Group Cognitive Therapy Research Articles

Effectiveness of Group Cognitive Therapy for Social Anxiety Disorder in Routine Care

AbstractSocial anxiety disorder (SAD) is a prevalent chronic condition with a large demand for treatment. This community outpatient study examined the effectiveness of a group intervention version of the established one-to-one cognitive therapy derived from the Clark and Wells model for SAD. Questionnaires were completed pre-treatment and post-treatment for SAD symptoms (Social Phobia Scale, Social Interaction Anxiety Scale), depressive symptoms (BDI-II), self-focused attention, safety behaviours (Social Phobia Weekly Summary Scale and Subtle Avoidance Frequency Examination), and impaired functioning (Work and Social Adjustment Scale). From an initial sample of 159 participants, 101 completed at least seven of the nine weekly group sessions (Mage = 34.1 years, SDage = 10.8 years, 53% female). Significant improvements were demonstrated on all measures. Large effect sizes were found for social anxiety symptoms and safety behaviour use. Self-focused attention, depressive symptoms, and impaired functioning had moderate effect sizes. Effect sizes for anxiety (d = 1.00 and 1.32) and mood measures (d = 0.71) were as high, or in some cases, higher than previous group treatment studies. Results suggest group cognitive therapy for SAD based on the Clark and Wells model is effective in a clinical setting for individuals with moderate/severe and treatment-resistant social anxiety.

Canadian Consensus Conference on Psychological and Non-Pharmacological Interventions for Dementia

Psychological and non-pharmacological interventions that could have a positive effect on outcomes important to persons living with dementia are essential to identify given the the limited efficacy of dementia medications and the diverse needs of persons living. In 2019, for the first time the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) created a working group to develop recommendations related to a broad range of psychosocial and non-pharmacological interventions exist, typically aimed at improving cognition, symptoms, or well-being, as well as improving caregiver well-being and coping. The recommendations, primarily intended for primary care physicians, may also allow clinicians, organizations, and communities and help to better meet the needs of people living with dementia and their caregivers. A group of 11 experts, including persons living with dementia and informal caregivers, as well as clinicians and researchers from various organizations both nationally and internationally were invited to participate. A rapid review of meta-analyses and literature reviews on psychological and non-pharmacological interventions was conducted. The synthesized results were submitted for a consensus building approach using a Delphi method, involving a panel of more than 50 Canadian participants. Recommendations with a positive vote of 80% or more were considered to have reached consensus. All proposed recommendations reached consensus using the Delphi process. Details of the recommendations are presented. Five recommendations are made: group or individual physical exercise, group cognitive stimulation therapy, psychoeducational interventions for caregivers, dementia friendly organizations/communities, and case management.

Effects of creative expression program on the event-related potential and task reaction time of elderly with mild cognitive impairment

ObjectivesThis study aimed to evaluate the effects of a 16-week creative expression intervention program (CrExp) on the event-related potential (ERP) and task reaction time in older individuals with mild cognitive impairment (MCI). MethodsThis study is a randomized controlled clinical trial conducted in the Memory Center of Fujian Provincial hospital. Thirty-six MCI patients were randomly distributed into two groups. One group underwent a 16-week creative expression program (CrExp, n = 18) and the other performed as a control group (CG, n = 18) by general social activities. The amplitude and latency of ERP-P300 from the central (Cz), parietal (Pz), frontal (Fz) cortices and task reaction time (RT) were assessed at baseline, post-interventi on, and 24-week follow-up. ResultsThe CrExp group showed greater differences than CG of P300 latency in Cz (F = 4.37, P = 0.015), Pz (F = 2.78, P = 0.009), Fz (F = 6.45, P = 0.031) brain area after 16 weeks of intervention and in Fz (F = 3.23, P = 0.028), Cz (F = 3.79, P = 0.024), and Pz (F = 5.60, P = 0.036) at 24 weeks follow-up. Also, we analyzed the task reaction time between two groups and found that a shorten reaction time at post-intervention (F = 4.47, P = 0.011) and 24 weeks follow-up (F = 3.12, P = 0.007) in the CrExp group. However, there was no difference in P300 amplitude in either brain area between the two groups. ConclusionThe electrophysiological results of the creative expression cognitive therapy group were more obvious than those of the general cognitive therapy group, and the latency and task reaction time may be considered as supported parameters in diagnosing the effects during non-drug therapy intervention in clinical practice.

Clinical study on electroacupuncture for obese patients with binge eating disorder: A retrospective study.

Binge eating disorder (BED) is a common dietary disorder among obese people. Obesity and eating disorders are related to mental health and physical health. At present, there is no definite and effective method for treatment in clinic. The curative effect of electroacupuncture on obesity is definite. Although there is no conclusive evidence to support its long-term benefits, electroacupuncture has been increasingly used in clinic. This retrospective study determined the prognosis and outcome of electro-acupuncture on obese patients with BED.One hundred forty-three patients with BED and obesity were found from 658 people who participated in the scientific experiment of obesity treatment in Nanjing Hospital of Traditional Chinese Medicine and Nanjing Brain Hospital from March 2015 to June 2018, and 84 patients (aged 18–40 years old) with valid data and uninterrupted treatment were found to be eligible for this retrospective study. According to the intervention methods, the patients were divided into electro-acupuncture combined with cognitive group (n = 32), cognitive therapy group (n = 28), and control group (n = 24). In this study, the 5th edition of Diagnosis and Statistics Manual of Mental Diseases, fasting blood glucose, fasting insulin, total cholesterol (TC), triglyceride, high-density lipoprotein, low-density lipoprotein, body fat rate, muscle mass, visceral index grade, nutrient intake (energy, protein, fat, carbohydrate), body weight, and weight changes before and after treatment were observed.Compared with the cognitive therapy group, negative emotion score, TC, triglyceride, high-density lipoprotein, waist circumference, BW, BMI, body fat percentage of the electroacupuncture combined with cognitive group were lower, while positive emotional scores were higher, and there were significant differences in negative emotional scores, TC, waist circumference and BMI (P < .05). The dietary energy and three major nutrients in the electroacupuncture combined with cognitive group were lower than those in the cognitive group and the blank group (P < .05).The current results suggest that electroacupuncture combined with cognitive therapy is more effective than cognitive therapy alone in treating obese patients with BED. Future prospective studies are necessary to further study the mechanism of electroacupuncture on the obese with BED.

A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders

BackgroundThe goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders.MethodsA total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data.ResultsMindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups.ConclusionsThe predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed.Trial registrationHKU Clinical Trials Registry. Identifier: HKUCTR-2558. Registered 21st Nov 2018.

Predictors of Functional Outcome in Patients With Bipolar Disorder: Effects of Cognitive Psychoeducational Group Therapy After 12 Months

Background: Cognitive deficits are known as a core feature in bipolar disorder. Persisting neurocognitive impairment is associated with low psychosocial functioning. The aim of this study was to identify potential cognitive, clinical and treatment-dependent predictors for functional impairment, symptom severity and early recurrence in bipolar patients, as well as to analyze neurocognitive performance compared to healthy controls.Methods: Forty three remitted bipolar patients and 40 healthy controls were assessed with a neurocognitive battery testing specifically attention, memory, verbal fluency and executive functions. In a randomized controlled trial, remitted patients were assigned to two treatment conditions as add-on to state-of-the-art pharmacotherapy: cognitive psychoeducational group therapy over 14 weeks or treatment-as-usual. At 12 months after therapy, functional impairment and severity of symptoms were assessed.Results: Compared to healthy controls, bipolar patients showed lower performance in executive function (perseverative errors p < 0.01, categories correct p < 0.001), sustained attention (total hits p < 0.001), verbal learning (delayed recall p < 0.001) and verbal fluency (p-words p < 0.002). Cognitive psychoeducational group therapy and attention predicted occupational functioning with a hit ratio of 87.5%. Verbal memory recall was found to be a predictor for symptom severity (hit ratio 86.8%). Recurrence in the follow-up period was predicted by premorbid IQ and by years of education (hit ratio 77.8%).Limitations: Limitations of the present study result mainly from a small sample size. The extent of cognitive impairment appears to impact occupational disability, clinical outcome as well as recurrence rate. This result must be interpreted with caution because statistical analysis failed to show higher significance.Conclusions: Bipolar patients benefit from cognitive psychoeducational group therapy in the domain of occupational life. Deficits in sustained attention have an impact on occupational impairment. Implications for treatment strategies are discussed. Further evaluation in larger studies is needed.

Seeing the Bigger Picture: A Lesson for Accessible Treatment Design

A cognitive remediation group therapy was adapted to accommodate a participant with acquired blindness in an early psychosis intervention program. The modifications facilitated group inclusion and self-reported positive outcomes. This case highlights the need to consider accessibility during treatment design and transitioning therapies from research settings into clinical environments.

Reflections from a Mindfulness Based Cognitive Therapy (MBCT) group in a Recovery College setting: Working across primary and secondary care

The article describes an innovative and flexible approach to running a mindfulness group, open to primary and secondary care services. The group was run by a clinical psychologist and a trainee clinical psychologist, reflections on the process and outcomes are provided.

An exploration of group cognitive analytic therapy for anxiety and depression.

Cognitive analytic therapy has been shown to be an effective psychological treatment for a range of differing presentations but little research to date has focused on the use of Group CAT (GCAT). The aim of this study was to explore the acceptability, feasibility, and preliminary effectiveness of GCAT for clients with mood and anxiety disorders in primary care. This study utilized a mixed method design. A 12-session GCAT programme was developed covering key CAT concepts. The structure reflected the three phases of CAT - reformulation, recognition, and revision. Participants completed outcome measures pre- and post-treatment and at 3-month follow-up. Acceptability was reported using session attendance and participant feedback in addition to asking clients to rank the utility of CAT treatment components. A therapist interview was also completed. Fifty-five per cent of clients completed the treatment, and feedback suggests that GCAT is an acceptable and feasible intervention for a primary care population. Clients also reported on the utility of specific CAT treatment components. Clients demonstrated positive change on a number of outcome measures. Group cognitive analytic therapy shows promise as an acceptable and feasible treatment for clients with mood and anxiety disorders presenting to primary care services. Further larger and more controlled studies are indicated. The study supports the idea that GCAT is an acceptable and feasible treatment for clients with mood and anxiety disorders in a primary care setting. Clients indicated the utility of various aspects of GCAT The study provides tentative evidence for the effectiveness of GCAT in ameliorating symptoms of stress, anxiety, and depression in primary care.

Effectiveness of Health-Led Cognitive Behavioral-Based Group Therapy on Pain, Functional Disability and Psychological Outcomes among Knee Osteoarthritis Patients in Malaysia.

Background: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia. Methods: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat. Results: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI −1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing. Conclusion: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.

The Effect of Group Cognitive Rehabilitation Therapy on the Problem Solving Skills of Students with Attention Deficit Hyperactivity Disorder

The Effect of Group Cognitive Rehabilitation Therapy on the Problem Solving Skills of Students with Attention Deficit Hyperactivity Disorder

Comparison of the Effects of two Interventional Programs of Group Cognitive Therapy with Group Islamic-based spiritual Intervention in Palliative care on Quality of life, Anxiety, and Depression in patients with Breast Cancer

Comparison of the Effects of two Interventional Programs of Group Cognitive Therapy with Group Islamic-based spiritual Intervention in Palliative care on Quality of life, Anxiety, and Depression in patients with Breast Cancer

Scapular exercise combined with cognitive functional therapy is more effective at reducing chronic neck pain and kinesiophobia than scapular exercise alone: a randomized controlled trial

Objective: The aim of this study was to compare the effectiveness of scapular exercises alone and combined with cognitive functional therapy in treating patients with chronic neck pain and scapular downward rotation impairment. Design: Single-blind randomized controlled trial. Setting: Outpatient. Subjects: A total of 72 patients (20–45 years old) with chronic neck pain were studied. Intervention: Allocation was undertaken into three groups: scapular exercise (n = 24), scapular exercise with cognitive functional therapy (n = 24) and control (n = 24) groups. Each programme lasted three times a week for six weeks. Main outcomes: The primary outcome measure was pain intensity measured by the visual analogue scale scores. The secondary outcome measures included kinesiophobia and muscles activity. Results: Statistically significant differences in pain intensity were found when multidisciplinary physiotherapy group including a cognitive functional approach was compared with the scapular exercise alone group at six weeks (effect size (95% CI) = −2.56 (−3.32 to −1.80); P = 0.019). Regarding kinesiophobia, a significant between-group difference was observed at six-week (effect size (95% CI) = −2.20 (−2.92 to −1.49); P = 0.005), with the superiority of effect in multidisciplinary physiotherapy group. A significant between-group differences was observed in muscle activity. Also, there were significant between-group differences favouring experimental groups versus control. Conclusion: A group-based multidisciplinary rehabilitation programme including scapular exercise plus cognitive functional therapy was superior to group-based scapular exercise alone for improving pain intensity, kinesiophobia and muscle activation in participants with chronic neck pain.

Cognitive evolutionary therapy versus standard cognitive therapy for depression: Asingle-blinded randomized clinical trial.

To compare the efficacy of cognitive evolutionary therapy (CET) with cognitive therapy (CT) for depression. Ninety-seven participants (78females/19males) were randomized to a single-blinded controlled trial (CET: n = 51vs. CT: n = 46). Assessments were conducted at baseline, Sessions 4and 8, posttreatment, and 3-month follow-up. Clinical diagnoses were made with Structured Clinical Interview for DSM-IV (SCID)and self-reports for depression and secondary outcomes. Although both groups showed significant reductions in depressive symptomatology, the overall Time × Treatment group interaction in the intent to treat analysis was not significant (p = .770, posttreatment: d = 0.39). However, CET was superior to CT at increasing engagement in social and enjoyable activities (p = .040, posttreatment: d = 0.83, p = .040) and showed greater reductions than the CT group in behavioral inhibition/avoidance (p = .047, d = 0.62). The between-group differences generally diminished at the 3-month follow-up. CET is a novel therapy for depression that may add therapeutic benefits beyond those of CT.

Effectiveness of Midwifery Counseling on Adaptation to Pregnancy, Maternal-Fetal Attachment, and Quality of Life in Unplanned Pregnant Women: A Randomized Controlled Trial

Background: Women with unplanned pregnancy experienced a number of psychological problems. Thus, the present study aimed to examine the effectiveness of midwifery counseling based on cognitive approach in improvement of adaptation to pregnancy, mother-fetal attachment and quality of life among unplanned pregnant women. Materials and Methods: This pre-test posttest control group single blind study was done on pregnant women who were chosen from the healthcare centers of Zanjan city, Iran.Of 187 women screened for eligibility to participate in the study, 54 unplanned pregnant women met inclusion criteria and were randomly assigned into intervention group or control group. The intervention group received eight weekly group cognitive therapy sessions. The control group received prenatal routine care. The participants answered WHO Quality of Life Questionnaire, Maternal–Fetal Attachment Scale, and Lederman Prenatal Self-evaluation Questionnaire at pretest, posttest, and one-month follow- up periods. Results: The two groups were not different in terms of age (p = 0.89), educational status (p = 0.56), and job status (p = 0.31). In addition, they were not different regarding pre-test scores of Lederman Prenatal Self-evaluation Questionnaire (p = 0.27), Maternal–Fetal Attachment Scale (p = 0.22), and WHO Quality of Life Questionnaire (p = 0.37). At posttest and one-month follow- up, the intervention group showed significant improvement in adaptation to pregnancy (p < 0.0001), Maternal-fetal attachment (p < 0.0001), and quality of life (p < 0.0001) than the control group. Conclusion Midwifery counseling based on cognitive approach could be an effective approach to improve adaption to pregnancy, maternal-fetal attachment, and quality of life among women who became pregnant unintentionally.

T244. FURTHER EVIDENCE SUPPORTING COORDINATED SPECIALTY CARE FOR EARLY PSYCHOSIS: FINDINGS FROM THE SAMHSA SUPPORTED PENN PSYCHOSIS EVALUATION AND RECOVERY CENTER (PERC)

BackgroundThe early years following a first episode of psychosis (FEP) present unique opportunities to prevent declines in clinical and social function. Early intervention programs target factors known to be associated with poor long-term outcomes, including longer duration of untreated psychosis, treatment non-adherence, affective symptoms, and cognitive dysfunction. The RAISE trial and other work in the U.S. and internationally spurred congress to fund comprehensive specialty care (CSC) programming across the US through a SAMHSA block-grant set-aside that began in 2015 and was doubled in 2016. As a Pennsylvania recipient of these funds since 2015, the Penn Psychosis Evaluation and Recovery Center (PERC) enrolls individuals age 15–34 who have experienced psychosis onset within two years prior to enrollment. We received complementary funding in 2018 to provide step-down care to FEP participants, and to expand PERC services to individuals at clinical high risk for psychosis.MethodsPERC services, offered for a minimum of two years, include pharmacotherapy, recovery oriented cognitive therapy and case management, supported employment and education, multi-family group cognitive therapy and psycho-education, peer support, and cognitive remediation. SAMHSA funds are used to provide CSC elements that cannot be supported through available insurance coverage. A comprehensive computerized assessment, conducted at admission and at 6-, 12-, 18- and 24- month follow-up intervals, includes measures from the Pennsylvania FEP Program Evaluation core battery assessing participant-level outcomes (employment and education, hospitalization, criminal justice involvement and risk behaviors, and overall functioning and clinical symptoms), complemented by standardized measures of cognitive insight, sleep quality, and other relevant domains. Systems-level data on outreach efforts, incoming and outgoing referrals, admissions and discharges are also collected. Data collection is integrated into clinical care.ResultsTo date, PERC has enrolled 202 individuals (mean age=22.2, SD=4.4; 78% male; 56% European-American, 31% African-American, 13% other), of whom 106 consented to use of clinical data for research purposes. Admission and 6- month follow-up data reflect improved psychosis and mood symptoms, increased engagement in employment or school, and low re-hospitalization rates. Clinician rated global role and social function significantly increased by 6-month follow-up. Participants self-reported significantly increased satisfaction with mental health services and improved perception of their recovery process at 6-month follow-up. Duration of untreated psychosis prior to PERC admission (mean=7.4 months, SD=7.4) was not correlated with improvements in global role or social function at 6-months. Clinical and functional changes beyond 6 months remain to be analyzed.DiscussionOur results add to growing evidence that individuals who have experienced a first episode of psychosis benefit from participating in comprehensive interventions that can improve clinical symptoms, function and quality of life. They also provide further evidence of the feasibility and clinical utility of FEP CSC programs supported by federally mandated funds, which can reduce the personal and societal burdens associated with psychotic disorders. As our program continues to expand, ongoing comprehensive assessment across the early psychosis spectrum will afford evaluation of longer-term therapeutic benefits and analyses of predictors of varying outcomes.

Group Cognitive Rehabilitation Therapy improves Cognitive Function in patients with Multiple Sclerosis (590)

Group Cognitive Rehabilitation Therapy improves Cognitive Function in patients with Multiple Sclerosis (590)

"Effectiveness of a mindfulness-based cognitive therapy group intervention in reducing gambling-related craving"

"Effectiveness of a mindfulness-based cognitive therapy group intervention in reducing gambling-related craving"

Predictors of Treatment Outcome in Group or Individual Cognitive Processing Therapy for Posttraumatic Stress Disorder Among Active Duty Military.

The purpose of this study was to examine demographic, psychological, military, and deployment variables that might predict posttraumatic stress disorder (PTSD) symptom improvement in a sample of active duty service members who received either group or individual cognitive processing therapy (CPT). Data were analyzed from 165 active duty service members with pre- and posttreatment data participating in a randomized controlled trial comparing group with individual CPT. Pretreatment variables were examined as predictors of change in PTSD severity from baseline to posttreatment, assessed using the PTSD Symptom Scale-Interview Version (PSS-I). Predictors of PSS-I change were first evaluated using Pearson correlations, followed by partial and multiple correlations to clarify which associations remained when effects of other predictors were controlled. Multiple regression analyses were used to test for interactions between pretreatment variables and treatment format. Only age was a significant predictor of PTSD symptom change after controlling for other variables and statisitically correcting for testing multiple variables. There was also an interaction between age and treatment format. Younger participants had greater symptom improvement, particularly if they received individual treatment. Other pretreatment variables did not predict outcome. CPT appears to be robust across most pretreatment variables, such that comorbid disorders, baseline symptom severity, and suicidal ideation do not interfere with application of CPT. However, individual CPT may be a better option particularly for younger service members.

Effectiveness of Mindfulness-Based Cognitive Therapy on Sleep Quality and Perceived Social Support Improvement in Patients with HIV/AIDS

Background: Human immunodeficiency virus (HIV/AIDS) is the factor causing AIDS. The virus is categorized into retroviruses that attack and destroy the immune system of the body and cause lethal infections. Objectives: The present study aimed to investigate the effectiveness of mindfulness-based cognitive therapy in the improvement of sleep quality and perceived social support of the patients with HIV/AIDS. Methods: The present study is randomized controlled trial research. The study population included individuals with HIV-AIDS from Ahvaz county’s center of behavioral disease counseling. The study sample volume consisted of two groups, named mindfulness-based cognitive therapy and control groups, each one contained 15 individuals who were selected randomly. The experimental intervention was undertaken during eight 1.5-hour sessions that were held once a week. To gather the data, the sleep quality scale, perceived social support questionnaire, SCL-90-R scale, and demographic factors questionnaire were used. Multivariate covariance analysis and SPSS-22 Software were utilized for analyzing the data. Results: In terms of gender, the experimental group consisted of 8 (53.3) women and 7 (46.7) men. In the control group, 4 (26.7) were women and 11 (73.3) were men. The mean (standard deviation) age of the participants in the experimental group was 35.7 (7.42) and the mean (standard deviation) of the age of the control group was 37.8 (9.1). The results showed that mindfulness-based cognitive therapy had a significant effect on sleep quality (F = 27.98, P < 0.001) and perceived social support (F = 36.20, P < 0.001) in patients with HIV/AIDS. Conclusions: It can be concluded that mindfulness-based cognitive therapy is effective in improving the sleep quality and perceived social support of patients with HIV/AIDS. Based on the results of this study, it seems that by teaching mindfulness-based cognitive therapy, patients’ sleep quality and perceived social support can be reduced.