Cognitive-behavioral Group Treatment Program Research Articles

Efficacy of a treatment program based on positive psychology for drug use in juvenile offenders.

One of the factors that increase the likelihood of adolescents starting to exhibit and consolidate anti-social behavior is drug use, with a consistent pattern of consumption of different substance found in young offenders (Aebi, Bessler & Steinhausen, 2021). A cognitive-behavioral group treatment program inspired by the positive psychology approach was developed and applied to drug use in minors deprived of liberty (experimental group); the results were compared to those of a group of adolescents with the same type of drug use in the same center (active control group) at two points in time: during and after incarceration. The fall in the rate of problems associated with drug use after incarceration in the experimental group was statistically significant compared to the control group, and the effect size of the experimental condition was large (ῆ2 = 0.55), much higher than the control group (ῆ2 = 0.16). The treatment program has proven to be an effective tool for reducing problems associated with drug use and is especially effective in reducing alcohol and cannabis consumption.

The Social Suspiciousness Scale: Development, Validation, and Implications for Understanding Social Anxiety Disorder

The Social Suspiciousness Scale (SSS) is a 24-item self-report questionnaire designed to assess suspiciousness, along with the associated constructs of anger and hostility, within a social context. The present research evaluated the psychometric properties of this newly developed scale. The sample consisted of outpatients with social anxiety disorder (SAD; n = 145), unselected undergraduate university students (n = 162), and healthy community controls (n = 46). A principal components analysis suggested a one-factor solution. Internal consistency of the scale was high, and interitem correlations indicated that items were nonredundant. Test-retest reliability was strong. SSS scores were moderately correlated with measures of social anxiety, paranoia, anger and hostility. Moreover, in the outpatient SAD sample, SSS scores decreased significantly following a 12-week cognitive-behavioral group treatment program for SAD. The SSS may be a useful tool for measuring suspiciousness, anger and hostility across a variety of social contexts, particularly in individuals with SAD. This research contributes more generally to a broader understanding of SAD, and supports the importance of considering the role of mistrust and suspiciousness in this disorder.

The Development of a Transdiagnostic, Cognitive Behavioral Group Intervention for Childhood Anxiety Disorders and Co-Occurring Depression Symptoms

Anxiety and depression are highly prevalent and frequently comorbid classes of disorder associated with significant impairment in youth. While current transdiagnostic protocols address a range of potential anxiety and depression symptoms among adult and adolescent populations, there are few similar treatment options for school-aged children with symptoms of these emotional disorders. Such a protocol could be of particular benefit to children experiencing emergent anxiety and depressive symptoms prior to adolescence, as these youth may be at risk for a more severe and protracted course of illness. For this reason, Emotion Detectives, a cognitive behavioral group treatment program, was developed as a downward extension of existent transdiagnostic protocols for emotional disorders in older populations (e.g., Barlow et al., 2010; Ehrenreich et al., 2008) for use with children ages 7 to 12 and their families. This paper will discuss the theoretical basis for Emotion Detectives and provide a description of its 15-session protocol, its unique and developmentally sensitive features, and case studies of 2 children enrolled in an ongoing open trial.

Clinical effectiveness of a cognitive behavioral group treatment program for anxiety disorders: A benchmarking study

Previous research has established efficacy of cognitive behavioral therapy (CBT) for anxiety disorders, yet it has not been widely assessed in routine community clinic practices. Efficacy research sacrifices external validity to achieve maximum internal validity. Recently, effectiveness research has been advocated as more ecologically valid for assessing routine clinical work in community clinics. Furthermore, there is a lack of effectiveness research in group CBT. This study aims to extend existing research on the effectiveness of CBT from individual therapy into group therapy delivery. It aimed also to examine outcome using not only symptom measures, but also measures of related symptoms, cognitions, and life quality and satisfaction. Results from a cohort of patients with various anxiety disorders demonstrated that treatment was effective in reducing anxiety symptoms to an extent comparable with other effectiveness studies. Despite this, only 43% of individuals showed reliable change, and 17% were ‘recovered’ from their anxiety symptoms, and the post-treatment measures were still significantly different from the level of anxiety symptoms observed in the general population.

Preliminary evaluation of a broad-spectrum cognitive-behavioral group therapy for anxiety

This study involved the development and outcome evaluation of a cognitive-behavioral group treatment program for anxiety disorder using a randomized controlled design. This treatment program deviated from traditional anxiety disorder treatment protocols in that anxiety diagnosis was de-emphasized and treatment focused on shared common features across the anxiety disorders. Twenty-three participants were recruited and randomly assigned to either immediate treatment or waitlist control conditions. Nine randomly assigned participants representing a range of anxiety diagnoses completed the 12-week group treatment, and were compared with 10 waitlist control participants who stayed in the study during the waitlist period. Participants in the two conditions were compared on change in diagnosis, diagnostic severity, self-report fear on ideographic measures, and self-report questionnaires of anxiety and state negative affect. Results were generally supportive of the efficacy of the treatment program. Compared to controls participants, those receiving treatment showed significantly greater improvement on diagnostic measures and ideographic fear-avoidance hierarchies. Data from self-report measures of anxiety and state negative affect were less supportive of the treatment efficacy. Implications for emerging conceptualizations of anxiety disorders, as well as implications for treatment and treatment dissemination, are discussed.

Changes in body image during cognitive-behavioral treatment in women with bulimia nervosa

The purposes of this study were: (1) to examine multidimensional aspects of body image of individuals with bulimia nervosa (BN) at pre-treatment, post-treatment, and at follow-up, compared to a group of participants without BN; and (2) to investigate whether measures of body image predicted outcome at post-treatment and follow-up. The clinical sample consisted of 109 females with BN who were enrolled in a 12-week cognitive-behavioral group treatment program. Participants were assessed at baseline, at the completion of treatment, and at 1- and 6-month follow-up visits. The 82 females who comprised the non-bulimic sample were assessed at comparable time intervals. At baseline, the participants with BN reported greater body dissatisfaction and overestimated body size to a significantly greater degree than the comparison group, and reported a significantly smaller ideal size relative to perceived size. Results at the end of treatment indicated significant improvement in self-reported attitudinal disturbance and size overestimation, with continued reductions at follow-up. Logistic regression analyses did not demonstrate a predictive relationship between body image measures at baseline and outcome at post-treatment or follow-up, or between post-treatment and follow-up. Implications for treatment include specifying the source of body image-related distress and enhancing treatment efforts for perceptual and attitudinal aspects of body image.

Personality, interpersonal, and motivational predictors of the working alliance in group cognitive-behavioral therapy for partner violent men.

Recent studies have demonstrated that the working alliance predicts treatment outcome for partner violent men. This study examined the influence of personality and interpersonal characteristics, motivational readiness to change, and demographic factors on working alliance formation among a sample of men (N = 107) participating in a cognitive-behavioral group treatment program for partner violence. Motivational readiness to change was the strongest predictor of the working alliance. Psychopathic personality characteristics also emerged as a strong (negative) predictor of the working alliance. Lower levels of borderline personality characteristics and interpersonal problems, self-referred status, married status, and higher age and income predicted higher working alliance ratings. The results support recent clinical efforts to address motivational readiness in programs for partner violent men.

Cognitive behavior therapy for functional gastrointestinal disorders: is group treatment effective?

The intention of this study was to evaluate therapy outcome of a cognitive-behavioral group treatment program for functional gastrointestinal disorders. As a particular characteristic, gastrointestinal symptoms were investigated independently from diagnostic categories on a dimensional basis, considering the persistence of symptoms as well as the aspect of severity. A total of 64 subjects participated in the 10-week treatment program, and 49 completed the study. Subjects underwent four assessments (baseline, pre-, post-treatment, 12-month follow-up), each comprising several self-rated questionnaires on gastrointestinal, somatoform, depressive, hypochondriacal and anxious symptoms, and health locus of control, as well as a diagnostic interview of functional gastrointestinal and mental disorders at the baseline assessment. Treatment effects were controlled by subjects' waiting list period before treatment. Gastrointestinal symptoms, as well as comorbid psychopathology scores, decreased significantly during treatment and remained unchanged during the follow-up period, whereas no relevant changes were found in health locus of control. Largest effect sizes were found for gastrointestinal symptoms, which decreased by 30-50% of their initial number. The group treatment investigated was effective and particularly successful with respect to functional gastrointestinal symptoms. However, the mechanisms of treatment outcome remain indistinct. Further studies comparing different setting conditions directly are required to clarify the question of whether group treatment is significantly superior or inferior to individual therapy.

Cognitive-behavioral group treatment program for adults with epilepsy in Hong Kong

A subjective sense of uncertainty is a common theme in the experience of patients with epilepsy. Lack of control has also been implicated as an etiologic factor in the development of psychosocial problems in epilepsy. Cognitive-behavioral interventions emphasizing the mediating role of thoughts and self-control appear to be particularly relevant for patients with epilepsy because anxiety and depression are the most common problems. Despite its apparent importance, very little systematic research has been published on the effectiveness of psychological treatment of epilepsy. The purpose of the present study was to conduct a seminal outcome evaluation of psychological intervention for adult patients in Hong Kong. Using a waitlist control group, the treatment program focused particularly on cognitive restructuring and seizure control. Results indicated significant gains by the treatment group in overall quality of life and self-efficacy. In particular, marked improvements were noted for emotional well-being, seizure, and stress management. The clinical implications are discussed in the context of developing specific intervention programs and outcome measures specific to the various needs of adult patients with epilepsy.

Multicomponent standardized treatment programs for fear of flying: Description and effectiveness

This paper has two objectives. The first is to describe a multimodal, standardized treatment program used by the VALK Foundation, an agency that specializes in the treatment of patients with fear of flying. The second is to present the results of an evaluation of this program, particularly with regard to the effectiveness of a 2-day cognitive-behavioral group treatment program and a 1-day behavioral group treatment program for flying phobics. On the basis of individualized assessment, patients (N = 1,026) were nonrandomly assigned to 1 of the 2 group treatment modalities. Self-report data and behavioral indicators for fear of flying were collected at pretreatment and at 3-, 6-, and 12-month follow-ups. Complete data were obtained from 757 participants. Results showed that both treatment programs produced statistically significant, clinically relevant decreases in self-reported anxiety and behavioral anxiety indices. This paper explains the procedures and outcomes of a well-established clinical program. Limitations of the study are discussed and future research suggested.

Female Perpetrators of Partner Aggression

Summary The topic of female partner aggression has been a controversial focus of debate over the past 25 years, and yet we lack a coherent body of literature that effectively describes the phenomenon of female partner violence and guides the treatments we are able to provide. This paper is an attempt to gather and integrate the fragments of data that we do have with related treatment issues, such as substance abuse, trauma, and attachment disorders, that appear to be highly relevant to this population. A structured cognitive-behavioral group treatment program, designed to address women's needs as both victims and perpetrators, is described, and suggestions for further investigation are offered.

Changes in eating self-efficacy and body image following cognitive–behavioral group therapy for binge eating disorder: A clinical study

Binge eating disorder (BED) is a frequent and significant psychiatric comorbidity among individuals seeking treatment for obesity. Cognitive–behavioral therapy (CBT) is frequently recommended for the treatment of obese individuals with BED. However, there is limited investigation into the effectiveness of the specific components of CBT. In this study, we examine the impact of CBT for BED in obese women on self-efficacy for eating behavior and body image issues. Participants were 12 obese women who participated in a 15-week CBT group program. As predicted, results indicated a reduction in binge episode frequency and significant improvements in self-efficacy and body image pre- and posttreatment. These findings support the premise that a structured cognitive–behavioral group treatment program for obese individuals with BED will promote changes in self-efficacy and body image.

The effect of a cognitive-behavioral group treatment program on hypoactive sexual desire in women

The present paper describes the first extensive controlled study designed to assess and treat Hypoactive Sexual Desire Disorder (HSD) following an innovative, short-term, cognitive-behavioral group treatment program. HSD is well known to be among the most complex and difficult sexual disorders to treat. While the clinical literature reports positive treatment outcomes and descriptions of successful sex therapy techniques for sexual desire disorders, most of these are based primarily on single or multiple case studies following various therapeutic approaches. To date, there are no comprehensive controlled treatment outcome studies on the effect cognitive-behavioral treatment has on HSD. Results of this study are presented, as well as some descriptive information on women presenting with HSD. In general, results indicate that the treatment protocol is effective. It not only decreases the symptoms of this sexual disorder, but also improves overall cognitive, behavioral and marital functioning associated with HSD.

Moral Development Among Court-Ordered Batterers: Evaluating the Impact of Treatment

Objective: This study evaluated the impact of a standard cognitive-behavioral group treatment program on altering levels of moral reasoning among court-ordered batterers. Method: The study employed a nonequivalent control group design in examining the moral reasoning level of 32 adult men, 84% African American, court ordered into a standard group treatment program for domestic violence offenders. Results: Analysis of the pretest data indicated that the entire sample of batterers was employing a level of moral reasoning two standard deviations lower than adults in general. In addition, analysis of the posttest data demonstrated that there was no significant increase in moral reasoning at the conclusion of the treatment program. These findings indicated that the current treatment program was ineffective in influencing moral reasoning. Conclusion: Implications of the findings for providing a culturally relevant theoretical framework to approach intervention with court-ordered batterers are explored and discussed.

Treatment of Social Phobia in Adolescents: Cognitive Behavioral Programs Focused on Intervention and Prevention

Social phobia is an exaggerated fear of a variety of social and performance situations due to the concern that one may become embarrassed or humiliated in front of others. Such fear is considered “normal” to some degree, especially during the period of adolescence. However, for a significant proportion of youth, social fear and social phobia become pathological conditions impacting upon functioning across a variety of life domains (friendships, academics, family functioning, vocational functioning). Youth with social phobia report greater feelings of depression, estrangement from others, hopelessness, and loneliness. Moreover, research indicates that social phobia, if left untreated, can be a major pathway for more complex and destructive complications, such as suicidality and substance abuse. This paper reviews the research in the area of social anxiety and social phobia in adolescents. The phenomenology of the disorder, particularly within a developmental context, is presented. Current data supporting the efficacy of a cognitive behavioral group treatment program for adolescents are presented, along with a presentation of a new program under development which is designed to target youth at risk of developing the disorder.

Cognitive behavioral group treatment for physically abused children

The purpose of this case study was twofold: to assess the feasibility of implementing a multiple-module, 16-week cognitive behavioral group treatment program for physically abused children; and to evaluate preliminary data from this group treatment program designed to address the multiple sequelae common to school-aged physically abused children (i.e., aggression and other behavioral problems, social skills deficits, and trauma-related symptoms). Results indicate that the multiple components of this group treatment program were implemented successfully and allowed for flexibility across children, even within a group format. Preliminary data show decreases on self-report measures of trauma-related emotional symptoms targeted by the group treatment. Increases were evident in parent ratings of children's internalizing and externalizing behaviors. Interpretations of these findings and future research recommendations are discussed.

Treatment of social anxiety in adolescents

This paper describes a new cognitive behavioral group treatment program for social phobia in adolescents (CBGT-A). Based upon empirically validated methods of treating shy adolescents and adults with social phobia, CBGT-A was developed to meet the needs of adolescents with social phobia between the ages of 13 and 17. In this paper, the diagnosis and phenomenology of social phobia is described, with emphasis on the expression of the disorder in youth. Comorbid conditions and behavioral concomitants unique to adolescents are described, so that clinicians may attend to the particular presentation of the disorder in this population. The CBGT-A program is described in detail and illustrated with case examples. Attention is given to the role of parents in the treatment process. Potential obstacles to successful treatment are defined and suggestions for managing these difficult clinical situations are offered.

Cognitive-Behavioral and Pharmacological Treatments of Social Phobia

Sixty-five patients with social phobia were treated in a study that compared a cognitive-behavioral group treatment program with pharmacotherapy with alprazolam, phenelzine sulfate, or pill-placebo plus instructions for self-directed exposure to phobic stimuli. Statistically significant repeated-measures effects were shown on all measures, indicating that the treatments studied were associated with substantial improvements in patients with severe and chronic social phobia. Patients who were treated with phenelzine were rated by clinicians as more improved on a measure of work and social disability than patients who were treated with alprazolam or placebo (patients in the cognitive-behavior therapy group were not rated on this measure). Subjects showed positive cognitive changes from before to after treatment, and there were no differences between treatment groups on the cognitive measure. We discuss the implications of these findings within the context of demographic and clinical predictors of response.