Group Cognitive Behavioral Therapy Research Articles

The Effect of Cognitive-Behavioral Therapy on the Sexual Function of Women with Maternal Near Miss: A Randomized Controlled Trial

Background: There is evidence that maternal near miss (MNM) may adversely affect sexual function later in life. Objectives: This study aimed to evaluate the effect of cognitive-behavioral therapy (CBT) on the sexual function of women with MNM. Methods: Forty-eight women with MNM were randomly assigned to 2 groups: CBT (n = 24) and control (n = 24). Women in the CBT group received 8 counseling sessions based on CBT. Data were collected using a demographic questionnaire and the Female Sexual Function Index (FSFI). Women were requested to complete the FSFI questionnaire before and after the 8-session intervention. A total score of > 26 was considered normal sexual function. The intervention started in June and was completed in October 2021. The Shapiro-Wilk test, independent t-test, Chi-square test, and Mann-Whitney test were used to analyze the data. Results: The scores of all components of sexual function improved in the CBT group compared to the control group as follows: Sexual desire (3.77 ± .64 vs. 2.25 ± .53, P < 0.001), sexual arousal (3.72 ± .45 vs. 2.40 ± .48, P < 0.001), lubrication (3.13 ± .35 vs. 2.60 ± .36, P < 0.001), orgasm (3.11 ± .45 vs. 1.0 ± .42, P < 0.001), sexual satisfaction (4.25 ± .52 vs. 2.83 ± .81, P < 0.001), pain (2.36 ± .80 vs. 4.21 ± .54, P < 0.001), total score of sexual function (20.37 ± 1.44 vs. 15.3 ± 1.40, P < 0.001). Conclusions: While CBT significantly improved the sexual function of women with MNM, their sexual performance score still did not fall within the normal range. Our results indicate that women with a near miss may require additional counseling sessions or alternative interventions.

Evaluation of effect of brief-intensive cognitive behavior therapy on symptoms severity in relation with catastrophic cognition in patients with panic disorder: a randomized controlled trial

Introduction Due to a dearth of evidence, we examined the effectiveness of brief-intensive CBT on symptom severity and catastrophic cognition in patients with panic disorder (PD). Materials and methods In this randomized controlled trial, 155 patients were assigned to either the experimental group (2 successive days of brief-intensive CBT-3 h per day) or the control group (regular pharmacotherapy only). After excluding ineligible participants, 20 patients in the brief intensive CBT group and 18 patients in the control group completed the study and were included in the final analysis. The primary outcome was symptom severity, and the secondary outcome was catastrophic cognition, assessed by the Panic Disorder Severity Scale (PDSS) for symptoms severity and the Agoraphobic Cognition Scale (ACS) for cognitive assessment, respectively. Results The study showed that after one month of treatment, the PDSS (1.70 vs. 4.78; p = 0.0172) in the brief-intensive CBT group was significantly lower compared to the control group in contrast with the ACS (5.10 vs. 5.44; p = 0.8533). The mean score of PDSS and ACS significantly decreased from 21.60 to 1.7 (p < 0.0001) and from 22.55 to 5.10 (p < 0.0001) in the brief CBT group and from 19.44 to 4.78 (p < 0.0001) and 20.00 to 5.44 (p < 0.0001) in the control group, respectively. After treatment, the mean scores of PDSS and ACS significantly decreased in the brief intensive CBT and control groups. Both higher ACS and lower education levels contributed to higher PDSS in the brief intensive CBT group. However, only the PDSS correlated to the ACS in the control group. Conclusions The study showed that brief-intensive CBT is an effective technique for reducing the severity of symptoms among PD patients. But, it was not effective to improve the cognitive level in PD patients at one month.

Prediction of the efficacy of group cognitive behavioral therapy using heart rate variability based smart wearable devices: a randomized controlled study

BackgroundDepression and anxiety are common and disabling mental health problems in children and young adults. Group cognitive behavioral therapy (GCBT) is considered that an efficient and effective treatment for these significant public health concerns, but not all participants respond equally well. The aim of this study was to examine the predictive ability of heart rate variability (HRV), based on sensor data from consumer-grade wearable devices to detect GCBT effectiveness in early intervention.MethodsIn a study of 33 college students with depression and anxiety, participants were randomly assigned to either GCBT group or a wait-list control (WLC) group. They wore smart wearable devices to measure their physiological activities and signals in daily life. The HRV parameters were calculated and compared between the groups. The study also assessed correlations between participants’ symptoms, HRV, and GCBT outcomes.ResultsThe study showed that participants in GCBT had significant improvement in depression and anxiety symptoms after four weeks. Higher HRV was associated with greater improvement in depressive and anxious symptoms following GCBT. Additionally, HRV played a noteworthy role in determining how effective GCBT was in improve anxiety(P = 0.002) and depression(P = 0.020), and its predictive power remained significant even when considering other factors.ConclusionHRV may be a useful predictor of GCBT treatment efficacy. Identifying predictors of treatment response can help personalize treatment and improve outcomes for individuals with depression and anxiety.Trial registrationThe trial has been retrospectively registered on [22/06/2023] with the registration number [NCT05913349] in the ClinicalTrials.gov.Condensed abstractVariations in heart rate variability (HRV) have been associated with depression and anxiety, but the relationship of baseline HRV to treatment outcome in depression and anxiety is unclear. This study predicted GCBT effectiveness using HRV measured by wearable devices. 33 students with depression and anxiety participated in a trial comparing GCBT and wait-list control. HRV parameters from wearables correlated with symptoms (PHQ, PSS) and GCBT effectiveness. Baseline HRV levels are strongly associated with GCBT treatment outcomes. HRV may serve as a useful predictor of efficacy of GCBT treatment,facilitating personalized treatment approaches for individuals with depression and anxiety.

Liver Cancer: A Psychological CBT Group Intervention Possibility Based on Scientific Review

Liver Cancer: A Psychological CBT Group Intervention Possibility Based on Scientific Review

Effects of Cognitive Behavioral Group Therapy on Reduction of Anxious Thoughts among Selected High School Students in Iran: A Case Study

Cognitive behavioral group therapy (CBT) helps reduce individuals&amp;rsquo; anxious thoughts. Considering this, the present study aimed to determine the level of anxious thoughts among selected Iranian high school students and to explore whether cognitive behavioral group therapy curtails anxious thoughts among Iranian high school students. To do so, a one-group pretest-posttest design was adopted (quantitative design) in this research, to measure the effectiveness of anxious thoughts-reduction policies to reduce anxiety among Iranian high school students. To address the research objectives, 20 teenagers who were students at some schools in Mashhad, Iran, participated in this study after taking the Anxious Thoughts Inventory (AnTI) designed by Wells (1994). The analysis of the data obtained from implementing the questionnaires was performed through SPSS 25 software in two sections: descriptive and inferential (Paired sample t-test). The results revealed that the means score of the students at the beginning of the experiment in the pretest at Anxious Thoughts Inventory was 63 which was a sever level of anxious thoughts at the pretest.&amp;nbsp; The item &amp;ldquo;I worry about my appearance&amp;rdquo; remained on top both in the pretest and posttest. A paired t-test was used and showed that there was a significant difference in the pretest and posttest scores of anxious thoughts of the participants after using the cognitive behavioral group therapy. Therefore, it can be concluded that cognitive behavioral group therapy curtails anxious thoughts effectively.

Group cognitive behavioural therapy (CBT) for university students with attention-deficit/hyperactivity disorder (ADHD): a feasibility study

Coping with academic demands can be challenging for university students with Attention-Deficit/Hyperactivity Disorder (ADHD). Treatment can help them cope and prevent related mental health issues. The present study aimed to investigate the feasibility of a randomized controlled trial for group Cognitive Behavioural Therapy (CBT), including the use of an app for CBT homework assignments, and to explore the effects of CBT for university students with ADHD. University students (n = 36) participated in the first phase of the study, involving the design of an app to present CBT homework assignments, by evaluating prototypes of the app along with the development team. In the second phase, a pre- vs. post-test design was used. Students with ADHD (n = 7) were offered manual-based CBT once a week for 6 weeks using the app or a paper manual to do the homework, as preferred. University students who took part in the development of the app noted that they would rather use the app than a printed manual. On the other hand, participants in the CBT feasibility study preferred doing homework on paper rather than using the developed app. They all found group CBT and the key elements in the CBT manual helpful. The findings suggest that providing group CBT for university students with ADHD through 6 sessions is feasible and assessing its effects in a randomized controlled trial (RCT) is feasible. Such treatment might improve coping with ADHD symptoms and related mental health issues. Further studies on the development of an app supporting CBT are needed.Trial registration Registry name: Cognitive Behavioural Therapy for University Students with Attention-deficit Hyperactivity Disorder (ADHD). URL: https://register.clinicaltrials.gov. Registration number: NCT 04714866.

Effects of Myofascial Release Technique along with Cognitive Behavior Therapy in University Students with Chronic Neck Pain and Forward Head Posture: A Randomized Clinical Trial.

The purpose of this randomized controlled trial was to evaluate the effectiveness of the Myofascial Release Technique (MRT) along with Cognitive Behavioral Therapy (CBT) on pain, craniovertebral angle (CVA), and neck disability in university students with chronic neck pain and forward head posture. A total of sixty-six eligible participants with chronic neck pain and forward head posture were randomized into the Myofascial Release Therapy (MRT) group (n = 33) and MRT and Cognitive Behavior Therapy (CBT) group (n = 33). Clinical outcomes included neck pain measured using the numerical pain rating scale, neck disability measured through the neck disability index, and forward head posture measured through the cranial vertebral angle. The outcomes were assessed at baseline and the four and eight weeks after the intervention. Both groups showed significant improvement in pain intensity, CVA, and neck disability after the intervention. However, the CBT group demonstrated greater improvements than the MRT group. The difference in outcomes between the groups was statistically significant. Myofascial Release Therapy combined with CBT is an effective treatment method for patients with chronic neck pain and forward head posture.

Efficacy of Cognitive Behavioral Therapy in Managing Anxiety Disorders among Adolescents: An In-Depth Analysis of Individual, Group, and Digital Approaches

This research article delves into the efficacy of Cognitive Behavioral Therapy (CBT) in addressing adolescent anxiety disorders. It explores various facets of CBT, including its theoretical underpinnings and mechanisms of change, highlighting its role in altering dysfunctional beliefs and thought patterns that contribute to anxiety. The article underscores the advantages of CBT, such as its structured approach, cost-effectiveness, and the provision of practical coping skills, making it a preferred choice for dealing with adolescent anxiety. The study then investigates the efficacy of different CBT approaches, including individual, group, and computerized CBT (cCBT) in details, specifically in the context of the COVID-19. It encompasses a range of research, from meta-analyses to controlled trials, evaluating the impact of these treatments on anxiety symptoms and their long-term efficacy. Research demonstrates CBT's high efficacy in treating youth anxiety, offering sustained symptom reduction and complementing psychopharmacological treatments backed by extensive studies and neuroimaging advancements. Group CBT for adolescents shows effectiveness in anxiety treatment, offering peer support and shared experiences in a communal setting, enhancing coping strategies and social skill development. The findings indicate cCBT's effectiveness in providing accessible mental health support to adolescents, aligning well with their tech-savvy tendencies. In conclusion, this research underlines CBT’s flexibility in addressing adolescent anxiety in both traditional and digital formats, with an emphasis on the promising potential of cCBT. It calls for future research to focus on standardizing CBT practices and validating the long-term effectiveness of cCBT.

Preliminary Impact of Group-Based Interventions on Stigma, Mental Health, and Treatment Adherence Among Adolescents Living with Human Immunodeficiency Virus in Uganda

To examine the preliminary impact of group cognitive behavioral therapy and multiple family group-based family strengthening to address HIV stigma and improve the mental health functioning of adolescents living with HIV in Uganda. We analyzed data from the Suubi4Stigma study, a 2-year pilot randomized clinical trial that recruited adolescents living with HIV (10-14 years) and their caregivers (n = 89 dyads), from 9 health clinics. We fitted separate three-level mixed-effects linear regression models to test the effect of the interventions on adolescent outcomes at 3 and 6 months post intervention initiation. The average age was 12.2 years and 56% of participants were females. Participants in the multiple family group-based family strengthening intervention reported lower levels of internalized stigma (mean difference = -0.008, 95% CI = -0.015, -0.001, P = .025) and depressive symptoms at 3 months (mean difference = -0.34, 95% CI = -0.53, -0.14, P < .001), compared with usual care. On the other hand, participants in the group cognitive behavioral therapy intervention reported lower levels of anticipated stigma at 3 months (mean difference =-0.039, 95% CI=-0.072, -0.006), P=.013) and improved self-concept at 6months follow-up (mean difference=0.04, 95% CI=0.01, 0.01, P=.025). Outcome trends from this pilot study provide compelling evidence to support testing the efficacy of these group-based interventions on a larger scale. The study is registered in the Clinical trials.gov database (Identifier #: NCT04528732).

HealthySMS Text Messaging System Adjunct to Adolescent Group Cognitive Behavioral Therapy in the Context of COVID-19 (Let's Text!): Pilot Feasibility and Acceptability Study.

The widespread occurrence and devastating impact of adolescent depression warrant health service research focused on feasible and acceptable digital health tools to supplement evidence-based intervention (EBI) efforts, particularly in the context of shelter-in-place guidelines disrupting youth socialization and service use in the wake of the COVID-19 pandemic. Given the promise of SMS text message interventions to enhance EBI engagement, our team developed the HealthySMS system as an adjunct to one of the most empirically supported interventions for adolescent depression: cognitive behavioral therapy (CBT) group services. The system sends daily SMS text messages requesting responses assessing mood, thoughts, and activities; weekly attendance reminder messages; daily tips about adherence (eg, a prompt for activity completion); and personalized responses based on participants' texts. This study aims to evaluate the feasibility and acceptability of HealthySMS in a real-world setting and explore potential mechanisms of change in EBI engagement, before evaluating the system's impact on adolescents' group CBT engagement and, ultimately, depression outcomes. Over the course of 2020, we invited all 20 adolescents receiving CBT group services for depression at an outpatient psychiatry clinic to enroll in our HealthySMS study; ultimately, 17 (85%) adolescents agreed to participate. We tracked participant initiation and engagement with the HealthySMS system as well as the content of SMS text message responses to HealthySMS. We also invited each participant to engage in a semistructured interview to gather additional qualitative inputs on the system. All (n=17, 100%) research participants invited agreed to receive HealthySMS messages, and 94% (16/17) of the participants maintained use during the first month without opting out. We uncovered meaningful qualitative themes regarding the feasibility and acceptability of HealthySMS, as well as its potential impact on EBI engagement. Taken together, the results of this pilot study suggest that HealthySMS adjunct to adolescent CBT group depression services is feasible and acceptable, as evidenced by high rates of HealthySMS initiation and low rates of dropout, as well as meaningful themes uncovered from participants' qualitative feedback. In addition, the findings provide evidence regarding iterative improvements to the HealthySMS system and research protocol, as well as potential mechanisms of change for enhanced EBI engagement and, ultimately, adolescent depression outcomes, which can be used in future effectiveness research.

Enhancing Nutritional Status and Quality of Life in Hemodialysis Patients: The Impact of Internet-Based Cognitive Behavioral Therapy

This study examined the effects of internet-based cognitive behavioral therapy on the nutritional status and scores from the Knowledge, Attitude, and Practice questionnaire in maintenance hemodialysis patients. Patients in the traditional therapy group received standard health education, whereas those in the experimental group participated in three months of this therapy. Clinical and nutritional indicators, including blood biomarkers and Knowledge, Attitude, and Practice questionnaire scores, were recorded for both groups before and after the treatment. Post-treatment, the group receiving internet-based cognitive behavioral therapy exhibited higher blood calcium levels, increased upper arm circumference, and reduced levels of potassium and phosphorus. They also showed comparatively lower scores in Nutritional Risk Screening 2000 and Malnutrition Inflammation, along with higher Visual Analog Scale scores (P &lt; 0.05). The internet-based cognitive behavioral therapy group exhibited higher albumin and prealbumin levels, reduced transferrin, total cholesterol, creatinine, and urea levels, and modified quantitative subjective global assessment scores than the traditional therapy group (P &lt; 0.05). They also scored higher on the Knowledge, Attitude, and Practice questionnaire (P &lt; 0.05). These results indicate that internetbased cognitive behavioral therapy can improve the nutritional status, Knowledge, Attitude, and Practice questionnaire scores, and overall quality of life in maintenance hemodialysis patients, highlighting its potential benefit in patient outcomes.

Effectiveness of Cognitive Behavior Group Therapy in Reducing the Risk of Eating Disorder among University Students

Eating disorders are serious mental illnesses that typically originate during adolescence, often persist over an extended period, and significantly affect one's overall well-being. These disorders contribute significantly to the worldwide health burden. Despite a rising number of individuals seeking treatment for eating disorders, there is limited study regarding the effectiveness of therapy in preventive measures of the risk of eating disorders. Therefore, this research aims to study the effectiveness of cognitive behavior group therapy (CBGT) in reducing the risk of eating disorders among university students. Using a pretest-posttest with a control group design. The adapted Bangla version of the Eating Attitude Test (EAT-26) was utilized and socio-demographic data for all participants at the baseline and post-intervention. Thirty-six participants i.e., university students with a risk of eating disorders were chosen by purposive sampling. Participants were randomly assigned into two groups (intervention and non-intervention groups). However, the experimental (intervention) group (n = 18) received cognitive behavioral group therapy, and the control also known as the non-interventional group (n = 18) did not. To analyze the obtained data descriptive statistics, independent sample t-test, and paired sample t-test were performed. Findings showed that receiving CBGT sessions significantly reduced eating disorder risk in the intervention group. However, there is no difference in the risk of eating disorders in the pre-test and post-test of the non-intervention group was observed. This study's findings emphasize the importance and effectiveness of cognitive behavior group therapy in addressing and mitigating the risk of eating disorders among university students. Jagannath University Journal of Science, Volume 10, Number II, Dec. 2023, pp. 124−135

Feasibility and Acceptability of Group-Based Stigma Reduction Interventions for Adolescents Living with HIV and Their Caregivers: The Suubi4Stigma Randomized Clinical Trial (2020-2022).

This study examined the feasibility and acceptability of two group-based interventions: group-cognitive behavioral therapy (G-CBT) and a family-strengthening intervention delivered via multiple family group (MFG-FS), to address HIV stigma among adolescents living with HIV (ALHIV) and their caregivers. A total of 147 adolescent -caregiver dyads from 9 health clinics situated within 7 political districts in Uganda were screened for eligibility. Of these, 89 dyads met the inclusion criteria and provided consent to participate in the study. Participants were randomized, at the clinic level, to one of three study conditions: Usual care, G-CBT or MFG-FS. The interventions were delivered over a 3-month period. While both adolescents and their caregivers attended the MFG-FS sessions, G-CBT sessions were only attended by adolescents. Data were collected at baseline, 3 and 6-months post intervention initiation. The retention rate was 94% over the study period. Across groups, intervention session attendance ranged between 85 and 92%, for all sessions. Fidelity of the intervention was between 85 and 100%, and both children and caregivers rated highly their satisfaction with the intervention sessions. ALHIV in Uganda, and most of sub-Saharan Africa, are still underrepresented in stigma reduction interventions. The Suubi4Stigma study was feasible and acceptable to adolescents and their caregivers -supporting testing the efficacy of the interventions in a larger trial.

Omega-3 Supplementation Reduces Schizotypal Personality in Children: A Randomized Controlled Trial.

Based on a childhood intervention from ages 3 to 5 years that included additional fish consumption and which resulted in reduced schizotypal personality at age 23, we had previously hypothesized that omega-3 could reduce schizotypy. The current study tests the hypothesis that omega-3 supplementation reduces schizotypy in children. In this intention-to-treat, randomized, single-blind, stratified, factorial trial, a community sample of 290 children aged 11-12 years were randomized into Omega-3 Only, Cognitive Behavioral Therapy (CBT) Only, Omega-3 + CBT, and Control groups. Schizotypy was assessed using the SPQ-C (Schizotypal Personality Questionnaire for Children) at 0 months (baseline), 3 months (end of treatment), 6 months (3 months post-treatment), and 12 months (9 months post-treatment). A significant group × time interaction (P = .013) indicated that, compared with Controls, total schizotypy scores were reduced in both Omega-3 Only and Omega-3 + CBT groups immediately post-treatment (d = 0.56 and 0.47, respectively), and also 3 months after supplementation terminated (d = 0.49, d = 0.70). Stronger findings were observed for the interpersonal schizotypy factor, with both omega-3 groups showing reductions 9 months post-treatment compared with the CBT Only group. Schizotypy reductions were significantly stronger for those with higher dietary intake of omega-3 at intake. Sensitivity analyses confirmed findings. Results are unique in the field and suggest that omega-3 can help reduce schizotypal personality in community-residing children. From an epidemiological standpoint, if replicated and extended, these findings could have implications for early prevention of more significant schizotypal features developing later in adolescence. "Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)." ClinicalTrials.gov Identifier: NCT00842439, https://clinicaltrials.gov/ct2/show/NCT00842439.

Effectiveness and predictors of group cognitive behaviour therapy outcome for generalised anxiety disorder in an out-patient hospital setting.

Cognitive behavioural therapy (CBT) is an empirically supported treatment for generalized anxiety disorder (GAD). Little is known about the effectiveness of CBT for GAD in real-world treatment settings. This study investigated the effectiveness of group CBT and predictors of treatment response in an out-patient hospital clinic. Participants (n = 386) with GAD participated in 12 sessions of group CBT at an out-patient clinic. Of those who provided at least partial data (n = 326), 84.5% completed treatment. Most questionnaires were completed at pre- and post-treatment; worry severity was assessed weekly. Group CBT led to improvements in chronic worry (d = -0.91, n = 118), depressive symptoms (d = -1.22, n = 172), GAD symptom severity (d = -0.65, n = 171), intolerance of uncertainty (IU; d = -0.46, n = 174) and level of functional impairment (d = -0.35, n = 169). Greater pre-treatment GAD symptom severity (d = -0.17, n = 293), chronic worry (d = -0.20, n = 185), functional impairment (d = -0.12, n = 292), and number of comorbid diagnoses (d = -0.13, n = 299) predicted greater improvement in past week worry over treatment. Biological sex, age, depression symptom severity, number of treatment sessions attended, and IU did not predict change in past week worry over time. These findings provide support for the effectiveness of group CBT for GAD and suggest the outcomes are robust and are either not impacted or are slightly positively impacted by several demographic and clinical factors.

Comparable Efficacy of Repeated Transcranial Direct Current Stimulation, Cognitive Behavioral Therapy, and Their Combination in Improvement of Cold and Hot Cognitive Functions and Amelioration of Depressive Symptoms.

This study aimed to evaluate the effectiveness of repeated transcranial direct current stimulation (rtDCS), cognitive behavioral therapy (CBT), and their combination (rtDCS-CBT) in the treatment of cognitive dysfunction, social cognition, and depressive symptoms in women diagnosed with major depressive disorder (MDD). A total of 40 female participants with MDD were randomly assigned to one of four groups: rtDCS, CBT, rtDCS-CBT, and a control group. The participants' depressive symptoms, executive functions, and social cognition were assessed at baseline, preintervention, postintervention, and during a 1-month follow-up. The rtDCS group received 10 sessions of anodal dorsolateral and cathodal ventromedial prefrontal cortex (2 mA for 20 minutes). The CBT group received 10 sessions of traditional CBT, whereas the combined group received CBT after the tDCS sessions. The results of the analysis of variance indicated that all intervention groups demonstrated significant improvements in depressive symptoms, cognitive dysfunction, and social cognition compared with the control group (all p < 0.001). Furthermore, the rtDCS-CBT group exhibited significantly greater reductions in depressive symptoms when compared with each intervention alone (all p < 0.001). Notably, working memory improvements were observed only in the rtDCS group ( p < 0.001). In conclusion, this study suggests that both CBT and tDCS, either individually or in combination, have a positive therapeutic impact on enhancing executive functions, theory of mind, and depressive symptoms in women with MDD.

Renewed Feedback-Informed Group Treatment for Patients with Anxiety and Depressive Disorders.

Feedback-Informed Group Treatment (FIGT) shows promise for improving outcomes, but results are mixed. The aim was investigating the feasibility, acceptability and effects of renewed FIGT on clinical outcomes and therapy processes. In a quasi-experimental pilot study, 65 patients with anxiety or depressive disorders and 15 therapists of interpersonal psychotherapy or cognitive behavioural therapy groups using renewed FIGT were included. Renewed FIGT contained three additions compared to the previous tool: (1) personalized goals along with the Outcome Questionnaire-45 (OQ-45), (2) therapists' training, coaching and intervision, and (3) instructions to actively use feedback in the group. Data on feasibility, acceptability, outcomes and process factors were analysed and compared with those of historical cohorts using only OQ-45 feedback or no feedback, using descriptive, multilevel and covariance statistical analyses. Feasibility was mostly improved, with patients experiencing more feedback discussions and better usability compared to only OQ-45 feedback. At least two thirds of the patients and therapists give preference to using feedback in the future. At the end of the study, therapists were less convinced that the OQ-45 and goals were able to detect change. Renewed FIGT did not improve effectiveness on clinical outcomes. Compared to no feedback, patients experienced more cohesion, engagement and less avoidance, but improved less on depressive symptoms. Even when renewed FIGT is more feasible and usable than only OQ-45 feedback and associated with more cohesiveness and engagement, it may not automatically lead to improved effectiveness on clinical outcomes in short-term group therapy. Implications and future directions are described.

Public health nurse-delivered cognitive behavioral therapy for postpartum depression: Assessing the effects of maternal treatment on infant emotion regulation.

The effects of maternal postpartum depression (PPD) on offspring emotion regulation (ER) are particularly deleterious as difficulties with ER predict an increased risk of psychopathology. This study examined the impact of maternal participation in a public health nurse (PHN)-delivered group cognitive behavioral therapy (CBT) intervention on infant ER. Mothers/birthing parents were ≥ 18 years old with an Edinburgh Postnatal Depression Scale (EPDS) score ≥ 10, and infants were < 12 months. Between 2017 and 2020, 141 mother-infant dyads were randomized to experimental or control groups. Infant ER was measured at baseline (T1) and nine weeks later (T2) using two neurophysiological measures (frontal alpha asymmetry (FAA) and high-frequency heart rate variability (HF-HRV)), and informant-report of infant temperament. Mothers were a mean of 30.8 years old (SD = 4.7), 92.3% were married/ common-law, and infants were a mean of 5.4 months old (SD = 2.9) and 52.1% were male. A statistically significant group-by-time interaction was found to predict change in HF-HRV between T1 and T2 (F(1,68.3) = 4.04, p = .04), but no significant interaction predicted change in FAA or temperament. Results suggest that PHN-delivered group CBT for PPD may lead to adaptive changes in a neurophysiological marker of infant ER, highlighting the importance of early maternal intervention.

Increasing the Therapeutic Dosage by Combining Cognitive Behavior Group Therapy With a Monitored Self-Help Group.

Objective: A problem in psychotherapy is the limited availability of psychotherapists. This can not only delay the start of therapy but also curtail the number of sessions and the therapeutic dosage. An option to extend the therapeutic dose without an increase in therapist time may be to combine group psychotherapy with a self-help group. The goal of the present study is to investigate how patients judge this treatment mode and to what degree the contents of a regular group treatment are pursued in a parallel self-help group.Method: Seventy-two psychosomatic inpatients participated in cognitive behavior group therapy and parallel self-help group, which was monitored by the therapist during the regular group therapy sessions. Patients in both groups filled in a questionnaire that asked for the content of the group session, how patients had experienced the interaction, and what they had taken from the group.Results: Patients reported that in the self-help group, they discussed similar topics as in the regular group therapy, like how to deal with anxiety or sadness, how to interact with other people, and how to cope with their mental disorder and problems at work, in the family, or with friends. Patients indicated that there was more relaxed chatting in the self-help group, whereas learning new behavior was reported more frequently for the regular group therapy.Conclusions: In the regular group therapy and the guided self-help group, similar topics were discussed, which suggests that a combination of both can extend the therapeutic process and increase the therapeutic dosage without costs for the therapist or the institution.

Digital cognitive behavioural therapy for patients with insomnia and depression: A systematic review and meta-analysis.

Sleep problems are common among those with depression, and there is increasing evidence that sleep problems should be addressed during treatment simultaneously rather than treating depression alone. The first-line treatment for insomnia is cognitive behavioural therapy for insomnia (CBT-I), due to a lack of well-trained therapists and patient time constraints (travelling, work), CBT-I has not been popularized. The development of digital cognitive behavioural therapy for insomnia (dCBT-I) is making the treatment more accessible. Interventions for dCBT-I were significantly better than other control conditions in both reducing insomnia and improving depression in patients with depression and insomnia comorbidities. The effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention and therapist-involved dCBT-I has less shedding than self-help. It's important for mental health practitioners to realize that insomnia in depressed people needs to be treated. Future trials may explore the effectiveness of therapist-guided dCBT-I in depressed populations and analyse the cost-effectiveness of this treatment. Aim The aim of the study was to systematically identify and synthesize the evidence for the effectiveness of digital cognitive behavioural therapy in insomnia with comorbid depression. Design Systematic review and metaanalysis. Methods A search was conducted on five English and four non-English databases from the inception of the databases to November 2023. This review adhered to the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-analysis Statement 2020 and the included studies were evaluated using version 2 of the Cochrane risk of bias tool. This review examined sleep-related outcomes, including insomnia severity and sleep diaries, along with psychological outcomes, such as depression. We conducted a meta-analysis of each outcome using a random effects model. Heterogeneity was assessed by the I2 statistic. Results A total of seven articles with 1864 participants were included in this review. The results showed that the digital cognitive behavioural therapy group demonstrated a statistically significant amelioration in the severity of insomnia symptoms, as well as a reduction in depressive symptomatology compared with the control groups. The post-intervention effect was found to be related to the duration of the intervention and the severity of insomnia before the intervention. Conclusions Digital cognitive behavioural therapy for insomnia application in patients with depression and insomnia was demonstrated to be effective, less time-consuming and more accessible. Relevance to Clinical Practice We may consider incorporating nurses into treatment plans and conducting nurse-led interventions in specific programs. In the future, nurses may be able to provide exclusive digital behavioural therapy for insomnia to patients with depression to achieve greater effectiveness.