Enhancing self-esteem through cognitive behavioural group therapy - a randomized feasibility study of a transdiagnostic approach in psychiatric care

Abstract

• The majority of psychiatric patients complain about severely disturbed self-esteem • The enhancement of self-esteem is one of the major therapeutic goals for patients • Self-esteem CB group offers an effective, transdiagnostic and economic treatment • Self-esteem interventions should be integrated as standard in inpatient psychiatry Working with patients with mental disorders, one most likely comes across a common ground: self-esteem issues. In view of the high cross-diagnostic relevance, it is surprising that psychotherapeutic group treatments mostly treat self-esteem as a marginal topic. A promising treatment opportunity in psychiatry might have been neglected. We developed a 12-session cognitive behavioral group therapy module to treat low self-esteem in a diagnostically mixed group of psychiatric inpatients (average age: 43,31 years, 60,78% female), the affective disorder category forming the largest portion of our sample, who were randomly assigned: 61 patients participated in the intervention group in addition to treatment‐as‐usual (TAU) and 41 served as controls by receiving TAU. The MANOVA not only showed a significant improvement in self-esteem and depression scores within the intervention group over the course but also in comparison to the control group. The aim of a broad application of the group therapy concept under realistic clinical conditions requires the inclusion of patients with various disorders and treatment plans and therefore an acceptance of a high sample heterogeneity. High external validity is often at the expense of internal validity, even with the review of possible confounding variables. Furthermore, long-term effects of the training are yet to be investigated. Self-esteem issues represent a topic that unites a large group of patients and therefore offers a promising cross-diagnostical approach. The group module appears to be effective in a heterogonous patient population and promises an effective economic therapy approach and could therefore be integrated in the clinical standard of psychiatric inpatient treatments.