Behavioral Group Therapy Research Articles

Therapist and supervisor perspectives about two train-the-trainer implementation strategies in schools: A qualitative study.

Train-the-trainer (TT) implementation strategies (in which designated clinicians are trained to then train others in an intervention) are promising approaches to support mental health clinician use of evidence-based interventions in school contexts. However, there is little evidence to date examining clinicians' perceptions of the acceptability and feasibility of TT strategies, or comparing clinicians' perceptions of different types of TT strategies. The current study was conducted as part of a larger hybrid effectiveness-implementation trial, in which school-based therapists and supervisors received one of two different types of implementation support to implement cognitive behavioral therapy (CBT) groups for anxiety: TT (i.e., initial training for therapists and supervisors) or enhanced TT (TT+; i.e., initial training for therapists and supervisors, and ongoing external consultation for supervisors). We used applied thematic analysis to compare qualitative interview transcripts from 28 therapist interviews and 33 supervisor interviews from therapists and supervisors who received TT or TT+ support and report themes that were similar and different across the two groups. Most themes were similar across the TT and TT+ conditions: therapists and supervisors in both conditions perceived the group anxiety intervention as acceptable and viewed supervision as acceptable, helpful, and feasible. Therapists and supervisors in both conditions had mixed impressions of the contextual appropriateness of the group anxiety intervention, and some reported logistical challenges with weekly supervision. Some unique themes were identified among the TT+ condition, including supervisors experiencing professional growth, and therapists and supervisors perceiving supervision as critically important and enjoyable. These results suggest that TT implementation support, using a model in which an internal supervisor receives initial training and then provides ongoing supervision, is acceptable and feasible to support a group CBT intervention in schools. The results also highlight additional benefits that therapists and supervisors perceived when supervisors received ongoing consultation. The clinical trial from which these data were derived was registered at ClinicalTrials.gov (https://clinicaltrials.gov/) prior to the time of first patient enrollment. The registration number is: NCT02651402.

‘I almost felt like I can be a little bit more honest’: experiences of a telehealth group for bipolar disorder

Abstract Despite the increasing use of telehealth platforms to deliver cognitive behavioural group therapy programs, few studies have been conducted that explore the experience of using telehealth platforms for those living with bipolar disorder. The present study aimed to explore the impact of the telehealth platform on the delivery of a recovery-orientated well-being plan group program for participants living with bipolar disorder. A total of 19 participants completed the qualitative interviews (3 male, 16 female). Using content analysis, data were deductively coded in line with pre-existing codes and matrix categories with unexpected data that discussed the telehealth experience being coded using an inductive content analysis framework. Two themes were identified: (1) Social inclusion, which included the subthemes of (a) connection to others via telehealth and (b) feeling safe using telehealth; and (2) Barriers and engagement, which included the subthemes of (a) removing barriers by using telehealth and (b) symptom impacts to engagement using the telehealth platform. Participants reported increased connection with others using telehealth and feeling greater safety overall when using the telehealth platform; however, some noted that dominant personalities could contribute to feeling unsafe within the group at times. Overall, the platform reduced barriers and was easy to use with this being a convenient way to attend, even if in some instances the platform highlighted differences between the members. Key learning aims (1) Telehealth platforms provide a unique opportunity for connection for those living with bipolar disorder. (2) Telehealth platforms may increase feelings of personal safety but may also increase feelings of difference between group members. (3) Symptoms may impact on engagement with anxiety and mood symptoms playing a role; however, telehealth may also decrease barriers to engagement.

Comparing of the effectiveness of group acceptance and commitment therapy and group cognitive behavioral therapy on emotion regulation, psychological capital and coping strategies of students

Background and Aim: The needs of today's life, human beings with numerous challenges, stress and pressures that require effective coping with them to have socio-psychosocial abilities. This study aimed to compare the effectiveness of acceptance and commitment-based group therapy and cognitive behavioral group therapy on emotional regulation, psychological capitals and and coping strategies of students. Methods: The research method was quasi-experimental with pre, post and follow-up design with control group. To this end, 75 students whom had criteria for entering the research were selected through convenience sampling and using simple random selection to input them into three groups (two experimental proups and one control group- each group 25 members). The workshops were held once a week for 12 sessions of 90 mins. In this research emotion regulation breaf form (Garnefski & Kraaij, 2006), psychological capitals (Luthans & Avolio, 2007) and coping strategies (Folkman & Lazarus, 1988) questionnaires administered among selected samples. Results: The findings confirmed that two interventions were not significantly different on emotion regulation (P=0.440) but acceptance and commitment-based group therapy was significantly more effective than cognitive behavioral group therapy on psychological capitals (P=0.024) and coping strategies (P<0.0001); and this significant difference effectiveness was stable in follow-up stage only on coping strategies (P=0.044), but for emotion regulation (P=0.840) and psychological capitals (P=0.680) no significant difference had found. Conclusion: Based on the findings, it can be concluded that acceptance and commitment therapy and cognitive behavioral group therapy are two useful methods of therapy to help the students.

Comparing the Effectiveness of Cognitive Behavioral Group Therapy and Mindfulness and Acceptance Group Therapy for Adults who Stutter: A Randomized Clinical Trial.

Considering the importance of psychological interventions for adults who stutter (AWS), the present study compared the effectiveness of Cognitive Behavioral Group Therapy (CBGT) and Mindfulness and Acceptance Group Therapy (MAGT), in combination with Speech Therapy (ST) in AWS. A randomized clinical trial was conducted with 36 AWS in Tehran and Alborz provinces in Iran from September-2019 to September-2020. Participants were assigned to CBGT + ST and MAGT + ST groups. Outcomes variables, the fear of negative evaluation scale (FNE) and the social avoidance and distress scale (SAD), were measured at four stages: (1) pretest, (2) after MAGT/CBGT, (3) after ST, and (4) at 6-month follow-up. The results of repetitive measure-analysis on variance showed that CBGT + ST and MAGT + ST were significantly effective (P = 0.001 and P = 0.003) on SAD. The same analysis showed that CBGT + ST was significantly effective (P = 0.001) on FNE. The results of Analysis of Covariance showed that there was no significant difference between CBGT + ST and MAGT + ST on SAD but CBGT + ST was more effective than MAGT + ST at stage 3 (P < 0.05) on FNE. Data indicated that CBGT + ST and MAGT + ST were both effective for SAD of AWS. Regarding FNE, unlike MAGT + ST, CBGT was effective either alone or in combination with ST for AWS. Further studies are needed to confirm the results of this study.

The Effects of Group Based Cognitive Behavioral Therapy on Self-Compassion, Social Anxiety and Ruminative Thought Style of Turkish Youth Transitional Age: A Controlled Study on University Students

Abstract Background: Social anxiety disorder (SAD) occurs in social environment or performance conditions, is characterized by the fear of being negatively evaluated or showing symptoms of anxiety and usually causes avoidance behavior. It is known that that changing negative thoughts and producing alternative thoughts have an important place in the treatment of social anxiety disorder. In Cognitive Behavioral Therapy, the focus is mainly on the person's negative thoughts about himself. Group Based Cognitive Behavioral Therapy (CBGT) is frequently used therapy model in anxiety disorders, including social anxiety. The aim of this study is to examine the effect of CBGT on the social anxiety levels of university students with SAD, as well as on their ruminative thinking and self-compassion. Methods: Liebowitz Social Anxiety Scale was applied to 1200 students. 30 university students who had highest social anxiety levels were selected. The selected students were assigned to the experimental and placebo groups. CBGT was applied to the experimental group, and communication-based group therapy was applied to the placebo group. Results: There is a significant difference between pretest and posttest of the LSF and rumination levels of the experimental group. In addition, LFS and rumination post-test levels were found to differ significantly according to the group. There was no significant difference in self-compassion levels. Conclusion: The social anxiety and ruminative thinking levels of the students with social anxiety disorder who were applied cognitive behavioral group therapy decreased. No change was observed in the self-compassion levels of the individuals.

A eficácia da Terapia do Sandplay versus Terapia Cognitiva Comportamental: um estudo comparativo

Abstract Objective This study was designed to compare the effectiveness of Sandplay Therapy and Cognitive Behavioral Therapy in the reduction of clinical/borderline symptoms in children and adolescents. Method The participants were 21 victims of domestic violence with clinical or borderline scores on the Child Behavior Checklist and Young Self Report. They were also tested with Wechsler Abbreviated Intelligence Scale (T0) and designed by random to treatment and control groups. They were tested with the same instruments at T1 (after 20 sessions/ 20 weeks) and T2 (after 6 months). Results For the children, there were no changes across the groups, but a significant improvement in internalizing behavior problems in the sandplay group and in externalizing and total behavior problems in the Cognitive Behavioral Therapy group. For the adolescents, there was a significant improvement in externalizing behavioral problems in the sandplay group and in the total behavior problems for the Cognitive Behavioral Therapy group. Conclusion The results of this research do not allow to conclude that one technique is better than another since we did not have a consistent significative difference across the groups. These results may be due to the different approaches of the techniques. While Sandplay Therapy provides a free and protected space to allow the participants to express their feelings through images and histories, Cognitive Behavioral Therapy follows a program that focuses more on promoting behavior adaption to outside world. The application of this research design with a large population and with more sessions will allow to observe the consistence of these findings, providing a more solid ground to choose which technique would be more efficient for each specific case.

Comparing the effectiveness of schema therapy with cognitive behavioral therapy on negative emotions in women with MS

Background and Aim: Negative emotions are one of the things that a person with MS is dealing with and it reduces their opportunities to establish social interactions, and this issue threatens their social relationships, quality of life, and as a result, their mental health. The purpose of this study was to compare the effectiveness of schema therapy with cognitive behavioral therapy on negative emotions in women with MS in Kermanshah. Method: The current research was of applied purpose type and in terms of methodology, it was semi-experimental with a pre-test-post-test design, a control group and a two-month follow-up. The statistical population of the research included all women with multiple sclerosis (MS) in Kermanshah during 2019-2020 who had referred to the Imam Reza Educational-Therapeutic Center. In this research, in order to select the research sample, first of all, among the female patients with multiple sclerosis who were referred to the Imam Reza Educational-Therapeutic Center (AS) in Kermanshah to receive medical services, the research questionnaires were distributed (taking into account the observance of all health principles in the face of the corona virus disease), the data collection tool included the DASS-21 questionnaire. Analysis of variance with repeated measurements and SPSS software were used for statistical analysis of data. Results: The findings showed that there was a statistically significant difference in the overall negative emotions scores of the participants in the control group compared to the negative emotions scores of the participants in the first intervention group (schema therapy) and the participants in the cognitive behavioral therapy group. This is while there was no significant difference in the score of negative emotions between the two intervention groups of schema therapy and cognitive behavioral therapy. This situation applies to the two components of depression and stress. That is, the level of depression and stress of the people in the two educational intervention groups has decreased significantly compared to the people in the control group, but there was no difference between the two intervention groups. Regarding the anxiety component, the results of the follow-up test indicate that although the anxiety of the two intervention groups has a mean difference (2.27 and 2.07) with the control group, this difference is not significant. Conclusion: Based on the available findings, it can be concluded that there was no difference between the effects of schema therapy and cognitive-behavioral therapy on reducing negative emotions.

Comparison of the effectiveness of compassionate mind-based therapy and dialectical behavior therapy on cognitive deficits, emotional processing defects and impulsivity of adolescent soldiers aged 18 to 20 years with high-risk behaviors

Background and Aim: High-risk behaviors are behaviors that increase the likelihood of physical, psychological and social disastrous consequences for the individual. The aim of this study was to compare the effectiveness of compassionate mind therapy and dialectical behavior therapy on cognitive deficits, emotional processing defects and impulsivity of adolescent soldiers aged 18 to 20 years with high-risk behaviors. Methods: The method of the present study was quasi-experimental with a pretest-posttest design with a follow-up group. The statistical population of this study included all adolescent soldiers aged 18 to 20 years who referred to Valiasr Medical Center in Tehran in 2020. The sample selection process in the present study consisted of two stages: The first stage was done by purposeful sampling method of high-risk behaviors questionnaire to screen soldiers referred to Valiasr Medical Center in Tehran and among those who received a score higher than the screening method 50 people were selected based on the completion of the consent form for participation in the research as well as the inclusion and exclusion criteria of 45 people (15 people in the first experimental group, 15 people in the second experimental group and 15 people in the control) and specialized in 3 groups at random. To collect data, Iranian adolescents' risk questionnaires, cognitive deficits, Toronto Alexithymia scale, and Impulsivity Scale were used. Results: A pairwise comparison between the two treatment groups showed that cognitive deficits in the two treatment groups of compassion (I-J=7.20; P&lt;0.01) and dialectical behavior therapy (I-J=8.66; P&lt;0.01), Was significant from pre-test to post-test in contrast to control group (I-J=1.56; P&lt;0.05); Also, the study of emotional processing deficits shows that only the dialectical behavior therapy group (I-J=12.73; P&lt;0.01) was significant from pre-test to post-test. Also, the study of impulsivity in treatment groups shows that only compassion treatment was effective in reducing impulsivity (I-J=7.66; P&lt;0.01). Conclusion: According to the findings of the present study, it seems that with compassionate practice and increasing positive emotions, a person's behavioral-intellectual treasury expands, which can it provided the basis for problem-solving and the reduction of conflicts between intrapersonal and interpersonal emotions, thereby reducing impulsivity and risky behaviors.

Supplemental Material for A Randomized Trial of Telehealth Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy Groups for Adolescents With Mood or Attenuated Psychosis Symptoms

Supplemental Material for A Randomized Trial of Telehealth Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy Groups for Adolescents With Mood or Attenuated Psychosis Symptoms

The effectiveness of cognitive-behavioural group therapy on infertile men, a randomised clinical trial

ABSTRACT Background Infertility can result in the emergence of depression and anger, the loss of one’s identity, and the feeling of guilt in the infertile person. Present study aimed to investigate the effects of cognitive behavioural group therapy (CBGT) on infertile men’s anger and positive and negative affect. Materials and methods Forty-three men with infertility for at least five years were selected for the present randomised clinical study. Spielberger’s State-Trait Anger Expression Inventory-II (STAXI-II) and the PANAS scale (positive and negative affect) were filled out by the participants, and they were randomly divided into the experimental (22) and control (21) groups. The experimental group received 18 ninety-minute sessions of hybrid group therapy held twice a week, while the control group received no intervention. When the intervention program was over, all participants performed the post-test. Moreover, the post-hoc stage was held two months later. Results The effects of the intervention were significant in terms of state anger, trait anger, anger expression in, anger expression out, positive effects, and negative effects (p < 0.004), but they were not significant concerning the anger control out index (p = 0.241). The significant differences between the two groups were also observed in the post-hoc stage. Conclusions The CBGT therapy seems to be helpful for infertile men to reduce their anger and negative affect and increase their positive affect by implementing a set of techniques like cognitive regeneration, assertiveness, daily joyful activities, exercises to relax one’s muscles, diaphragm respiration, the identification of various fillings, and emotional expression.

Outcomes from a brief group behavior therapy approach for social anxiety disorder in adolescence: An exploratory clinical trial

Social anxiety disorder (SAD) usually develops in adolescence and is maintained by avoidance and safety seeking behaviors, which are the focus of behavioral therapy (BT). This work explored the outcomes of a brief group BT for SAD in adolescence, combining exposure with skills training. Fourteen adolescents (aged 14-18 years old) diagnosed with SAD received the intervention. BT was compared to a waiting list condition (n = 10) from pre- to post-intervention; how change in avoidance and safety behaviors predicted post-intervention social anxiety was also tested. Significant improvement was limited to anxiety and avoidance when interacting in new social situations, which may be due to skills training having been focused on general interaction. Only change in avoidance predicted post-intervention social anxiety. Though exploratory, current findings suggest BT to be a relevant approach to SAD. As such, it may inform future more robust studies on interventions tailored to specific core social fears.

Efikasi Konseling Kelompok Cognitive Behavior Therapy dengan Teknik Self-Instruction untuk Meningkatkan Kepercayaan Diri

The purpose of this study was to determine the level of self-confidence, which is a positive attitude of an individual that enables him/herself to develop positive judgments, using group counseling the Cognitive Behavior Therapy Group Counseling Efficacy approach with Self-Instruction Techniques to Increase Self-Confidence. This study uses a quantitative approach with quasi-experimental research methods. The design used in this study used a pretest and multiple posttest repeated measure experimental design. From the results obtained, it can be said that there was significant interaction between times (pre-test, post-test, and follow-up) in the self-confidence group given self-instruction techniques of (M = 85.71, SE = 4.24). Based on the research that has been done, it can be seen that group counseling with self-instruction techniques is effective in increasing the self-confidence of students who use social media at SMP Negeri 13 Semarang.

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

• 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.

A specific cognitive behavioral group therapy program for stimulant use disorder.

Stimulant use is an important health issue. In the US in 2018, 2.8% of males and 1.5% of females older than 18 had used cocaine in the preceding 12 months. To intervene in a specific targeted group of Stimulant Use Disorder (SUD) patients according to CBT and relapse prevention theories, and to determine the program's feasibility and attendance. Stimulant Use Disorder patients in addiction care were evaluated for addictive, psychological and psychiatric dimensions at baseline and conclusion in a 9-session CBT group program with several themes: define SUD, enhance motivation, involve close companions, cope with craving, decline a proposal, solve problems, invite expert patients, invest time and money, and review content. In total, 41 patients attended at least one session. They were mainly poly dependent, primarily cocaine users. Sixty percent of the population also suffered from another psychiatric comorbidity. Median attendance for participants was 7/9 sessions. A specific targeted CBT group for stimulant dependent highly comorbid patients is feasible. These findings suggest that peers should be included in addiction care services.

Comparison of outcomes across low-intensity psychological interventions for depression and anxiety within a stepped-care setting: A naturalistic cohort study using propensity score modelling.

Low-intensity interventions for common mental disorders (CMD) address issues such as clinician shortages and barriers to accessing care. However, there is a lack of research into their comparative effectiveness in routine care. We aimed to compare treatment effects of three such interventions, utilizing four years' worth of routine clinical data. Users completing a course of guided self-help bibliotherapy (GSH), internet-delivered cognitive behavioural therapy (iCBT) or psychoeducational group therapy (PGT) from a stepped-care service within the NHS in England were included. Propensity score models (stratification and weighting) were used to control for allocation bias and determine average treatment effect (ATE) between the interventions. 21,215 users comprised the study sample (GSH=12,896, iCBT=6862, PGT=1457). Adherence-to-treatment rates were higher in iCBT. All interventions showed significant improvements in depression (PHQ-9), anxiety (GAD-7) and functioning (WSAS) scores, with largest effect sizes for iCBT. Both propensity score models showed a significant ATE in favour of iCBT versus GSH and PGT, and in favour of GSH versus PGT. Discernible differences in effectiveness were seen for iCBT in comparison with GSH and PGT. Given variance in delivery mode and human resources between different low-intensity interventions, building on these findings would be valuable for future service provision and policy decision making.

Konseling Kelompok Rational Emotive Behaviour Therapy Berbasis Nilai Budaya Jawa Untuk Meningkatkan Kebermaknaan Hidup Pada Masa Pandemi Covid-19

he meaning of life is a condition in which the individual has a high motivation for the life lived to achieve the goals and happiness of his life. However, the Covid-19 pandemic has also caused problems in various fields, one of which has an impact on decreasing life goals, life satisfaction, freedom of choice, passions, and responsibility for life. The purpose of this study is to help people improve their survival through counseling groups rational emotive behaviour therapy based on Javanese cultural values. This research method pre-experiments one group pretest posttest design with random sampling techniques. The results showed that counseling the rational emotive behaviour therapy group based on Javanese cultural values succeeded in improving the meaning of people's lives during the Covid-19 pandemic as evidenced by the results of statistical tests with the Wilcoxon Test seen by Asymp. Sig/Asymptotic significance of two sides is 0.043 and the probability value is less than 0.05. This confirms that the intervention in the form of Rational Emotive Behavior Therapy counseling services based on Javanese Cultural Values Can Increase the Meaningfulness of Life During the Covid-19 Pandemic

Web-based Evidence on the Treatment of Behavioral Addictions in United States Model Treatment Centers.

Behavioral addictions are highly comorbid with substance use disorders, presenting in as many as 54% of service users receiving substance use treatment. Few studies have examined whether treatment centers are attentive to such other addictions, which may undermine treatment. This study examined the mention and treatment of behavioral addictions on United States treatment center websites. The 2021 Newsweek America's Best Addiction Treatment Centers website was utilized to examine the mention and treatment of behavioral addictions in 300 leading treatment centers across 25 states in the United States. Of 289 active websites, only 61 (21.1%) treatment centers mentioned anything about behavioral addictions. The highest prevalence was for gambling (n = 38), sex (n = 22), food/eating (n = 21), and internet gaming (n = 12). A total of 49 treatment centers reported treating those addictions. The most prevalent treatments involved 12-step programming (n = 18), cognitive behavioral therapy (CBT; n = 16), individual counseling (n = 16), and group therapy (n = 15). Little formalized importance via websites was provided regarding the mention or treatment of behavioral addictions at treatment centers. A greater emphasis on concurrent and substitute behavioral addictions is needed to improve the quality of life and lower the possibility of relapse among those persons in addictions treatment.

Effects of Two Modes of Groups Counseling Approaches on HIV Voluntary Counseling and Testing Among School-going Adolescents

Aims: The study investigated the effects of cognitive behavioral and reality group therapies in fostering human immunodeficiency virus/ voluntary counseling and testing among school-going adolescents in Benin Metropolis, Edo State, Nigeria. Method: A pre- and post-test true experimental control group design was observed. While 120 school-going adolescents from three randomly selected schools were recruited and randomly assigned to two treatments (Cognitive Behavior [37] and Reality [34] Therapies) and control [38] groups, with 11 dropout accounting for 9% alteration rate. The treatment last six weeks. Two hypotheses were formulated to guide the study. The instruments used for data collection were self-administered scales with a test-retest reliability coefficient of 0.87 after an interval of three weeks. Data generated was analyzed using the inferential statistics of Analysis of Variance tested at a 0.05 level of significance. Results: The results showed that cognitive behaviour and reality therapies were significantly effective in fostering HIV/voluntary counselling and testing among school-going adolescents. That is, the two modes of group interventions improve the willingness of adolescents of these schools towards receiving counselling and performing testing for HIV. Conclusion: It was concluded that cognitive behaviour and reality therapies were found to be potent on school-going adolescents’ willingness toward HIV voluntary counselling and testing for prevention and treatment.

Comparing the effectiveness of behavioral activation group therapy and treatment based on acceptance and commitment on depression and quality of life of people with cancer

Comparing the effectiveness of behavioral activation group therapy and treatment based on acceptance and commitment on depression and quality of life of people with cancer

Culturally adapted cognitive behavioural group therapy for mental disorders in refugees plus problem solving training (ReTreat): study protocol for a multicentre randomised controlled trial

IntroductionSince a high proportion of refugees in Germany suffer from mental disorders, culturally adapted treatments are needed that target a broad range of symptoms. There is much evidence for the...