315125231153778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
High scores on Harm Avoidance (HA) on Cloniger's Temperament and Character Inventory (TCI) have been identified as a risk factor for depression. Group cognitive-behavioral therapy (GCBT) has been found effective in preventing depression and improving depressive symptoms among university students. However, no randomized controlled trials of GCBT have been conducted with university students with high HA. Although we initiated a randomized controlled trial in this study, some participants submitted incomplete questionnaires at baseline interfering with assured randomization; therefore, we report this study as a non-randomized controlled trial. We evaluated whether a GCBT intervention would be effective at reducing HA and, thereby, preventing depression in university students with high HA. We performed final analysis of data on 59 participants in the intervention group and 60 in a control group. We used scores on the Beck Depression Inventory-II (BDI-II) as the primary outcome measure and analysis of covariance to assess group differences on mean BDI-II change scores before the intervention and at six months and one year after the intervention. The intervention group had lower BDI-II scores than the control group at six months after the intervention. GCBT may have facilitated cognitive modification in individuals with high HA, or GCBT may have fostered mutual modeling by group participants. Thus, GCBT may contribute to reducing depressive symptoms in university students with high HA, and associated risk for developing depression.
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Affiliation(s)
- Sayaka Ogawa
- Health Center, 12961Nagasaki University, Nagasaki, Japan
| | | | - Jun Tayama
- 68397Faculty of Human Sciences Waseda University, Tokorozawa, Japan
| | - Tatsuo Saigo
- Graduate School of Psychological Science, 12811Health Sciences University of Hokkaido, Ishikari-Tobetsu, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, 13101Tohoku University, Sendai Aoba-ku, Japan
| | - Toshimasa Sone
- Department of Occupational Therapy, 183174Fukushima Medical University School of Health Sciences, Fukushima, Japan
| | | | - Peter Bernick
- Health Center, 12961Nagasaki University, Nagasaki, Japan.,Student Accessibility Office, 12961Nagasaki University, Nagasaki, Japan
| | | | - Susumu Shirabe
- National Research Center for the Control and Prevention of Infectious Diseases, 12961Nagasaki University, Nagasaki, Japan
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7
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Namasaba M, Nabunje S, Baguwemu AA. Effectiveness of multi-modal cognitive behavioural therapy in improving mental well-being among caregivers of children with disabilities in urban Uganda: A cluster-randomized controlled trial. J Glob Health 2022; 12:04102. [PMID: 36579518 PMCID: PMC9798245 DOI: 10.7189/jogh.12.04102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background In Sub-Saharan Africa, 41 to 58% of the caregivers of children with disabilities experience psychological distress and have poor mental well-being. Cognitive behavioural therapy (CBT) has a moderate effect on improving mental well-being. However, no study has examined its effects among caregivers of children with disabilities at home and in schools. This study evaluated the effectiveness of CBT in improving mental well-being among caregivers of children with disabilities in urban Uganda. Methods We conducted a two-arm cluster-randomized controlled trial in 11 schools across the Kampala district of Uganda. The intervention was a multi-modal CBT training program conducted for six months among 392 home and school caregivers of children with disabilities. In the first three months, caregivers received group-based CBT, and in the next three months, they received phone-based CBT. We used generalized linear mixed-effects regression to examine the differences in the mental well-being of caregivers in the control group vs those in the intervention group. Results Home caregivers' mental well-being was significantly higher after phone-based CBT (unstandardized coefficient of the estimate (B) = 4.31, 95% CI = 1.18-6.82; P < 0.001, Cohen's D (d) = 0.27). School caregivers' mental well-being was significantly higher after group-based CBT (B = 3.98, 95% CI = 0.22-7.47; P = 0.038, d = 0.25). Conclusions Group-based CBT improved mental well-being among school caregivers, and phone-based CBT improved mental well-being among home caregivers. Interventions targeting school caregivers of children with disabilities should employ group settings and those targeting home caregivers should utilize peer-to-peer networks to enhance the caregivers' mental well-being. Registration The study protocol was registered with UMIN Clinical Trials Registry (UMIN-CTR). Trial ID: UMIN000040912.
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Affiliation(s)
- Mariam Namasaba
- Department of Psychology, Kyambogo University, Kampala, Uganda
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8
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Ghasemi F. A randomized controlled trial of an adapted group cognitive-behavioral therapy for burned-out teachers. Psychother Res 2022; 33:494-507. [PMID: 36404282 DOI: 10.1080/10503307.2022.2131476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Reports regarding experienced teacher burnout in public schools are becoming a concerning issue. Although several therapeutic interventions have been proposed to alleviate burnout symptoms, CBT programs appear to be more practical with large effects on burnout. However, there is limited research investigating the effects of an adapted group-based CBT program on teacher burnout. METHODS The Maslach Burnout Inventory-Educators Survey was administered to 201 teachers working in public schools in Iran. Initial analyses indicated burnout symptoms in 66 teachers, who were randomly assigned to either a CBT treatment program or a waitlist group. The treatment group attended an adapted group therapy program with various therapeutic coping strategies, cognitive restructuring techniques, and applied relaxation training to facilitate cognitive and behavior change. Multilevel modeling was used to estimate treatment effects on teachers' burnout symptoms. RESULTS The results indicated the positive effects of the treatment program in improving teachers' emotional exhaustion, depersonalization, and reduced personal accomplishment, which remained significantly elevated at a 6-month follow-up of the intervention. However, treatment effects and improvements in outcome measures were larger for novice teachers. Accordingly, teaching experience moderated the relationship between the group conditions and burnout levels. CONCLUSIONS The findings from the study suggest this culturally-adapted CBT intervention may contribute to overcoming occupational stressors and reducing teachers' burnout, which is critically important for sustaining the workforce.
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Affiliation(s)
- Farshad Ghasemi
- Missouri Prevention Science Institute, University of Missouri, Columbia, MO, USA
- Faculty of Humanities and Social Science, Urmia University, Urmia, Iran
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Demir S, Ercan F. The effectiveness of cognitive behavioral therapy-based group counseling on depressive symptomatology, anxiety levels, automatic thoughts, and coping ways Turkish nursing students: A randomized controlled trial. Perspect Psychiatr Care 2022; 58:2394-2406. [PMID: 35332542 DOI: 10.1111/ppc.13073] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/20/2021] [Accepted: 03/12/2022] [Indexed: 11/27/2022] Open
Abstract
PURPOSE This study aimed to evaluate the effectiveness of cognitive behavioral therapy (CBT)-based group counseling focused on depressive symptoms, anxiety levels, automatic thoughts, and coping ways among undergraduate nursing students with mild to moderate depressive symptoms. DESIGN AND METHODS A randomized, nonblinded, controlled trial was conducted. The study was completed with a total of 63 participants (n = 31, intervention group; n = 32, control group). The effect of the intervention was evaluated with Beck depression inventory, Beck anxiety inventory, automatic thoughts questionnaire, and ways of coping questionnaire. The measurements were taken three times: pretest, posttest, and 2-months posttest. FINDINGS CBT-based group counseling was found to reduce depressive symptoms, automatic thoughts, and ineffective coping with stress and to increase effective coping with stress. In both groups, 2-months posttest mean anxiety score was lower than the pre-test mean score. PRACTICE IMPLICATIONS CBT-based group counseling reduced depressive symptoms, automatic thoughts, and emotion-focused/ineffective ways for coping with stress.
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Affiliation(s)
- Satı Demir
- Department of Psychiatric and Mental Health Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Feride Ercan
- Department of Psychiatric and Mental Health Nursing, Faculty of Health Sciences, Gazi University, Ankara, Turkey
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Koementas-de Vos MMW, Colleye LC, Tiemens B, Engelsbel F, de Jong K, Witteman CLM, Nugter MA. The feasibility, acceptability and effectiveness of a feedback-informed group treatment (FIGT) tool for patients with anxiety or depressive disorders. RESEARCH IN PSYCHOTHERAPY (MILANO) 2022; 25:647. [PMID: 36121108 PMCID: PMC9893042 DOI: 10.4081/ripppo.2022.647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 09/07/2022] [Indexed: 02/05/2023]
Abstract
Monitoring treatment progress by the use of standardized measures in individual therapy, also called feedback-informed treatment (FIT), has a small but significant effect on improving outcomes. Results of FIT in group therapy settings are mixed, possibly due to contextual factors. The goals of this study were to investigate the feasibility, acceptability and effectiveness of a feedback-informed group treatment (FIGT) tool, based on the principles of the Contextual Feedback Theory and earlier FIGT research. Patients with anxiety or depressive disorders following interpersonal or cognitive behavioural group psychotherapy (IPT-G or CBT-G) were randomized to either feedback (n=104) or Treatment As Usual (TAU; n=93). In the feedback condition, patients filled out the Outcome-Questionnaire 45 (OQ-45) weekly in a FIGT tool and therapists were instructed to discuss the results in each session. Dropout, attendance and outcomes were measured. Additionally, in the feedback condition, OQ-45 response, feedback discussions and acceptability by patients and therapists were assessed. Results showed no differences on dropout, but lower attendance rates in the feedback condition. Although therapists reported high rates of feedback use and helpfulness, patients experienced that results were discussed with them only half of the time and they were also less optimistic about its usefulness. The findings indicate that the FIGT instrument was partially feasible, more acceptable to therapists than patients, and was not effective as intended. Future research is needed to discover how feedback can be beneficial for both therapists and patients in group therapy.
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Affiliation(s)
- Marjolein M. W. Koementas-de Vos
- Radboud University, Nijmegen, The Netherlands,GGZ Noord-Holland-Noord, Heerhugowaard, The Netherlands,GZZNoord- Holland-Noord, Antwoordnummer 1506, 1850 VB Heiloo, The Netherlands.
| | | | - Bea Tiemens
- Radboud University, Nijmegen, The Netherlands
| | | | - Kim de Jong
- Leiden University, Institute of Psychology, Clinical Psychology Unit, Leiden, The Netherlands
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Orozco M, Harris S. Psilocybin and the Meaning Response: Exploring the Healing Process in a Retreat Setting in Jamaica. ANTHROPOLOGY OF CONSCIOUSNESS 2022. [DOI: 10.1111/anoc.12162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Chonthannathi B, Pisitsungkagarn K, Jurukasemthawee S. The Effects of Cognitive Behavioral Group Therapy on Anxiety and Emotion Regulation in Thai Middle School Students. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2022; 44:569-585. [PMID: 35991770 PMCID: PMC9375075 DOI: 10.1007/s10447-022-09482-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2022] [Indexed: 11/29/2022]
Abstract
This quasi-experimental study examined the effects of Cognitive Behavioral Group Therapy (CBGT) in alleviating anxiety and enhancing emotion regulation in community-sample Thai middle school students. Forty-seven community-sample students in Grades 7–9 with elevated SCARED scores participated in this pre-post treatment–control study. Twenty-three in the treatment group attended the eight-session 2-hour semi-weekly CBGT. The remaining were the control group. Before and after the intervention, the participants completed the measures of anxiety and emotion regulation. Data obtained were subsequently analyzed using repeated-measures and between-groups MANOVAs. At post-intervention, the treatment group reported a significant decrease in anxiety but a significant increase in emotion regulation. Furthermore, when compared with the control group, their anxiety score was significantly lower but their emotion regulation score was significantly higher, respectively. Findings supported the benefits of CBGT in reducing anxiety in Thai middle school students and in enhancing their emotion regulation skills. Therapeutic implications for anxiety reduction were discussed.
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Affiliation(s)
- Boonjira Chonthannathi
- Faculty of Psychology, Chulalongkorn University, 7th Fl. Boromratchachonnanee Sri Satrapatra Bldg., Wang Mai, Patumwan, Bangkok, 10330 Thailand
- Office of Health Welfare, Counseling Center, Rangsit University, Lak Hok, Thailand
| | - Kullaya Pisitsungkagarn
- Faculty of Psychology, Chulalongkorn University, 7th Fl. Boromratchachonnanee Sri Satrapatra Bldg., Wang Mai, Patumwan, Bangkok, 10330 Thailand
| | - Somboon Jurukasemthawee
- Faculty of Psychology, Chulalongkorn University, 7th Fl. Boromratchachonnanee Sri Satrapatra Bldg., Wang Mai, Patumwan, Bangkok, 10330 Thailand
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Huynh AT, Gaboury I, Provencher MD, Norton PJ, Roberge P. Patient acceptability of group transdiagnostic cognitive behavior therapy for the treatment of anxiety disorders in community-based care: a qualitative study. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2041363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Ai-Thuy Huynh
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Canada
| | | | | | - Pasquale Roberge
- Department of Family Medicine and Emergency Medicine, Université de Sherbrooke, Sherbrooke, Canada
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Delivery of a trauma-focused CBT group for heterogeneous single-incident traumas in adult primary care: a follow-on case study. COGNITIVE BEHAVIOUR THERAPIST 2022. [DOI: 10.1017/s1754470x22000149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Group therapy for adult post-traumatic stress disorder (PTSD) has been a subject of debate over the past few years. A recent update on five international clinical practice guidelines on the use of group-therapy for PTSD in adults ranged from moderate support (e.g. the International Society for Traumatic Stress Studies) to no recommendation (e.g. the National Institute for Health and Care Excellence, NICE). However, a unanimous recommendation was that practitioners collaborated with their clients and weighed up the guidelines and client preferences to make the appropriate decisions. The current case study was guided by these recommendations. A minority of clients presenting to the service expressed a preference for group therapy for their PTSD symptoms. The current study follows on from a previous shared-trauma therapy group. It illustrates how the service took the NICE guidelines fully into account alongside the clients’ needs and preferences to deliver a NICE-compliant heterogenous trauma-focused CBT group. Twenty-four clients presenting with PTSD from different single-incident traumas opted for group therapy. Clients attended one of three 8-session trauma-focused CBT groups depending on preference (e.g. date/time, location). The groups were conducted face-to-face on a weekly basis. Seventeen clients completed treatment. Eleven clients no longer showed clinically important symptoms of PTSD as assessed on the PCL-5 and interview. This was sustained at 3-month follow-up. Four other clients showed reliable change. Two clients showed minimal improvement. This study is discussed with reference to opportunities, challenges and recommendations for clinical practice and research.
Key learning aims
It is hoped that the reader of this case study will increase their understanding of the following:
(1)
Delivery of a trauma-focused CBT group for heterogeneous single-incident traumas.
(2)
Taking full consideration of the NICE guidelines alongside the clients’ needs and preferences.
(3)
Guiding the focus of therapy on processing the trauma memory and its aftermath.
(4)
Effective use of group processes to facilitate outcomes.
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Group Cognitive-Behavioral Therapy With Interoceptive Exposure for Drug-Refractory Irritable Bowel Syndrome: A Randomized Controlled Trial. Am J Gastroenterol 2022; 117:668-677. [PMID: 35103022 DOI: 10.14309/ajg.0000000000001664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/26/2022] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Few people can access psychotherapy for irritable bowel syndrome (IBS). Group cognitive-behavioral therapy (GCBT) may be efficient, but the evidence for its efficacy is weak and limited. We aimed to assess the efficacy and safety of GCBT with interoceptive exposure (GCBT-IE), a novel form of GCBT for drug-refractory IBS. METHODS A single-center, open-label, randomized, controlled trial was conducted in Japan among people aged 18-75 years with moderate-to-severe drug-refractory IBS. Participants were stratified by IBS severity and allocated 1:1 to 10-week GCBT-IE or waiting list (WL) in a blockwise randomization by independent staff. Both arms practiced self-monitoring and received treatment as usual. Multiple primary outcomes were changes from baseline to week 13 in the IBS Symptom Severity Score and the IBS Quality of Life Measure (IBS-QOL), assessed in the intention-to-treat sample. RESULTS A total of 114 people with drug-refractory IBS were randomized to GCBT-IE (n = 54) or WL (n = 60). Forty-nine participants (90.7%) in the GCBT-IE arm and 58 (96.7%) in the WL arm completed the week 13 assessment. Participants in the GCBT-IE arm reported greater improvements in both IBS symptom severity and quality of life compared with the WL arm, with -115.8 vs -29.7 on the IBS Symptom Severity Score (a difference of -86.1, 95% confidence interval -117.3 to -55.0), and 20.1 vs -0.2 on the IBS-QOL (a difference of 20.3, 95% confidence interval 15.2-25.3), respectively. Six unexpected serious adverse events were reported but were judged as unrelated to the interventions. DISCUSSION GCBT-IE is an efficacious, safe, and efficient treatment option for people with drug-refractory IBS.
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Bryde Christensen A, Pavlo AJ, Davidson L, Poulsen S, Reinholt N, Hvenegaard M, Simonsen E, Arnfred S. Does one treatment benefit all? Patients’ experiences of standardized group CBT for anxiety and depression. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-02820-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Patient Perspectives on Co-Therapists’ Behaviors in Group CBT. JOURNAL OF CONTEMPORARY PSYCHOTHERAPY 2022. [DOI: 10.1007/s10879-022-09530-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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McCarthy M, Houghton C, Matvienko-Sikar K. Women's experiences and perceptions of anxiety and stress during the perinatal period: a systematic review and qualitative evidence synthesis. BMC Pregnancy Childbirth 2021; 21:811. [PMID: 34865642 PMCID: PMC8647378 DOI: 10.1186/s12884-021-04271-w] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 11/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The perinatal period, from pregnancy to the first year postpartum, is a transitional period that can result in anxiety and stress for some women. Perinatal anxiety and stress can adversely impact the physical and psychological health of women and children. Understanding women's lived experiences of perinatal anxiety and stress is essential to better support women. The aim of this qualitative evidence synthesis was to examine women's experiences and perceptions of, and barriers and facilitators to coping with, perinatal anxiety and stress. METHODS Databases CINAHL, EMBASE, MEDLINE, PsycINFO and Maternity and Infant Care were searched from inception to June 2020. Eligible studies included women who were pregnant or up to one year postpartum and examined women's experiences of anxiety and/or stress during the perinatal period. Data were synthesised using thematic synthesis. RESULTS Of 20,318 identified articles, 13 studies met inclusion criteria and were included in this review. Five key themes emerged: Social support, women's experiences of healthcare, social norms and expectations, factors that impact on coping and mother and baby's health. CONCLUSION This review provided a comprehensive synthesis of perinatal anxiety and stress. Findings indicate that increased support for perinatal mental health in antenatal and postpartum care is needed. Addressing unrealistic expectations and conceptualisations of motherhood is also important to better support women. Enhancing women's social support networks and provision of clear and consistent information are also essential to support women and minimise stress and anxiety in the perinatal period.
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Affiliation(s)
- Megan McCarthy
- School of Public Health, University College Cork, Cork, Ireland.
| | - Catherine Houghton
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
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Mason EC, Gaston JE, Pestell CF, Page AC. A comprehensive group-based cognitive behavioural treatment for blood-injection-injury phobia. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 61:494-509. [PMID: 34750831 DOI: 10.1111/bjc.12345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/14/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVES A key feature of blood-injection-injury (BII) phobia is activation of disgust responses, in addition to fear. Yet, standard treatments have largely neglected addressing disgust responses. The disorder is further complicated by fainting in 75% of sufferers. Moreover, treatments have been traditionally delivered in an individual format, which may not be as efficient as group treatment. The aim of this study was to develop a group-based programme for BII phobia, with components targeting fear, disgust, and fainting, to determine feasibility and effectiveness of such an intervention. METHODS Participants took part in an 8-session, group-based Cognitive Behavioural Therapy (CBT) programme for BII phobia (N = 40). The key outcome measure was the Multidimensional Blood/Injury Phobia Inventory, which assesses a range of phobic stimuli and responses (including fear, disgust, and fainting). RESULTS There were significant improvements, with large effect sizes, across symptoms over the course of treatment. Participants with higher disgust sensitivity reported higher pre-treatment symptom severity and greater life interference than those with lower disgust scores. Despite this, neither pre-treatment disgust sensitivity nor fainting history impacted on treatment response. For the first time, however, we showed that greater reductions in disgust to BII stimuli were associated with greater overall symptom reductions, highlighting the importance of disgust in the treatment of this disorder, and potentially others. CONCLUSION Despite the heterogeneous nature of BII phobia, this group-based, modified CBT intervention was effective in reducing a variety of phobic responses, including fear, disgust, and fainting. PRACTITIONER POINTS Disgust is a key maintaining factor in blood-injection-injury phobia, which clinicians should consider in their assessment and treatment of this disorder. There is little in the existing literature to guide clinicians in this regard. This study examined a novel group treatment for blood-injection-injury phobia which included strategies to target disgust, in addition to traditional CBT strategies to address fear and fainting. The treatment was feasible and acceptable. Symptoms of fear, disgust, and fainting reduced significantly over treatment. Changes in disgust symptoms were associated with overall symptom changes, however a control group is needed to determine the effects of individual treatment components and to make more robust conclusions about the benefits of this enhanced approach.
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Affiliation(s)
- Elizabeth C Mason
- Clinical Research Unit for Anxiety and Depression, St Vincent's Hospital, Darlinghurst, New South Wales, Australia
| | - Jonathan E Gaston
- Centre for Emotional Health, Department of Psychology, Macquarie University, North Ryde, New South Wales, Australia
| | - Carmela F Pestell
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Andrew C Page
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
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Ip AKY, Ho FYY, Yeung WF, Chung KF, Ng CH, Oliver G, Sarris J. Effects of a group-based lifestyle medicine for depression: A pilot randomized controlled trial. PLoS One 2021; 16:e0258059. [PMID: 34624047 PMCID: PMC8500430 DOI: 10.1371/journal.pone.0258059] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022] Open
Abstract
Given the growing evidence that a range of lifestyle factors are involved in the etiology of depression, a ‘lifestyle medicine’ approach can be potentially safe and cost-effective to prevent or treat depression. To examine the effects and acceptability of a group-based, integrative lifestyle medicine intervention as a standalone treatment for managing depressive symptoms, a pilot randomized controlled trial (RCT) was conducted in a Chinese adult population in 2018. Participants (n = 31) with PHQ-9 score above the cut-off of ≥ 10, which was indicative of moderate to severe depression, were recruited from the general community in Hong Kong and randomly assigned to lifestyle medicine group (LM group) or care-as-usual group (CAU group) in a ratio of 1:1. Participants in the LM group received 2-hour group sessions once per week for six consecutive weeks, which covered diet, exercise, mindfulness, psychoeducation, and sleep management. Linear mixed-effects model analyses showed that the LM group had a significant reduction in PHQ-9 scores compared to the CAU group at immediate posttreatment and 12-week posttreatment follow-up (d = 0.69 and 0.73, respectively). Moreover, there were significantly greater improvements in anxiety, stress, and insomnia symptoms (measured by DASS-21 and ISI) at all time points in the LM group (d = 0.42–1.16). The results suggests that our 6-week group-based, integrative lifestyle intervention program is effective in lowering depressive, anxiety, stress, and insomnia symptoms in the Chinese population. Further studies in clinical populations with a larger sample size and longer follow-up are warranted.
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Affiliation(s)
- Agnes Ka-Yan Ip
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Fiona Yan-Yee Ho
- Department of Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
- * E-mail:
| | - Wing-Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hunghom, Hong Kong
| | - Ka-Fai Chung
- Department of Psychiatry, The University of Hong Kong, Pokfulam, Hong Kong
| | - Chee H. Ng
- Department of Psychiatry, Professorial Unit, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | - Georgina Oliver
- Department of Psychiatry, Professorial Unit, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jerome Sarris
- Department of Psychiatry, Professorial Unit, The Melbourne Clinic, The University of Melbourne, Melbourne, Victoria, Australia
- Western Sydney University, NICM Heath Research Institute, Westmead, NSW, Australia
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Hirakawa H, Terao T, Ishii N, Sakai A, Yamashita H, Kawatani M, Namba S, Goto C. Thought Process Evolved From Rigid to Flexible in a Patient With Bipolar Disorder Via "Return to Work Program": A Case Report. J Nerv Ment Dis 2021; 209:609-611. [PMID: 34397761 DOI: 10.1097/nmd.0000000000001353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT In the working population, bipolar disorder can have a significant negative effect on professional relationships, attendance, functioning, and loss of productivity. In Japan, workers who take a leave due to depressive episodes receive a work-focused intervention program called the "return to work program" during their leave. A 39-year-old Japanese woman with bipolar II disorder took a third sick leave of absence. We recommended her the return to work program of our university hospital. At the beginning of the program, she had a rigid thought process toward her perceptions of her duties in the workplace and at home. Through the program, mindfulness might identify rigidity, group cognitive-behavioral therapy might correct rigidity, and self-analysis might have regained flexibility. In conclusion, a variety of effects of our return to work program might have enabled her thought process to evolve from rigid to flexible, and she showed successful reinstatement.
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Affiliation(s)
- Hirofumi Hirakawa
- Department of Neuropsychiatry, Oita University Faculty of Medicine, Yufu, Oita, Japan
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Bantjes J, Kazdin AE, Cuijpers P, Breet E, Dunn-Coetzee M, Davids C, Stein DJ, Kessler RC. A Web-Based Group Cognitive Behavioral Therapy Intervention for Symptoms of Anxiety and Depression Among University Students: Open-Label, Pragmatic Trial. JMIR Ment Health 2021; 8:e27400. [PMID: 34042598 PMCID: PMC8193479 DOI: 10.2196/27400] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/02/2021] [Accepted: 03/15/2021] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Anxiety and depression are common among university students, and university counseling centers are under pressure to develop effective, novel, and sustainable interventions that engage and retain students. Group interventions delivered via the internet could be a novel and effective way to promote student mental health. OBJECTIVE We conducted a pragmatic open trial to investigate the uptake, retention, treatment response, and level of satisfaction with a remote group cognitive behavioral therapy intervention designed to reduce symptoms of anxiety and depression delivered on the web to university students during the COVID-19 pandemic. METHODS Preintervention and postintervention self-reported data on anxiety and depression were collected using the Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9. Satisfaction was assessed postintervention using the Client Satisfaction with Treatment Questionnaire. RESULTS A total of 175 students were enrolled, 158 (90.3%) of whom initiated treatment. Among those initiating treatment, 86.1% (135/158) identified as female, and the mean age was 22.4 (SD 4.9) years. The mean number of sessions attended was 6.4 (SD 2.8) out of 10. Among participants with clinically significant symptoms at baseline, mean symptom scores decreased significantly for anxiety (t56=11.6; P<.001), depression (t61=7.8; P<.001), and composite anxiety and depression (t60=10.7; P<.001), with large effect sizes (d=1-1.5). Remission rates among participants with clinically significant baseline symptoms were 67.7%-78.9% and were not associated with baseline symptom severity. High overall levels of satisfaction with treatment were reported. CONCLUSIONS The results of this study serve as a proof of concept for the use of web-based group cognitive behavioral therapy to promote the mental health of university students.
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Affiliation(s)
- Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Alan E Kazdin
- Department of Psychology, Yale University, New Haven, CT, United States
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Elsie Breet
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Munita Dunn-Coetzee
- Centre for Student Counselling and Development, Student Affairs, Stellenbosch University, Stellenbosch, South Africa
| | - Charl Davids
- Centre for Student Counselling and Development, Student Affairs, Stellenbosch University, Stellenbosch, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South African Medical Research Council Unit on Risk & Resilience in Mental Disorders, Cape Town, South Africa
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, United States
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Osma J, Martínez-García L, Quilez-Orden A, Peris-Baquero Ó. Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders in Medical Conditions: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5077. [PMID: 34064898 PMCID: PMC8151777 DOI: 10.3390/ijerph18105077] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 02/04/2023]
Abstract
Emotional disorders are those that most commonly present comorbidly with medical conditions. The Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral emotion-based intervention, has proven efficacy and versatility. The aim of this systematic review is to know the current (research studies) and future research interest (study protocols) in using the UP for the transdiagnostic treatment of emotional symptoms or disorders (EDs) in people with a medical condition. Using the PRISMA guidelines, a literature search was conducted in Web of Science, PubMed, Medline, and Dialnet. The nine research studies included in this review indicated that the UP is effective in treating emotional symptomatology in a population with a medical condition (effect sizes ranging from d = -3.34 to d = 2.16). The three included study protocols suggest interest in the future UP application to different medical conditions, and also in distinct application formats. Our review results are encouraging, and conducting more controlled studies is advised to recommend the UP to treat and/or prevent EDs in medical conditions, especially in children and youths.
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Affiliation(s)
- Jorge Osma
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Laura Martínez-García
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
| | - Alba Quilez-Orden
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
- Mental Health Unit of Tarazona, C/Plaza Joaquín Zamora, 2, 50500 Tarazona, Spain
| | - Óscar Peris-Baquero
- Department of Psychology and Sociology, Universidad de Zaragoza, C/Atarazanas, 4, 44003 Teruel, Spain; (L.M.-G.); (A.Q.-O.); (Ó.P.-B.)
- Instituto de Investigación Sanitaria de Aragón, C/San Juan Bosco, 13, 50009 Zaragoza, Spain
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Cole CL, Waterman S, Hunter ECM, Bell V, Greenberg N, Rubin GJ, Beck A. Effectiveness of small group cognitive behavioural therapy for anxiety and depression in Ebola treatment centre staff in Sierra Leone. Int Rev Psychiatry 2021; 33:189-197. [PMID: 32301358 DOI: 10.1080/09540261.2020.1750800] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Following the 2014 Ebola outbreak, South London and Maudsley NHS Foundation Trust (SLAM) were commissioned to provide a 'culturally appropriate, effective and sustainable' intervention to address the psychological needs of the Sierra Leonean Ebola Treatment Centre (ETC) staff. The study evaluated the effectiveness of group Cognitive Behavioural Therapy (CBT) developed to treat anxiety, depression and functional impairment amongst a sample of former ETC staff in Sierra Leone. Group comparisons explored whether the effect of the intervention differed dependent on the facilitators that delivered it, as well as whether it differed between former staff of high- and low-risk ETC roles. A sample of 253 former ETC staff attended the group CBT intervention comprised of eight sessions over six weeks. Outcome measures were administered upon entry and within two weeks after the intervention. At post-intervention, anxiety, depression and functional impairment significantly reduced. Reading ability (RA) was introduced as a covariate having impacted the outcomes. The intervention effect differed by facilitators delivering the sessions but not by ETC role risk. The implications of these results are discussed. Group CBT is a promising psychological intervention for treating the anxiety, depression and functional impairment of former ETC staff in Sierra Leone. Furthermore, as part of a stepped-care approach, it may provide a model for psychological support for staff that have worked on the frontline during future epidemics.
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Affiliation(s)
- Charles L Cole
- South London and Maudsley NHS Foundation Trust, London, UK.,Division of Psychiatry, University College London, London, UK
| | | | | | - Vaughan Bell
- South London and Maudsley NHS Foundation Trust, London, UK.,Division of Psychiatry, University College London, London, UK
| | - Neil Greenberg
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - G James Rubin
- Kings College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Alison Beck
- South London and Maudsley NHS Foundation Trust, London, UK
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Baker FRL, Baker KL, Burrell J. Introducing the skills‐based model of personal resilience: Drawing on content and process factors to build resilience in the workplace. JOURNAL OF OCCUPATIONAL AND ORGANIZATIONAL PSYCHOLOGY 2021. [DOI: 10.1111/joop.12340] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Kevin L. Baker
- East Midlands Psychology Ltd Nottingham UK
- St Andrews Healthcare, William Wake House Northampton UK
| | - Jo Burrell
- East Midlands Psychology Ltd Nottingham UK
- Clinical Psychology Unit University of Sheffield UK
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Pollok J, Van agteren J, Chong A, Carson‐chahhoud K, Smith B. Evaluation of existing experimental evidence for treatment of depression in indigenous populations: A systematic review. AUSTRALIAN JOURNAL OF PSYCHOLOGY 2020. [DOI: 10.1111/ajpy.12204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Justyna Pollok
- The University of Adelaide, Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia,
| | - Joseph Van agteren
- Wellbeing and Resilience Centre, South Australian Health and Medical Research Institute (SAHMRI), College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia,
| | - Alwin Chong
- Positive Futures Research Collaboration, Sansom Institute for Health Research, The University of South Australia, Adelaide, South Australia, Australia,
| | - Kristin Carson‐chahhoud
- Division of Health Sciences, The University of South Australia, Adelaide, South Australia, Australia,
| | - Brian Smith
- The University of Adelaide, Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia,
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Kar SK, Menon V, Arafat SMY. Online group cognitive behavioral therapy for panic buying: Understanding the usefulness in COVID-19 context. Indian J Psychiatry 2020; 62:607-609. [PMID: 33678858 PMCID: PMC7909013 DOI: 10.4103/psychiatry.indianjpsychiatry_610_20] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/16/2020] [Indexed: 01/14/2023] Open
Affiliation(s)
- Sujita Kumar Kar
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Vikas Menon
- Department of Psychiatry, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India. E-mail:
| | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Dhaka, Bangladesh
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Tunsuchart K, Lerttrakarnnon P, Srithanaviboonchai K, Likhitsathian S, Skulphan S. Benefits of Brief Group Cognitive Behavioral Therapy in Reducing Diabetes-Related Distress and HbA1c in Uncontrolled Type 2 Diabetes Mellitus Patients in Thailand. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155564. [PMID: 32752228 PMCID: PMC7432874 DOI: 10.3390/ijerph17155564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/23/2020] [Accepted: 07/30/2020] [Indexed: 12/11/2022]
Abstract
This study evaluated the short-term efficacy of brief group cognitive behavioral therapy (BG-CBT) in reducing diabetes-related distress (DRD), lowering hemoglobin A1c (HbA1c), improving food consumption behavior, increasing physical activity, and improving medication adherence behavior. A quasi-experimental pretest/post-test design with follow-up assessments was used with an experimental and a control group. Participants were patients with uncontrolled type 2 diabetes mellitus (T2DM) and moderate or high diabetes-related distress recruited from the Diabetes Mellitus Clinic of Hang Dong Hospital, Chiang Mai, Thailand. Fifty-six eligible participants were purposively selected and enrolled, then randomly assigned to either the BG-CBT group or the control group. The BG-CBT group received six brief weekly sessions of cognitive behavioral group therapy, while the control group received conventional care. Baseline data were collected at week 0 (pretest) and at week 6 (post-test), including food consumption behavior, physical activity, and adherence to medication regimes, as well as a blood examination to determine levels of HbA1c at the week 12 follow-up. DRD was assessed using the Diabetes Distress Scale (DDS-17) and analyzed using descriptive statistics, including pair t-test and independence t-test results. The BG-CBT had a significant effect on the amelioration of diabetes distress, improvement of food consumption behavior, and reduction of HbA1c levels, demonstrating the effectiveness of BG-CBT in maintaining diabetes control in people with T2DM-related distress.
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Affiliation(s)
- Kongprai Tunsuchart
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.); (K.S.)
| | - Peerasak Lerttrakarnnon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence:
| | - Kriengkrai Srithanaviboonchai
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (K.T.); (K.S.)
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Surinporn Likhitsathian
- Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
| | - Sombat Skulphan
- Department of Psychiatric Nursing, Faculty of Nursing, Chiang Mai University, Chiang Mai 50200, Thailand;
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Primary care community engagement – delivery of an enhanced and brief homogeneous group TF-CBT intervention for trauma from a single-incident road traffic accident: a case study. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The main current intervention for post-traumatic stress disorder (PTSD) in adult primary care is individual trauma-focused cognitive behavioural therapy (TF-CBT). Group TF-CBT for PTSD has been advocated in order to improve access and cost. Barriers to the development of group TF-CBT include the need for a large number of sessions and therapist input in order to manage high levels of affect, possible dissociation and secondary traumatisation. This case study was prompted via our community engagement project when local women who had been involved in a single road traffic accident requested group therapy. The aim was to develop a NICE guideline-compliant brief 8-session group TF-CBT intervention that circumvented the above-mentioned barriers and is described in detail. In order to improve access, the group was delivered in the community. Standard and PTSD-specific measures were administered pre-therapy and post-therapy. Eight clients were offered treatment: two dropped out and six completed treatment. At the end of treatment, 3/6 clients attained reliable improvement in their PTSD symptoms. Two of these three clients also reached recovery. This change was maintained at 3-month follow-up where 4/6 clients attained reliable improvement, with three maintaining recovery. The remaining two clients showed minimal change in their PTSD symptoms. Overall, clients reported high-level satisfaction with the treatment protocol. This case study demonstrates a potentially clinically effective and cost-effective group TF-CBT intervention for non-complex single-incident PTSD.
Key learning aims
It is hoped that the reader of this case study will increase their understanding of the following:
(1)
Use of a brief group TF-CBT protocol to treat homogeneous single incident trauma in adults.
(2)
Adaptations to overcome barriers to group TF-CBT in adults.
(3)
Implementation of individualised reliving based on written-narrative rather than spoken-narrative.
(4)
Focus on the processes of PTSD, whilst using content as a theme to contextualise the symptoms.
(5)
Emphasis on the use of homework in order to enhance group affect-modulation and individual learning.
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What are the recovery and attrition outcomes for group CBT and individual CBT for generalised anxiety disorder in an IAPT service? An exploratory study. COGNITIVE BEHAVIOUR THERAPIST 2020. [DOI: 10.1017/s1754470x20000045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Group cognitive behavioural therapy (gCBT) is commonly used in Increasing Access to Psychological Therapies (IAPT) services. However, there is limited knowledge of the efficacy of gCBT as a delivery format for generalised anxiety disorder (GAD). To address gaps in literature, this study aims to explore the efficacy and attrition of individual and group CBT interventions, respectively, at Step 3 for GAD using data from a routine IAPT service over a 24-month period. Data were retrospectively derived from a routine serviceʼs IAPTus database, separating those eligible for comparison into group (n = 44) and individual (n = 55) CBT for GAD. Outcomes were differences in pre–post self-reported anxiety (GAD-7) and depression (PHQ-9) scores, clinical recovery and attrition for gCBT and individual CBT. Both gCBT and individual CBT yielded significant reductions in self-reported anxiety and depression scores over time. Results indicate that 53% of patients attending individual CBT achieved clinical recovery, with similar but less competitive rates of 41% in gCBT. Attrition rates were similar between gCBT (29.5%) and individual CBT (27.3%), respectively. Preliminary results suggest that both individual and gCBT are effective interventions for GAD patients in IAPT, offering symptom alleviation and comparable recovery and attrition rates post-intervention. This observational design offers credibility and insight into a pragmatic evaluative and explorative comparison. gCBT may offer an acceptable and potentially economical alternative.
Key learning aims
(1)
To explore whether gCBT and individual CBT yield significant symptom reduction in self-reported anxiety and depression in GAD patients from a routine IAPT service.
(2)
To explore gCBT and individual CBT clinical recovery rates in non-optimum routine conditions.
(3)
To explore whether gCBT for GAD produces unacceptable attrition rates and if this differs from attrition rates in individual CBT for GAD in a routine IAPT service.
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Hensel JM, Molnar L, Bruno D. Cognitive-Behavioral Therapy in Dyads ("Shared CBT"): Expanding Options and Improving Access. Psychiatr Serv 2020; 71:525-526. [PMID: 32354305 DOI: 10.1176/appi.ps.201900507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Jennifer M Hensel
- Women's College Hospital, Toronto, Ontario, Canada (all authors); Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada (Hensel); Factor-Inwentosh School of Social Work, University of Toronto, Toronto (Molnar); Department of Psychiatry, University of Toronto, Toronto (Bruno)
| | - Leslie Molnar
- Women's College Hospital, Toronto, Ontario, Canada (all authors); Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada (Hensel); Factor-Inwentosh School of Social Work, University of Toronto, Toronto (Molnar); Department of Psychiatry, University of Toronto, Toronto (Bruno)
| | - Deanna Bruno
- Women's College Hospital, Toronto, Ontario, Canada (all authors); Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada (Hensel); Factor-Inwentosh School of Social Work, University of Toronto, Toronto (Molnar); Department of Psychiatry, University of Toronto, Toronto (Bruno)
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Uygun E, Ilkkursun Z, Sijbrandij M, Aker AT, Bryant R, Cuijpers P, Fuhr DC, de Graaff AM, de Jong J, McDaid D, Morina N, Park AL, Roberts B, Ventevogel P, Yurtbakan T, Acarturk C. Protocol for a randomized controlled trial: peer-to-peer Group Problem Management Plus (PM+) for adult Syrian refugees in Turkey. Trials 2020; 21:283. [PMID: 32192539 PMCID: PMC7082999 DOI: 10.1186/s13063-020-4166-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/12/2020] [Indexed: 11/10/2022] Open
Abstract
Background A large proportion of Syrians have been exposed to potentially traumatic events, multiple losses, and breakdown of supportive social networks and many of them have sought refuge in host countries where they also face post-migration living difficulties such as discrimination or integration problems or both. These adversities may put Syrian refugees at high risk for common mental disorders. In response to this, the World Health Organization (WHO) developed a trans-diagnostic scalable psychological intervention called Problem Management Plus (PM+) to reduce psychological distress among populations exposed to adversities. PM+ has been adapted for Syrian refugees and can be delivered by non-specialist peer lay persons in the community. Methods A randomized controlled trial (RCT) will be conducted with 380 Syrian refugees in Turkey. After providing informed consent, participants with high levels of psychological distress (scoring above 15 on the Kessler-10 Psychological Distress Scale (K10)) and functional impairment (scoring above 16 on the WHO Disability Assessment Schedule 2.0, or WHODAS 2.0) will be randomly assigned to Group PM+/enhanced care as usual (Group PM+/E-CAU) (n = 190) or E-CAU (n = 190). Outcome assessments will take place 1 week after the fifth session (post-assessment), 3 months after the fifth session and 12 months after baseline assessment. The primary outcome is psychological distress as measured by the Hopkins Symptom Checklist (HSCL-25). Secondary outcomes include functional impairment, post-traumatic stress symptoms, self-identified problems, and health system and productivity costs. A process evaluation will be conducted to explore the feasibility, challenges and success of the intervention with 25 participants, including participants, facilitators, policy makers and mental health professionals. Discussion The treatment manual of the Syrian-Arabic Group PM+ and training materials will be made available through the WHO once the effectiveness and cost-effectiveness of Group PM+ have been established. Trial registration Clinical Trial Registration: ClinicalTrials.gov Identifier NCT03960892. Unique protocol ID: 10/2017. Prospectively registered on 21 May 2019.
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Affiliation(s)
- Ersin Uygun
- Trauma Research Laboratory, Department of Psychology, Istanbul Sehir University, Istanbul, Turkey. .,Refugee Mental Health Outpatient Clinic, Bakırköy Training and Research Hospital for Mental Health and Neurological Disorders, Istanbul, Turkey.
| | | | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A Tamer Aker
- Department of Psychiatry, Bilgi University, Istanbul, Turkey
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Pim Cuijpers
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniela C Fuhr
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Anne M de Graaff
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Joop de Jong
- Faculty of Social and Behavioural Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - David McDaid
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Naser Morina
- University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - A-La Park
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Bayard Roberts
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Peter Ventevogel
- Public Health Section, United Nations High Commissioner for Refugees, Geneva, Switzerland
| | - Taylan Yurtbakan
- Trauma Research Laboratory, Department of Psychology, Istanbul Sehir University, Istanbul, Turkey
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Biggs K, Hind D, Gossage-Worrall R, Sprange K, White D, Wright J, Chatters R, Berry K, Papaioannou D, Bradburn M, Walters SJ, Cooper C. Challenges in the design, planning and implementation of trials evaluating group interventions. Trials 2020; 21:116. [PMID: 31996259 PMCID: PMC6990578 DOI: 10.1186/s13063-019-3807-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/17/2019] [Indexed: 11/10/2022] Open
Abstract
Background Group interventions are interventions delivered to groups of people rather than to individuals and are used in healthcare for mental health recovery, behaviour change, peer support, self-management and/or health education. Evaluating group interventions in randomised controlled trials (RCTs) presents trialists with a set of practical problems, which are not present in RCTs of one-to-one interventions and which may not be immediately obvious. Methods Case-based approach summarising Sheffield trials unit’s experience in the design and implementation of five group interventions. We reviewed participant recruitment and attrition, facilitator training and attrition, attendance at the group sessions, group size and fidelity aspects across five RCTs. Results Median recruitment across the five trials was 3.2 (range 1.7–21.0) participants per site per month. Group intervention trials involve a delay in starting the intervention for some participants, until sufficient numbers are available to start a group. There was no evidence that the timing of consent, relative to randomisation, affected post-randomisation attrition which was a matter of concern for all trial teams. Group facilitator attrition was common in studies where facilitators were employed by the health system rather than the by the grant holder and led to the early closure of one trial; research sites responded by training ‘back-up’ and new facilitators. Trials specified that participants had to attend a median of 62.5% (range 16.7%–80%) of sessions, in order to receive a ‘therapeutic dose’; a median of 76.7% (range 42.9%–97.8%) received a therapeutic dose. Across the five trials, 75.3% of all sessions went ahead without the pre-specified ideal group size. A variety of methods were used to assess the fidelity of group interventions at a group and individual level across the five trials. Conclusion This is the first paper to provide an empirical basis for planning group intervention trials. Investigators should expect delays/difficulties in recruiting groups of the optimal size, plan for both facilitator and participant attrition, and consider how group attendance and group size affects treatment fidelity. Trial registration ISRCTN17993825 registered on 11/10/2016, ISRCTN28645428 registered on 11/04/2012, ISRCTN61215213 registered on 11/05/2011, ISRCTN67209155 registered on 22/03/2012, ISRCTN19447796 registered on 20/03/2014.
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Affiliation(s)
- Katie Biggs
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
| | - Daniel Hind
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Rebecca Gossage-Worrall
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Kirsty Sprange
- Nottingham Clinical Trials Unit (NCTU), University of Nottingham, Nottingham, UK
| | - David White
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Jessica Wright
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Robin Chatters
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Katherine Berry
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Diana Papaioannou
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Mike Bradburn
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Stephen J Walters
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
| | - Cindy Cooper
- School of Health and Related Research (ScHARR) University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK
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Bryde Christensen A, Svart N, Bokelund H, Reinholt N, Eskildsen A, Poulsen S, Hvenegaard M, Simonsen E, Arnfred S. Therapists' Perceptions of Individual Patient Characteristics that May Be Hindering to Group CBT for Anxiety and Depression. Psychiatry 2020; 83:344-357. [PMID: 33064967 DOI: 10.1080/00332747.2020.1800292] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: Individual patient characteristics are important in trying to understand why people respond differently to group CBT. Only a few studies have explored therapists' perceptions of within-patient attributes that may be hindering in group CBT in a mental health setting. Method: We explored the perception of individual patient characteristics and related obstacles in 12 psychotherapists in Danish Mental Health Services through semi-structured interviews. The interviews were analyzed using a descriptive qualitative framework. Results: The results revealed four distinct themes that the therapists pointed to as important for the outcome of a 14-week group CBT intervention for social phobia, panic disorder, agoraphobia and major depressive disorder. The four themes were Complexity & severity, External circumstances, Attitudes & coping and Cognitive ability & reflection level. The therapists explained how they perceived higher complexity and severity in the patients as an obstacle, they highlighted that a calm and stable outside environment aided therapeutic change, whilst stressors were hindering. They perceived active coping mechanisms, positive attitudes and high readiness to change as positive factors, whilst dependent and hostile coping mechanisms and negative attitudes were seen as obstacles. Finally, the therapists pointed to cognitive abilities and reflection level, explaining how it could be difficult to obtain good outcomes for patients who's cognitive abilities were debilitated due to psychopathological factors or for patients with a generally low reflection level. Conclusions: The results indicated that the therapists experience group CBT as an intervention that requires certain prerequisites of the patients, and that the four themes should be considered when deciding on treatment options for any given patient. The clinical utility and theoretical implications of the results are discussed.
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Evaluation of a non-diagnostic 'Psychology of Emotions' group intervention within a UK youth IAPT service: a mixed-methods approach. Behav Cogn Psychother 2019; 48:129-141. [PMID: 31230599 DOI: 10.1017/s1352465819000407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A novel CBT-based intervention, tailored for young people, was developed in response to concerns about traditional diagnostically based approaches. Psychology of Emotions workshops use a normative approach to emotional difficulty instead of a diagnostic framework. AIMS To evaluate the acceptability and efficacy of Psychology of Emotions workshops within an IAPT service for young people aged 16-25 years. METHOD This was a mixed-methods study, evaluating routinely collected self-report measures of depression and anxiety, and qualitative feedback forms. The main outcomes were rates of attendance, change in symptom severity, and participant views of the intervention. RESULTS From January to September 2016, 595 young people were invited to attend the Psychology of Emotions workshops, of whom 350 (58.8%) attended at least one session. Young people who attended all six sessions (8.1%) experienced significant reductions in self-reported anxiety (d = .72) and depression (d = .58) and 35.5% were classified as recovered at completion. Those who attended at least two sessions (41.3%) reported smaller but significant improvements in anxiety (d = .42) and depression (d = .45); 22.0% were classified as recovered at the last session attended. Participants provided largely positive feedback about the intervention. CONCLUSION Psychology of Emotions is a promising treatment option, delivered outside of a diagnostic framework, for young people with mild to moderate mental health difficulties seen within IAPT services. Better understanding reasons for non-attendance might enable the intervention to be made accessible to more young people.
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Wan Mohd Yunus WMA, Musiat P, Brown JS. Evaluating the Feasibility of an Innovative Self-Confidence Webinar Intervention for Depression in the Workplace: A Proof-of-Concept Study. JMIR Ment Health 2019; 6:e11401. [PMID: 31025943 PMCID: PMC6658313 DOI: 10.2196/11401] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 12/13/2018] [Accepted: 02/10/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Depression in the workplace is a very common problem that exacerbates employees' functioning and consequently influences the productivity of organizations. Despite the commonness of the problem and the currently available interventions, a high proportion of employees do not seek help. A new intervention, a webinar (Web-based seminar), was developed, which integrated the use of technology and the traditional guided therapist support to provide accessible help for the problem of depression in the workplace. OBJECTIVE The aim of this study was to explore the feasibility, preliminary outcome, and acceptability of the webinar intervention conducted in organizations. METHODS In total, 2 organizations were invited to participate, and 33 employees participated in this proof-of-concept study. The webinar intervention consisted of 6 1-hour sessions conducted via the Adobe Connect platform, developed by Adobe Inc. The intervention was developed based on a systematic review, focus group studies, and face-to-face self-confidence workshops that utilized cognitive behavior therapy (CBT). The final webinar intervention used CBT and the coping flexibility approach. The structure of the intervention included PowerPoint presentations, animation videos, utilization of chat panels, and whiteboard features. The intervention was conducted live and guided by a consultant psychologist assisted by a moderator. Study outcomes were self-assessed using self-reported Web surveys. The acceptability of the intervention was assessed using self-reported user experience Web surveys and open-ended questions. RESULTS The findings showed: (1) evidence of feasibility of the intervention: the webinar intervention was successfully conducted in 3 groups, with 6 1-hour sessions for each group, with 82% (23/28) participants completing all 6 sessions; (2) positive improvements in depression: the linear mixed effects modeling analysis recorded a significant overall effect of time primarily for depression (F2, 48.813=31.524; P<.001) with a Hedge g effect size of 0.522 at 1-month follow-up. Individually, 8 subjects showed significant reliable and clinically significant changes, with 3 subjects showing clinically significant change only; and (3) encouraging evidence regarding the acceptability of the webinar intervention among the employees: the user experience score was above average for 4 out of 6 domains measured (perspicuity mean 1.198 [95% CI 0.832-1.564], efficiency mean 1.000 [95% CI 0.571-1.429], dependability mean 1.208 [95% CI 0.899-1.517], and stimulation mean 1.323 [95% CI 0.987-1.659]). The open-ended questions also yielded 52% (47/91) of the responses that reported facilitators, whereas only 12% (11/91) of the responses reported barriers. CONCLUSIONS The self-confidence webinar intervention appears to be a potentially feasible, effective, and acceptable intervention for depression in the workplace that merits further investigation.
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Affiliation(s)
- Wan Mohd Azam Wan Mohd Yunus
- Department of Psychology, School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities, Universiti Teknologi Malaysia, Skudai, Johor, Malaysia.,Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Peter Musiat
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - June Sl Brown
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Tanoue H, Yoshinaga N, Kato S, Naono-Nagatomo K, Ishida Y, Shiraishi Y. Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study. Int J Nurs Sci 2018; 5:218-222. [PMID: 31406828 PMCID: PMC6626260 DOI: 10.1016/j.ijnss.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 05/21/2018] [Accepted: 06/26/2018] [Indexed: 12/02/2022] Open
Abstract
Objectives The prevalence and burden of disease of depression necessitates effective and accessible treatment options worldwide. Since April 2016, Japanese national health insurance has covered nurse-administered cognitive behavioral therapy (CBT) for mood disorders. However, empirical support for nurse-led CBT for depression in Asian countries, especially in Japan, is still lacking. This preliminary study aimed to examine the feasibility and acceptability of nurse-led group CBT for Japanese patients with depression. Methods In this single-arm study, we evaluated the effects of a 6-week group CBT, led by trained nurses, on patients with major depression. The primary outcome was the Beck Depression Inventory-II (BDI-II). Assessments were conducted at the beginning and end of the intervention. Results Of 25 participants screened, 23 were eligible for the study (of these, three dropped out during the trial but were included in the analysis). Nurse-led group CBT led to significant improvements in the severity of depression (BDI-II, P < 0.001). The mean total BDI-II score improved from 23.1 (SD = 7.56) to 12.4 (SD = 8.57), and the pre-to post-effect size was large (Cohen's d = 1.33). After CBT, 45% of the participants were judged to be treatment responders, and 34% met the remission criteria. Conclusions Our preliminary findings indicate that 6 weeks of nurse-led group CBT produced a favorable treatment outcome for individuals with major depression in a Japanese clinical setting. The results of this study might encourage more Asian nurses to provide CBT as a part of their nursing practice. Further controlled trials that address the limitations of this study are required.
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Affiliation(s)
- Hiroki Tanoue
- Department of Psychiatric and Mental Health Nursing, School of Nursing, Faculty of Medicine, University of Miyazaki, Japan
| | - Naoki Yoshinaga
- Organization for Promotion of Tenure Track, University of Miyazaki, Japan
| | - Sayaka Kato
- Center for the Support and Development of Medical Professionals, Faculty of Medicine, University of Miyazaki, Japan
| | | | - Yasushi Ishida
- Department of Psychiatry, Faculty of Medicine, University of Miyazaki, Japan
| | - Yuko Shiraishi
- Department of Psychiatric and Mental Health Nursing, Faculty of Nursing, International University of Health and Welfare, Fukuoka, Japan
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Waterman S, Cole CL, Greenberg N, Rubin GJ, Beck A. A qualitative study assessing the feasibility of implementing a group cognitive-behavioural therapy-based intervention in Sierra Leone. BJPsych Int 2018; 16:31-34. [PMID: 31144684 PMCID: PMC6520535 DOI: 10.1192/bji.2018.7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Mental health support in Sierra Leone is sparse, and qualitative research into the feasibility of implementing psychological interventions is equally underdeveloped. Following the 2014 Ebola virus disease outbreak, South London and Maudsley NHS Trust were commissioned to develop a psychological intervention that UK clinicians could train national staff with minimal psychological experience to deliver to their peers. Following the completion of the stepped care, group-based cognitive–behavioural therapy intervention, qualitative interviews were conducted with the national team to identify key barriers and enablers to implementation of and engagement with this intervention. This article describes the key themes that came out of those interviews, and discusses the implications of these findings for future clinical teams.
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Affiliation(s)
- Samantha Waterman
- Assistant Psychologist, South London and Maudsley NHS Foundation Trust, UK; email
| | - Charles L Cole
- Assistant Psychologist, Division of Psychiatry, University College London, UK
| | - Neil Greenberg
- Professor of Defence Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - G James Rubin
- Reader in the Psychology of Emerging Health Risks, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Alison Beck
- Head of Psychology and Psychotherapy, South London and Maudsley NHS Foundation Trust, UK
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Waterman S, Hunter ECM, Cole CL, Evans LJ, Greenberg N, Rubin GJ, Beck A. Training peers to treat Ebola centre workers with anxiety and depression in Sierra Leone. Int J Soc Psychiatry 2018; 64:156-165. [PMID: 29432085 DOI: 10.1177/0020764017752021] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Following the 2014 Ebola virus disease (EVD) outbreak in West Africa, the UK Department for International Development funded South London and Maudsley National Health Service (NHS) to develop a psychological intervention that ex-Ebola Treatment Centre (ETC) staff could be trained to deliver to their peers to improve mental health in Sierra Leone. AIM The two key aims were to assess the feasibility of training a national team to deliver a cognitive behavioural therapy (CBT)-based group intervention, and to evaluate the effectiveness of the overall intervention within this population. METHODS UK clinicians travelled to Sierra Leone to train a small team of ex-ETC staff in a three-phased CBT-based intervention. Standardised clinical measures, as well as bespoke measures, were applied with participants through the intervention to assess changes in mental health symptomology, and the effectiveness of the intervention. RESULTS The results found improvements across all factors of mental health in the bespoke measure from phase 1 to phase 3. Additionally, the majority of standardised clinical measures showed improvements between phase 2 and the start of phase 3, and pre- and post-phase 3. CONCLUSION Overall, the findings suggest that it is possible to train staff from ETCs to deliver effective CBT interventions to peers. The implications of these results are discussed, including suggestions for future research and clinical intervention implementation within this population. The limitations of this research are also addressed.
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Affiliation(s)
| | | | - Charles L Cole
- 2 Division of Psychiatry, University College London, London, UK
| | | | - Neil Greenberg
- 3 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G James Rubin
- 3 Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Alison Beck
- 1 South London and Maudsley NHS Foundation Trust, London, UK
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Anclair M, Lappalainen R, Muotka J, Hiltunen AJ. Cognitive behavioural therapy and mindfulness for stress and burnout: a waiting list controlled pilot study comparing treatments for parents of children with chronic conditions. Scand J Caring Sci 2017; 32:389-396. [DOI: 10.1111/scs.12473] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/04/2017] [Indexed: 12/24/2022]
Affiliation(s)
- Malin Anclair
- Department of Social and Psychological Studies; Section of Psychology; Karlstad University; Karlstad Sweden
| | - Raimo Lappalainen
- Department of Psychology; University of Jyväskylä; Jyväskylä Finland
| | - Joona Muotka
- Department of Psychology; University of Jyväskylä; Jyväskylä Finland
| | - Arto J. Hiltunen
- Department of Social and Psychological Studies; Section of Psychology; Karlstad University; Karlstad Sweden
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Evans K, Morrell CJ, Spiby H. Women's views on anxiety in pregnancy and the use of anxiety instruments: a qualitative study. J Reprod Infant Psychol 2016. [PMID: 29517294 DOI: 10.1080/02646838.2016.1245413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To explore women's experience of anxiety in pregnancy and views on the use of anxiety instruments in antenatal care. BACKGROUND Anxiety in pregnancy is associated with adverse birth outcomes, developmental and behavioural problems in infants and postnatal depression. Despite recommendations for routine psychological assessment in pregnancy, the optimal methods to identify anxiety in pregnancy have not been confirmed. METHODS A qualitative study using two focus group discussions was undertaken. Focus group one included women in a community setting and focus group two included women in a hospital clinic setting who had received additional support for anxiety in pregnancy. Participants were women who had given birth within the past nine months and considered themselves to have been anxious during their pregnancy. RESULTS Three main themes were identified using template analysis: sources of support, administration of anxiety instruments and the use of instruments to prompt discussion. Women stated that anxiety instruments could help them to identify their anxious feelings and prompt a discussion around those feelings. However, they expressed concerns surrounding the administration of anxiety instruments and questioned how useful they would be in helping women access help and support. CONCLUSIONS The introduction of anxiety instruments in antenatal care may present an opportunity to discuss women's emotional health and anxieties. Providing women with sufficient time to discuss their anxious feelings, identified by such instruments, could facilitate access to additional support.
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Affiliation(s)
- Kerry Evans
- a Nottingham University Hospitals NHS Trust UK , Nottingham , UK
| | - C Jane Morrell
- b Health Research, School of Health Sciences , University of Nottingham, Queen's Medical Centre , Nottingham , UK
| | - Helen Spiby
- c Midwifery, School of Health Sciences , University of Nottingham , Nottingham , UK.,d School of Nursing & Midwifery , University of Queensland , Brisbane , Australia
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Morris L, Mansell W, Emsley R, Bates R, Comiskey J, Pistorius E, McEvoy P. Prospective cohort feasibility study of a transdiagnostic group intervention for common mental health problems: The Take Control Course. Psychol Psychother 2016. [PMID: 26200798 DOI: 10.1111/papt.12070] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES While transdiagnostic psychological treatments appear to be promising, they require greater empirical support. Further, a number of available transdiagnostic treatments are targeted at clients with a specific category of disorder, such as clients with anxiety disorders. This study is a preliminary examination of the effectiveness, feasibility, and acceptability of a new transdiagnostic six-session group-based intervention (Take Control Course; TCC) predominantly aimed at clients within primary care. The group is aimed at a broad range of clients; it is derived from an integrative transdiagnostic theory, which specifies mechanisms of psychopathology across disorders. Briefer interventions are gaining an increasing evidence base, and this study seeks to compare the TCC to an established brief intervention within primary care. DESIGN Prospective cohort study comparing two active psychological treatments. METHODS Take Control Course group (n = 66) was compared to a non-randomized control group of clients accessing individual low-intensity interventions (n = 43) using random-effect regression models. Primary outcomes were depression and anxiety scores; additional outcomes included social and other functioning. RESULTS For the TCC group, changes on all pre-post outcomes were significant with moderate effect sizes. The between-group differences were not significant. CONCLUSIONS Results show potential for TCC to be an effective intervention, but further work is required to validate these findings in a more rigorous, randomized study. PRACTITIONER POINTS Transdiagnostic understandings of psychological distress may inform pragmatic and effective treatments that can be offered to a broad range of clients. This study describes a transdiagnostic intervention (TCC) that targets maintenance processes common across disorders, and presents initial outcome data. The TCC was found to reduce pre-post scores on measures of anxiety and depression.
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Affiliation(s)
- Lydia Morris
- School of Psychological Sciences, University of Manchester, UK
| | - Warren Mansell
- School of Psychological Sciences, University of Manchester, UK
| | | | - Rachel Bates
- Six Degrees Social Enterprise, CIC, The Angel Centre, Salford, UK
| | - Jody Comiskey
- Six Degrees Social Enterprise, CIC, The Angel Centre, Salford, UK
| | - Emma Pistorius
- Six Degrees Social Enterprise, CIC, The Angel Centre, Salford, UK
| | - Phil McEvoy
- Six Degrees Social Enterprise, CIC, The Angel Centre, Salford, UK
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‘Life just kind of sparkles’: clients’ experiences of being in cognitive behavioural group therapy and its impact on reducing shame in obsessive compulsive disorder. COGNITIVE BEHAVIOUR THERAPIST 2015. [DOI: 10.1017/s1754470x15000100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractThis study explored the personal accounts of service users relating to their experiences of being in group cognitive behavioural therapy (GCBT) for obsessive compulsive disorder (OCD). Eight participants were purposively selected from two groups whose therapy had finished. These participants were interviewed, the data transcribed verbatim and analysed using interpretative phenomenological analysis (IPA). Five superordinate themes were generated: ‘Engagement in the group process’, ‘Normalizing’, ‘Courage to fight’, ‘Being my own therapist’ and ‘Restricted vs. engagement with life’. The findings in this study have implications for theory in terms of the relevance of shame-based appraisals in conceptualizations of OCD. Suggestions for future groups include the importance of exploring the development of the problem in the group setting and highlight an important role for the group in terms of increasing motivation and preventing dropout. Directions for future research and implications for theory are explored.
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Evaluation of a community reintegration outpatient program service for community-dwelling persons with spinal cord injury. Rehabil Res Pract 2014; 2014:989025. [PMID: 25574397 PMCID: PMC4276116 DOI: 10.1155/2014/989025] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/26/2014] [Accepted: 11/20/2014] [Indexed: 11/17/2022] Open
Abstract
Objective. To evaluate the effectiveness of a community reintegration outpatient (CROP) service for promoting well-being and
community participation following spinal cord injury (SCI).
Participants. Community-dwelling adults (N = 14) with traumatic and nontraumatic SCI. Interventions. The CROP service is a 12-week (1 × week; 120 minutes) interprofessional closed therapeutic education service. Main Outcome Measure(s). Moorong Self-Efficacy Scale (MSES); Impact on Participation and Autonomy (IPA); Positive Affect and Negative Affect Scale (PANAS); Coping Inventory of Stressful Situations (CISS); World Health Organization Quality of Life (WHOQOL-BREF); semistructured qualitative interviews. Methods. Twenty-one participants were recruited from two subsequent CROP services, with only 14 persons completing all data assessments.
Data were collected at baseline (week 0), at exit (week 12), and at a three-month follow-up. Semistructured interviews were conducted at exit. Results. Self-efficacy (MSES) and positive affect (PANAS) improved from baseline to exit (P < .05), but the changes were not maintained at follow-up. Qualitative analysis identified four major themes related to therapeutic benefits: (1) role of self; (2) knowledge acquisition; (3) skill application; and (4) group processes. Conclusions. Participation in a therapeutic education service has the potential to improve well-being in persons with SCI, but there is a need to identify strategies to maintain long-term gains.
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Thimm JC, Antonsen L. Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry 2014; 14:292. [PMID: 25330912 PMCID: PMC4209079 DOI: 10.1186/s12888-014-0292-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Accepted: 10/10/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Previous research has shown that cognitive- behavioral group therapy (group CBT) is an effective treatment for depression. However, the effectiveness of this approach in routine care needs more research. The current study retrospectively examines the outcomes of patients who received group CBT for depression at a psychiatric outpatient clinic between 2003 and 2013. METHODS Based on patient records, 143 patients were identified as having received the treatment, and 88 patients were included in the outcome analyses. The Beck Depression Inventory (BDI-II) score was the main outcome measure. RESULTS The dropout rate was 17.5%. The average BDI-II score decreased from 28.5 to 18.5 from pre-treatment to post-treatment and remained stable at 3-months follow-up. The effect sizes at post-treatment and follow-up were large (d = .97 and d = 1.10, respectively). At post-treatment, 44% of the patients showed a significant improvement in depression, including 30% who recovered; at follow-up, the proportions increased to 57% and 40%, respectively. No predictors of dropout or treatment response were found. CONCLUSIONS Group CBT for depression can be delivered in routine care settings with good results. However, there are still many patients who drop out or do not benefit from treatment.
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Affiliation(s)
- Jens C Thimm
- Department of Psychology, University of Tromsø, 9037 Tromsø, Norway ,Helgeland Hospital Trust, 8607 Mo i Rana, Norway
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Bullis JR, Sauer-Zavala S, Bentley KH, Thompson-Hollands J, Carl JR, Barlow DH. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Behav Modif 2014; 39:295-321. [DOI: 10.1177/0145445514553094] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated promising results among patients with heterogeneous anxiety and comorbid depressive disorders when delivered on an individual basis, but greater efficiencies may be achieved with group-based applications. The aim of the present study was to provide a preliminary exploration of the UP when delivered in a group format. Among diagnostically diverse patients ( N = 11), the UP group treatment resulted in moderate to strong effects on anxiety and depressive symptoms, functional impairment, quality of life, and emotion regulation skills, as well as good acceptability and overall satisfaction ratings from patients. Three clinical cases are presented in detail to illustrate the group-based UP delivery, followed by a critical discussion of associated challenges and proposed guidelines for group administration, as well as directions for future research.
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