Group Cognitive Therapy Research Articles

The Effectiveness of Mindfulness-Based Cognitive Group Therapy on the Quality Of Life and Hope in the Patients with Coronary Heart Disease

Background and objectives: The aim of this study was examining the effectiveness of mindfulness-based cognitive group therapy on the quality of life and hope in the patients with coronary heart disease. Methods: The present study was quasi-experimental with pre-test, post-test and follow-up with control group. To fulfill the study, 30 patients were selected randomly and were assigned into experimental (n = 15) and control groups (n = 15). To collect the data, participants of both groups completed demographic information sheet, MacNew Heart Disease Health-Related Quality of Life Questionnaire and Miller Hope Scale, respectively of coronary heart disease questionnaire at pre-test, post-test and follow-up (2 months after the intervention). Participants of experimental group received eight 90-minute intervention sessions. Results: The results of the multivariate covariance analysis with repeated measures showed that mean score quality of life(P<0.05), hope (P<0.001) in participants of the experimental group had a significant difference compared to the participants of the control group at post-test and follow-up. Conclusion: results showed that mindfulness – based stress reduction treatment can be effective in improving life quality and hope in coronary heart disease. Implication for further research and possible clinical applications are discussed.

Efficacy and feasibility of the Integrated Psychological Therapy for outpatients with schizophrenia in Greece: Final results of a RCT

The goal of this study was to evaluate the efficacy and the feasibility of cognitive remediation group therapy in patients with schizophrenia in Greece. For this purpose, the cognitive part of the Integrated Psychological Therapy (IPT), focusing on neuro- and social cognition, was compared in a randomized controlled trial (RCT) with treatment as usual (TAU). 48 outpatients took part in the study. IPT groups received 20 biweekly 1-h-therapy sessions. A test-battery was assessed at baseline, after therapy, and at a 3-month follow-up. Regarding cognitive functioning, significant effects favouring IPT were found in working memory and social perception during therapy and at follow-up. No effects could be found in verbal memory and vigilance. Significant effects favoring IPT were found in negative symptoms, in insight and in general symptoms during therapy and at follow-up using the Positive and Negative Syndrome Scale (PANSS). No effects were evident in positive symptoms and in psychosocial functioning. Significant effects favoring TAU were found in the quality of life assessment at follow-up. The study supports evidence for the feasibility and efficacy of IPT in psychiatric care in Greece and it hopefully will initiate the broader use of evidenced-based treatments like IPT in Greek Psychiatry.

Mindfulness in Sex Therapy and Intimate Relationships (MSIR): Clinical Protocol and Theory Development

Mindfulness has been used as an intervention for specific sexual dysfunctions in women; evidence has also accumulated for the role of mindfulness in treating the kinds of psychological difficulties which are associated with sexual dysfunction. This paper describes, within a clinical context, a qualitative approach to protocol and theory development for a mindfulness-based sex and intimate relationship (MSIR) programme as a generic adjunct to sex therapy. The aim was to adapt the mindfulness-based cognitive therapy (MBCT) group protocol to address diverse sexual and intimacy difficulties. The protocol was developed on an iterative basis and piloted with 30 patients referred from a sexual dysfunction clinic. Twelve participants came forward to be interviewed and their transcripts were analysed in two phases using a grounded theory approach, to produce a model generating testable hypotheses. The reduction of experiential and behavioural avoidance was central to the model that emerged from the analysis, along with the relinquishing of sexual goals in favour of focus on sensory experience. The analysis led also to a tentative staging of mindfulness, associated with enhanced experience. The adapted MBCT protocol for diverse sexual difficulties was found to be feasible and appeared positive for participants. Thus, MSIR shows promise as a generic adjunct to sex therapy.

Recent guidelines for evidence-based pharmacological treatment of social anxiety disorder

Pharmacological and psychological treatmentsThe findings of meta-analyses and randomized placebo-controlled treatment studies indicate that a range of approaches are efficacious in acute treatment. Pharmacological and psychological treatments, when delivered singly, have broadly similar efficacy in acute treatment. However, acute treatment with cognitive therapy (group or individual) may be associated with a reduced risk of symptomatic relapse at follow-up. Cognitive behaviour therapy is efficacious in adults and children: cognitive therapy appears superior to exposure therapy, but the evidence for the efficacy of social skills training is less strong. It is unlikely that the combination of pharmacological with psychological treatments is associated with greater overall efficacy than with either treatment, when given alone, as only 1 of 4 studies of the relative efficacy of combination treatment found evidence for superior efficacy.Efficacy and length of acute pharmacological treatmentAntidepressant drugs with proven efficacy include most SSRIs, the SNRI venlafaxine, the MAOI phenelzine and the RIMA moclobemide: the potential efficacy of tricyclic antidepressants is unknown. Some benzodiazepines and anticonvulsants and the antipsychotic olanzapine also appear efficacious in acute treatment. A number of small single-dose placebo-controlled crossover studies together suggest that beta-blockers can be beneficial in reducing anxiety symptoms in individuals with ‘performance anxiety’ (for example, when speaking in public), which overlaps with mild non-generalized social anxiety disorder. Acute treatment studies indicate that the proportion of responding patients increases steadily over time. A post-hoc analysis of the clinical trial database with paroxetine indicates that many non-responders to treatment at 8 weeks become responders with a further 4 weeks of double-blind treatment: however a post-hoc analysis of the clinical trial database for escitalopram indicates that response is unlikely if there is no onset of clinical effect within the first 4 weeks of treatment.Longer-term treatment and further treatment after non-responseThe findings of randomized placebo-controlled relapse prevention studies in patients who have responded to previous acute treatment reveal a significant advantage for staying on active medication (clonazepam, escitalopram, paroxetine, pregabalin, sertraline) for up to six months. Fixed-dose randomized controlled trials do not provide consistent evidence of a dose-response relationship with antidepressant drugs: but a fixed-dose study of pregabalin found that only the higher daily dosage was efficacious. A double-blind randomized controlled dosage escalation trial found no advantage for increasing to a higher daily dosage (of duloxetine), when compared to continuing treatment with a lower dosage. Switching between treatments with proven efficacy may be helpful. An uncontrolled study of augmentation of SSRI treatment with buspirone found some evidence of beneficial effects; but a placebo-controlled crossover-study of the augmentation of paroxetine with pindolol found no evidence of efficacy. A small placebo-controlled study of the augmentation of paroxetine with clonazepam found the combination was marginally short of superiority, when compared to paroxetine alone.Disclosure of interestThe author has not supplied his declaration of competing interest.

Benefits of group cognitive remediation therapy in anorexia nervosa: case series.

SummaryBackgroundCognitive remediation therapy (CRT) is a treatment targeting cognitive difficulties in psychiatric disorders. CRT has been used with patients with severe anorexia nervosa (AN) in individual and group formats. Research of group CRT in AN is limited.MethodsEvaluation of a series of CRT groups delivered in inpatient and intensive daycare services was performed. Participants’ self-reported cognitive flexibility and central coherence, as well as motivation to change were assessed pre- and post-group. Additionally, patients’ evaluative feedback was collected after completion of the group.ResultsThere was a significant improvement in the patients’ self-reported cognitive flexibility and bigger picture thinking, as well as in their self-efficacy to change. The feedback questionnaires highlighted that patients found the sessions useful and reported confidence in using some of the skills and strategies they learnt in the group.ConclusionIn line with evidence from small-scale reports, this larger scale case series study indicates that group CRT leads to increased flexibility and bigger picture thinking, as well as improved confidence in the ability to change for participants. CRT in a group format seems to be a practical and helpful intervention for patients with AN in intensive treatment programmes.

Comparison of the Effect of Schema Therapy and Cognitive Group Therapy on Depression in Women Engaging in High-Risk Sexual Behaviors Who Were Referred to Hamadan Health Center

Background: Treatment for psychological disorders is generally based on signs and symptoms, and research in this area has shown that major depression has become one of the most significant psychiatric disorders of the last decade. Objectives: This study was conducted to compare the eects of schema therapy and cognitive group therapy on women with de- pression who were engaging in high-risk sexual behaviors and were referred to the Hamadan Health Center for AIDS testing. Patients and Methods: This research was done at the Hamadan shohada infirmary from 2015 to 2016 and was confirmed by the ethics committee of Hamadan University of Medical Sciences. It was a semi-experimental study using single stage cluster sampling. The statistical sample consisted of 500 women ranging in age from 20 to 60 years old with at least a diploma. The women were engaging in high-risk sexual behaviors and were referred to the health center for AIDS testing. Psychologists and a physician con- ducted a diagnostic interview, and 217 subjects were randomly chosen using a sample volume formula, in addition to Depression Anxiety Stress Scales (DASS). Eighty five of the subjects were diagnosed with depression, of whom 45 were chosen randomly and divided into three groups of 15 consisting of two experimental groups and one control group. Twelve sessions of cognitive group therapy and 12 sessions of schema therapy were implemented for 90 minutes per session. At the end of the training period, the three groups were post-tested and depression components were then investigated in the pretest and post-test results. Results: The findings support the idea that a significant dierence exists in terms of the mean of depression between schema ther- apy and cognitive therapy, as follows: F (1, 41) = 60.650 P < 0.01. Conclusions: The results show that schema therapy is more eective than cognitive group therapy for treating depression in

WITHDRAWN: Psychological treatments for epilepsy.

BACKGROUND: Psychological interventions such as relaxation therapy, cognitive behaviour therapy, bio-feedback and educational interventions have been used alone or in combination in the treatment of epilepsy, to reduce the seizure frequency and improve the quality of life. OBJECTIVES: To assess whether the treatment of epilepsy with psychological methods is effective in reducing seizure frequency or leads to a better quality of life (QOL), or both. SEARCH METHODS: We searched the Cochrane Epilepsy Group Specialized Register (11 January 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2010) and MEDLINE (1948 to December 2010). No language restrictions were imposed. We checked the reference lists of retrieved studies for additional reports of relevant studies. SELECTION CRITERIA: Randomized or quasi-randomized studies assessing one or more types of psychological or behaviour modification techniques for people with epilepsy. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed the trials for inclusion and extracted data. Primary analyses were by intention to treat. Outcomes included reduction in seizure frequency and quality of life. MAIN RESULTS: We found three small trials (total 50 participants) of relaxation therapy. They were of poor methodological quality and a meta-analysis was therefore not undertaken. No study found a significant effect of relaxation therapy on seizure frequency.Two trials found cognitive behavioural therapy (CBT) to be effective in reducing depression among people with epilepsy and a depressed affect, whilst another did not. Two trials of CBT found improvements in QOL scores. One trial of group cognitive therapy found no significant effect on seizure frequency while another trial found a statistically significant reduction in seizure frequency as well as seizure index (product of seizure frequency and seizure duration in seconds) among participants treated with CBT.One small trial compared CBT with yoga and found similar rates of seizure freedom and 50% responder rates at the end of one year. Compared to pretest scores, the CBT group showed an improvement in the World Health Organization quality of life instrument, short version (WHO QOL-BREF) (P ≤ 0.01) while the yoga group had an improvement in their QOL according to the satisfaction with life scale (SWLS) (P ≤ 0.05).Two trials of combined relaxation and behaviour therapy, one of electroencephalographic (EEG) bio-feedback and four of educational interventions did not provide sufficient information to assess their effects on seizure frequency. One small study of galvanic skin response biofeedback reported significant reduction in seizure frequency.Combined use of relaxation and behaviour modification was found beneficial for anxiety and adjustment in one study. In one study EEG bio-feedback was found to improve cognitive and motor functions in individuals with the greatest seizure reduction. Educational interventions were found to be beneficial in improving knowledge and understanding of epilepsy, coping with epilepsy, compliance to medication and social competencies.Two trials investigated the effects of a self management program on QOL measures. One found no significant differences in overall QOL except for an improvement in the QOL in persons with epilepsy (QOLIE-89) role limitations - emotional score. The other study found no significant benefits in any of the outcomes studied except for more positive attitudes about the outcomes associated with taking medications. AUTHORS' CONCLUSIONS: In view of methodological deficiencies and the limited number of individuals studied, we have found no reliable evidence to support the use of psychological treatments and further trials are needed. Since the last version of this review, none of the new relevant studies have provided additional information to change the conclusions. Language: en

A Comparative Study of the Efficacy of Cognitive Group Therapy and Aerobic Exercise in the Treatment of Depression among the Students.

Depression is one of the most common mental disorders. Finding effective treatments for such a disorder with higher efficiency lower side effects and affordability is an active area of research in psychiatry. This study aimed to comparatively analyze the effects of the cognitive group therapy and aerobic exercises on depression, automatic negative thoughts and dysfunctional attitudes of students at Kermanshah University of Medical Science. In this clinical trial, 46 associate and undergraduate students at Kermanshah University of Medical Science were randomly divided into three groups: cognitive therapy, aerobic exercise, and control. The data was gathered both before and 8 weeks after the intervention. Beck Depression Inventory (BDI-II), automatic negative thoughts (ATQ), and the Dysfunctional Attitude Scale (DAS) were used as the data collection instruments. The data were analyzed with SPSS version 15 using paired samples T-test, chi-square test, Kruskal-Wallis test, and analysis of variance (ANOVA). Cognitive therapy caused a significant decrease in depression, belief in automatic negative thoughts, and dysfunctional attitudes in comparison to the control group (p<0.05). Although aerobics compared to the control group causes more reductions in the variables, however, It was only meaningful for the depression variable (p=0.049). Cognitive therapy also reduced the variables more than the aerobic exercise, but the decrease was not statistically significant. Cognitive group therapy and aerobic exercise are effective in treating depression. For treating depression, aerobic exercise can be used as a therapy itself or along with cognitive-behavioral therapy and pharmacotherapy.

Cognitive Group Therapy for Test Anxiety

Test anxiety is a major problem that affects students’ academic, vocational and emotional state and several treatment strategies have been developed and applied. Cognitive behavioral therapy is one of the efficacious treatments for test anxiety, but we know little about whether cognitive or behavioral techniques (or both) are effective. The aim of this study is to assess the efficacy of cognitive techniques without behavioral interventions. The study was carried out with 38 individual who complained of test anxiety and were divided into four groups. Six 90 min sessions of cognitive group therapy is applied weekly. Test Anxiety Inventory (TAI), Beck Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI), Ruminative Thought Style Questionnaire (RTSQ) and Automatic Thoughts Questionnaire (ATQ) were given to attendants. There was statistically significant difference between first and last evaluation of mean rank of BAI total and its cognitive and somatic subscales, ATQ and STAI-II. There was no significant difference for mean rank of STAI-I and RTSQ total scores. Statistically significant difference was found between first and last evaluation of total TAI and 3 subscales of TAI which were ‘Others’ opinions’, ‘Worry about future’, ‘Worry about preparation and unspecified test anxiety’. Cognitive techniques are effective for treatment of test anxiety even without behavioral interventions. However, its effect on self-related perception componenet of test anxiety and ruminative response styles is uncertain. Adding behavioral interventions to cognitive techniques may increase the efficacy of treatment for test anxiety.

The effect of Cognitive Stimulation Therapy (CST) groups for dementia on participant’s attitudes to ageing: A practice-based study

This practice-based study investigated the effects of Cognitive Stimulation Therapy (CST) in everyday NHS clinical settings on both routine outcomes and attitudes to ageing. This is important given that negative ageist beliefs have been linked to decline in health and wellbeing among older people, especially those with a dementia diagnosis. A quantitative pre-test/post-test design was used to evaluate changes in participant outcomes for cognition, quality of life and ageing attitudes. A total of 82 CST participants with mild to moderate dementia were included in the study. Significant improvements on measures of quality of life and attitudes to ageing were found pre- to post-CST, and a holding pattern of no change was observed for cognition. A significant positive correlation was established between ageing attitudes and quality of life. Demographic characteristics were not found to have an influence on the treatment effects of CST. These findings provide additional evidence that CST can produce routine improvements in clinical practice settings that are equally applicable across age and gender. Of clinical significance is the finding that CST improves the attitudes to ageing of older people with dementia, as this is the first time it has been empirically studied. This further highlights the potential of CST as a de-stigmatising, positive ageing intervention.

Implementing Mindfulness-Based Cognitive Therapy (MBCT) as mindfulness skills courses offered as an adjunct to individual therapy: a feasibility and effectiveness study of mixed staff and patient groups in secondary care

AbstractThere is growing evidence regarding the effectiveness of mindfulness-based interventions offered to diagnostically diverse groups of participants. This study examined the feasibility and effectiveness of adapted Mindfulness-Based Cognitive Therapy (MBCT) groups offered to NHS patients in a secondary-care Psychology and Psychotherapy Service. The group was run as an adjunct to individual therapy and accepted referrals from all therapists in the service, so participants had experienced a range of therapeutic approaches prior to attending the group. The nine groups run during the project also included staff participants, as part of a capacity-building strategy. Results indicate high levels of acceptability, with low drop-out rates. Standardized outcome measures were used to examine the effectiveness of the group, and patient participants demonstrated improvements which were statistically significant. Qualitative feedback from group participants and referrers was positive. The findings support implementation of MBCT as part of a package of psychological therapy interventions. Further research regarding this form of MBCT is discussed.

A randomized clinical trial of group cognitive processing therapy compared with group present-centered therapy for PTSD among active duty military personnel.

To determine whether group therapy improves symptoms of posttraumatic stress disorder (PTSD), this randomized clinical trial compared efficacy of group cognitive processing therapy (cognitive only version; CPT-C) with group present-centered therapy (PCT) for active duty military personnel. Patients attended 90-min groups twice weekly for 6 weeks at Fort Hood, Texas. Independent assessments were administered at baseline, weekly before sessions, and 2 weeks, 6 months, and 12 months posttreatment. A total of 108 service members (100 men, 8 women) were randomized. Inclusion criteria included PTSD following military deployment and medication stability. Exclusion criteria included suicidal/homicidal intent or other severe mental disorders requiring immediate treatment. Follow-up assessments were administered regardless of treatment completion. Primary outcome measures were the PTSD Checklist (Stressor Specific Version; PCL-S) and Beck Depression Inventory-II. The Posttraumatic Stress Symptom Interview (PSS-1) was a secondary measure. Both treatments resulted in large reductions in PTSD severity, but improvement was greater in CPT-C. CPT-C also reduced depression, with gains remaining during follow-up. In PCT, depression only improved between baseline and before Session 1. There were few adverse events associated with either treatment. Both CPT-C and PCT were tolerated well and reduced PTSD symptoms in group format, but only CPT-C improved depression. This study has public policy implications because of the number of active military needing PTSD treatment, and demonstrates that group format of treatment of PTSD results in significant improvement and is well tolerated. Group therapy may an important format in settings in which therapists are limited.

Change in Dysfunctional Beliefs About Sleep in Behavior Therapy, Cognitive Therapy, and Cognitive-Behavioral Therapy for Insomnia

As part of a larger randomized controlled trial, 188 participants were randomized to behavior therapy (BT), cognitive therapy (CT), or cognitive-behavioral therapy (CBT) for insomnia. The aims of this study were threefold: (a) to determine whether change in dysfunctional beliefs about sleep was related to change in sleep, insomnia symptoms, and impairment following treatment; (b) to determine whether BT, CT, and CBT differ in their effects on dysfunctional beliefs; and (c) to determine whether the treatments differ in their effects on particular kinds of dysfunctional beliefs. Beliefs, sleep, insomnia symptoms, and sleep-related psychosocial impairment were assessed at pretreatment, posttreatment, and 6- and 12-month follow-up. Greater change in dysfunctional beliefs occurring over the course of BT, CT, or CBT was associated with greater improvement in insomnia symptoms and impairment at posttreatment and both follow-ups. All groups experienced a significant decrease in dysfunctional beliefs during treatment, which were sustained through 6- and 12-month follow-up. Compared with the BT group, a greater proportion of participants in the CT and/or CBT groups endorsed dysfunctional beliefs below a level considered clinically significant at posttreatment and 12-month follow-up. The results demonstrate the importance of targeting dysfunctional beliefs in insomnia treatment, suggest that beliefs may be significantly modified with BT alone, and indicate that cognitive interventions may be particularly powerful in enhancing belief change.

Group cognitive remediation therapy for chronic schizophrenia: A randomized controlled trial

Individual-level cognitive remediation therapy (CRT) has been shown to be effective for cognitive improvement and social function amelioration. Here, we aimed to test the efficacy of group-based CRT in Chinese subjects with schizophrenia. One-hundred and four inpatients were randomly assigned to either 40 sessions of small-group CRT therapy or therapeutic contact-matched Musical and Dancing Therapy (MDT). Cognitive and social functioning, as well as clinical symptoms, were evaluated over the course of treatment. Specifically, cognitive function was evaluated using a battery of cognitive measurements, clinical symptoms were evaluated using the Positive and Negative Syndrome Scale, and social function was evaluated using the Nurse's Observation Scale for Inpatient Evaluation-30. All patients were evaluated pre- and post-treatment. Forty-four individuals in the CRT group and 46 in the MDT group completed all of the planned treatments and analyses. Cognitive functions, especially cognitive flexibility and memory, showed significant improvement in the CRT group over the course of the study. The MDT group also showed improvement in several cognitive flexibility assessments, but the degree of improvement was significantly greater in the CRT group. Several social-function factors exhibited a significant improvement in the CRT group, but not in the MDT group. Cognitive function improvement correlated positively with social function without predicting social function change. We conclude that group-based CRT is an effective and promising therapy.

Exposure therapy changes dysfunctional evaluations of somatic symptoms in patients with hypochondriasis (health anxiety). A randomized controlled trial

Dysfunctional evaluations of somatic symptoms are considered a central factor in maintaining hypochondriasis. The aim of the current study was to investigate whether exposure therapy (ET) without cognitive restructuring is sufficient to change dysfunctional evaluations of somatic symptoms. The current study was based on a randomized controlled trial and compared patients with hypochondriasis (N=73) receiving ET or cognitive therapy (CT) to a wait list (WL) control group. In both the ET and CT groups, dysfunctional symptom evaluations changed significantly compared with the WL group. No differences between the ET and CT groups emerged. The relationship between the treatment condition (active treatment vs. WL) and reductions in health anxiety was mediated by changes in somatic symptom evaluations only in a specific card sorting procedure. We conclude that addressing dysfunctional symptom evaluations is a necessary precondition for the effective treatment of hypochondriasis. However, the results indicate that ET and CT appear to change those processes to a similar degree.

Group cognitive analytic therapy for female survivors of childhood sexual abuse.

The effectiveness of cognitive analytic therapy delivered in groups has been under-researched considering the popularity of the approach. This study sought to investigate the effectiveness of 24 sessions of group cognitive analytic therapy (GCAT) delivered in routine practice for female survivors of childhood sexual abuse (CSA). In a longitudinal cohort design, N=157 patients were treated with 24 sessions of GCAT. Validated outcome measures were administered at assessment, pre-GCAT, and post-GCAT. This enabled rates of reliable and clinically significant change to be compared between wait time and active group treatment. The uncontrolled treatment effect size was then benchmarked against outcomes from matched studies. On the primary outcome measure, GCAT facilitated a moderate effect size of 0.34 with 11% of patients completing treatment meeting 'recovery' criteria. The dropout rate was 19%. Significant improvements in interpersonal functioning, anxiety, and well-being occurred during GCAT in comparison with wait time on secondary outcome measures. Group cognitive analytic therapy appears a promising intervention for adult female CSA survivors, with further controlled evaluation indicated. Group cognitive analytic therapy appears a promising and acceptable intervention for female CSA survivors experiencing high levels of psychological distress. Long-term follow-up studies are required with CSA survivors to index the clinical durability of GCAT. A GCAT treatment fidelity measure needs to be developed and evaluated.

How having exepertose does not make you the expert

While there’s a clear strategy around improving people’s ability to live at home, if individuals can’t communicate in a social setting, then they can’t be part of a strong and supportive community. The focus of this project was the introduction of Cognitive Stimulation Therapy Groups – a personcentred, evidence-based group programme for people with mild to moderate dementia. Where, previously, the community staff in the day care centre had had little or no involvement in the therapy required to maintain communication skills amongst their clients, this project meant everyone – therapists, social care staff, carers –all had a role to play in keeping communication skills active, and individuals engaged in their community settings. Learning and good practice was shared in both directions rather than SLTs coming in as the “experts”. This was much more person-centred, sustainable and engaging. It has relevance for the development of dementia friendly communities.

The development of a mindfulness group for stroke patients: A pilot study

A mindfulness based cognitive therapy (MBCT) group was run for stroke patients. Interviews and questionnaires enabled our understanding of the patients’ experience to inform practitioners of the strengths, difficulties and adaptations to consider for such a group.

Service users' involvement in the development of individual Cognitive Stimulation Therapy (iCST) for dementia: a qualitative study.

BackgroundIndividual Cognitive Stimulation Therapy (iCST) is a one to one, carer led psychosocial intervention for people with dementia, adapted from group Cognitive Stimulation Therapy (CST). It is increasingly recognised that involving service users in research is key to developing interventions and treatments that successfully address their needs. This study describes the contribution of people with dementia and carers during the development phase of the intervention and materials.MethodsTwenty-eight people with dementia and 24 carers were consulted in a series of six focus groups and 10 interviews. The purpose of this study was to gain insight into perceptions of mental stimulation from the point of view of carers and people with dementia, to ensure the materials are easy to use, clear, and appropriately tailored to the needs of people with dementia and their carers, and to assess the feasibility of the intervention.ResultsThe importance of mental stimulation was emphasized by carers and people with dementia. People with dementia saw activities as a way of ‘keeping up to date’ and spending time in a meaningful way. Carers reported benefits such as improved quality of life, mood and memory. The concept of iCST was well received, and both carers and people with dementia responded positively to the first drafts of materials. Feasibility issues, such as finding time to do sessions, were identified.ConclusionThe feedback from the focus groups and interviews will be used to further develop and refine the iCST programme materials in preparation for a field testing phase prior to a large scale randomized controlled trial (RCT).Trial registrationISRCTN65945963. Date of registration: 05/05/2010.

Group psychotherapy's impact on trust in veterans with PTSD: a pilot study.

Interpersonal trust is fundamental for the recovery of trauma survivors and the effectiveness of group psychotherapy. Yet there is limited research on the relationship between interpersonal trust and group psychotherapy. Twenty-one male Vietnam combat veterans with posttraumatic stress disorder (PTSD) (6 in a long-term process group [LTP], 10 in a short-term cognitive processing therapy group [CPT], and 5 treatment-as-usual controls) were evaluated before and after group psychotherapy using the Posttraumatic Stress Disorder Checklist-Military Version (PCL-M) and an in-vivo measure of interpersonal trust, the Iterated Trust Game. Three (14.3%) of the veterans were African American, 9 were Caucasian (42.9%), and 9 were Hispanic (42.9%); they averaged 61.9 years of age (SD = 1.8 years). Change in PCL-M scores differed by group (controls: -1.0 ± 3.7; CPT: -15.5 ± 6.8; LTP: -1.3 ± 12.2; p = .003). CPT group subjects improved more than controls (p < .001) and trended toward more improvement than the LTP group (p = .081). Members of the LTP group, compared to nonprocess group participants, showed greater initial (p = .042), and posttherapy trust (p = .003). Posttreatment, interpersonal trust was significantly higher in the LTP than the CPT group (p < .001). These results suggest that CPT treatment may be better than LTP treatment for improving PTSD symptoms, but LTP therapy may be better than CPT therapy for improving interpersonal trust in veterans with PTSD. They suggest important roles for both group treatments and point to the value of interpersonal trust in successful recovery from PTSD.