Group Cognitive Therapy Research Articles

The Effectiveness of Dialectical Behavior Therapy Skills Training Group vs. Cognitive Therapy Group on Reducing Depression and Suicide Attempts for Borderline Personality Disorder in Taiwan

In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.

Feasibility of group Cognitive Remediation Therapy in an adult eating disorder day program in New Zealand

ObjectiveTo explore the feasibility of integrating group Cognitive Remediation Therapy (gCRT) into an eating disorder day program in Auckland, New Zealand. MethodA consecutive series of 28 patients took part over an 8-month period in the context of a service audit. Main outcome measures were the Detail and Flexibility Questionnaire (DFlex) and qualitative feedback from patients. ResultsSignificant shifts in self-report inefficient cognitive style were observed pre/post gCRT with large effect sizes (Cohen's dav) for both cognitive rigidity and attention to detail outcomes. Patient feedback was positive, with themes of enjoyment, increased insight, and positive social interaction/esteem boosting in the context of the group emerging. ConclusionsSupport for the acceptability, adaptation, expansion, practicality, and limited-efficacy testing of gCRT in an Australasian day program setting has been found, suggesting integration of this module into existing day treatment programs is merited. Larger scale trials may help delineate the clinical characteristics of good responders.

The impact of Cognitive Processing Therapy on stigma among survivors of sexual violence in eastern Democratic Republic of Congo: results from a cluster randomized controlled trial

BackgroundSexual violence is associated with a multitude of poor physical, emotional, and social outcomes. Despite reports of stigma by sexual violence survivors, limited evidence exists on effective strategies to reduce stigma, particularly in conflict-affected settings. We sought to assess the effect of group Cognitive Processing Therapy (CPT) on stigma and the extent to which stigma might moderate the effectiveness of CPT in treating mental health problems among survivors of sexual violence in the Democratic Republic of Congo.MethodsData were drawn from 405 adult female survivors of sexual violence reporting mental distress and poor functioning in North and South Kivu. Women were recruited through organizations providing psychosocial support and then cluster randomized to group CPT or individual support. Women were assessed at baseline, the end of treatment, and again six months later. Assessors were masked to women’s treatment assignment. Linear mixed-effect regression models were used to estimate (1) the effect of CPT on feelings of perceived and internalized (felt) stigma, and (2) whether felt stigma and discrimination (enacted stigma) moderated the effects of CPT on combined depression and anxiety symptoms, posttraumatic stress, and functional impairment.ResultsParticipants receiving CPT experienced moderate reductions in felt stigma relative to those in individual support (Cohen’s D = 0.44, p = value = 0.02) following the end of treatment, though this difference was no longer significant six-months later (Cohen’s D = 0.45, p = value = 0.12). Neither felt nor enacted stigma significantly moderated the effect of CPT on mental health symptoms or functional impairment.ConclusionsGroup cognitive-behavioral based therapies may be an effective stigma reduction tool for survivors of sexual violence. Experiences and perceptions of stigma did not hinder therapeutic effects of group psychotherapy on survivors’ mental health.Trial registrationClinicalTrials.gov NCT01385163.

Efficacy of group cognitive rehabilitation therapy in multiple sclerosis.

Cognitive impairment occurs in 40%-65% of patients with multiple sclerosis (MS). Several techniques for cognitive rehabilitation (CR) in these patients have been evaluated; however, the results have been controversial. In this study, we investigated the efficacy of group compensatory CR in patients with MS-related cognitive impairment. Thirty-four female patients with diagnosed relapsing-remitting MS and evidence of impaired cognitive function were included and randomized to intervention (n=17) and control (n=17) groups. CR intervention consisted of eight 2-hour sessions of comprehensive group CR over a 4-week period that focused on improvement of memory, attention, and executive function. As placebo, the control group received the same number of non-therapeutic group sessions. Assessment of cognitive function was performed before intervention (pretest), at the end of intervention (post-test), and 3months later (follow-up). The study population included 34 patients with a mean age of 35.5years. Statistical comparison of memory assessments at 3-month follow-up showed significantly higher scores in the CR group than in the control group (93.33 vs 86.40 for Addenbrooke's Cognitive Examination test and 16.58 vs 12.00 for visual memory, 19.32 vs 14.05 for verbal memory, and 51.28 vs 44.41 for general scores on the Memory Functioning Questionnaire test, respectively). Wisconsin card sorting test score comparison showed significantly lower total time consumption in the CR group than in the control group (308.1 vs 340.8seconds, respectively). Behavior rating inventory of executive function-adultscores in all four subtests were significantly higher in the CR group than in the control group (40.25 vs 55.4 for behavioral regulation index, 51.16 vs 68.6 for metacognition index, and 97.41 vs 124.00 for global executive composite, respectively). Attention was the only domain in which we did not observe any significant variation between groups in terms of post-test and follow-up scores. This study supports the efficacy of group CR in the improvement of cognitive function in patients with MS.

The Effectiveness of Mindfulness Based Cognitive Therapy Training on Anxiety of Death and Thoughts of Suicide of Patients With Cancer

Background: This study aimed to evaluate the effectiveness of mindfulness-based cognitive group therapy (MBCT) on reducing suicidal thoughts and death anxiety of patients with cancer. Materials and Methods: This study was applied and semi-experimental conducted by using pre-test and post-test with a control group. The research community included all patients with cancer who referred to Shahid Mohammadi hospital in Bandar Abbas. It contained 30 cancer patients who were selected through purposive sampling method and randomly placed in two experimental and control groups (15 individuals per group). The members of both groups completed Templer’s death anxiety questionnaire and Beck's suicidal thoughts before and after the sessions of group therapy (within three months). Findings were analyzed by SPSS software and univariate covariance analysis (ANCOVA) test. Results: The results showed that mindfulness-based cognitive therapy (MBCT) training significantly reduced the suicidal thoughts and death anxiety in the experimental group (P < 0.01). Conclusion: Based on the results of this study, it is essential that medical care and support forums related to refractory patients to reduce psychological symptoms in patients use mindfulness-based cognitive therapy in their treatment programs.

Feasibility of a mindfulness-based cognitive therapy group intervention as an adjunctive treatment for postpartum depression and anxiety

BackgroundMany women experience moderate-to-severe depression and anxiety in the postpartum period for which pharmacotherapy is often the first-line treatment. Many breastfeeding mothers are reticent to increase their dose or consider additional medication, despite incomplete response, due to potential adverse effects on their newborn. These mothers are amenable to non-pharmacological intervention for complete symptom remission. The current study evaluated the feasibility of an eight-week mindfulness-based cognitive therapy (MBCT) intervention as an adjunctive treatment for postpartum depression and anxiety. MethodsWomen were recruited at an outpatient reproductive mental health clinic based at a maternity hospital. Participants had a diagnosis of postpartum depression/anxiety within the first year following childbirth. They were enrolled in either the MBCT intervention group (n = 14) or the treatment-as-usual control group (n = 16), and completed the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Mindful Attention Awareness Scale (MAAS) at baseline and at 4 weeks, 8 weeks, and 3 months following baseline. ResultsMultivariate analyses demonstrated that depression and anxiety levels decreased, and mindfulness levels increased, in the MBCT group, but not in the control group. Many of the between-group and over time comparisons displayed trends towards significance, although these differences were not always statistically significant. Additionally, the effect sizes for anxiety, depression, and mindfulness were frequently large, indicating that the MBCT intervention may have had a clinically significant effect on participants. LimitationsLimitations include small sample size and the non-equivalent control group design. ConclusionsWe demonstrated that MBCT has potential as an adjunctive, non-pharmacological treatment for postpartum depression/anxiety that does not wholly remit with pharmacotherapy. (249 words)

An 8-Week Group Cognitive Behavioral Therapy Intervention for Mobile Dependence

In China, college students with mobile phone dependence are more and more common, which is accompanied by many psychological problems. We developed a group cognitive therapy (CBT) program for mobile phone dependence and studied its effects in Chinese college students. Forty-two Chinese college students, whose scores in the revised Chinese Test of Mobile Phone Dependence (C-TMD) were 37 to 42 points, were assigned to two conditions at a random: the group CBT intervention and the wait-list control condition. The result showed that the CBT group demonstrated significantly more decrease in measures of the C-TMD and Simplified Symptom Checklist (SSCL) than the wait-list controls at post-test and two-month follow-up.

Effectiveness of Schema Therapy and Group Cognitive Therapy on Anxiety in Women with High-Risk Sexual Behavior

Effectiveness of Schema Therapy and Group Cognitive Therapy on Anxiety in Women with High-Risk Sexual Behavior

The Effectiveness of Cognitive Group Therapy Based on Schema-Focused Approach on Self-Esteem and Emotion Regulation in Drug Addicted Prisoners Under the Methadone Maintenance Treatment (MMT)

This study's purpose is to determine the effectiveness of cognitive group therapy based on schema-focused approach on self-esteem and emotion regulation in drug-addicted prisoners under methadone m...

Psychosocial therapy for Parkinson's-related dementia: intervention development.

BackgroundGroup-based psychosocial therapy, such as group Cognitive Stimulation Therapy, improves cognition and quality of life in people living with dementia. Neuropsychiatric symptoms and restricted mobility are common complications for people with Parkinson’s-related dementia (PRD) and may limit access to, and participation in, group activities. This study describes the development of a condition-specific, home-based psychosocial therapy for people with PRD ready to be trialled in a clinical population.MethodsBy means of a multistage process, a draft therapy manual was developed in an iterative manner through collaboration with medical experts, researchers and Patient and Public Involvement (PPI) representatives. In stage 1, an extensive literature search of psychosocial therapies for dementia with potential relevance for Parkinson’s disease (PD) was undertaken to select a candidate therapy for adaptation. In stage 2, qualitative feedback from stakeholders and intelligence regarding existing nonpharmacological therapies for cognitive impairment in PD was combined to produce a prototype therapy manual. In stage 3, the manual was field tested in: 1) a home-setting using a 25-item assessment tool; and 2) at a local PD support group with PPI representatives. Based on the feedback from this phase, final design modifications were implemented and a draft therapy manual produced.ResultsThe manual was developed in an iterative manner. Interview and focus group transcripts identified three enduring themes: manual form and content, therapy acceptability by people with PRD, and companion guidance and support. Major adaptations included: removal of discrete levels of task complexity, removal of images that were potentially hallucinogenic or lacked clarity, and updating of the content.ConclusionWe have successfully developed a Cognitive Stimulation Therapy-based psychosocial therapy specifically adapted for people with PRD. The therapy is ready to trial in a pilot randomized controlled study.

Effectiveness of Group Counseling Using Cognitive and Behavior Therapy Intervention to Reduce Stress among Nurses

This study was conducted as to explore the effectiveness of the treatment modules in group counselling between the Cognitive Therapy Group Counselling and Behavior Therapy Group Counselling in reducing stress level among nurses in Women and Children Hospital in Kota Kinabalu. There are two objectives that guided this mixed methods study. Firstly, this study was to test the effectiveness of the Cognitive Therapy Group Counselling (CTGC) by looking at the different between pre-test and post-test results on the level of stress among nurses who have followed the CTGC with nurses who did not follow the CTGC (control group). Secondly, this study was to test the effectiveness of the Behavior Therapy Group Counselling (BTGC) by looking at the different between pre-test and post-test results on the level of stress among nurses who have followed the BTGC with nurses who did not follow the BTGC (control group). The results showed that there was a significance difference on the level of stress between nurses who joined either GCCT and GCBT with those nurses who did not join the treatment (Control group). In fact, nurses who have joined either treatment have shown some decrease in their stress level. However, when comparing between the two (CTGC and BTGC), BTGC showed better results in reducing stress level among nurses in the hospital. Therefore, both CTGC and BTGC are suitable to reduce stress among nurses in the hospital.

What Works in Israeli Prison-Based Sex Offender Rehabilitation Programs: Program Participants' Perspective.

This study invited 10 of the 22 sex offenders enrolled in a prison-based rehabilitation program in one of the prisons in Israel to engage in the two first of the 4-D ( Discover, Dream, Design, and Deliver) stages of the Appreciative Inquiry . Consistent with the responsivity principle, and the IA tenets, program participants were interviewed to Discover components to which they were responsive and Dream/envision additional ones that would increase engagement and progress. Content analysis of the interviews indicated that despite the initial decision to enrol based on external incentives, participants eventually engaged in group therapy and expressed the desire to understand and regulate their sexual behaviour. While the the modules of Cognitive Behabioral Group Therapy (CBT) were viewed as assets, the lack of sufficient recruitment criteria, the large therapy group size, and its open-ended structure were mentioned as impediments reaching therapeutic goals. Social workers/therapists were criticized for their request that they be informers, and for their accusative therapeutic style whenever sexual issues were broached. Recommendations derived from the offenders' narrative were to increase staff professionalism to create a therapeutic alliance that promotes trust and open communication. Criminal justice practitioners may then take up the challenge of the never-ending process of Appreciative Inquiry to Design and Deliver program components envisioned by the participants to increase participants' responsivity to the program and thus its effectiveness.

Journal Digest

Journal Digest

Résultats préliminaires d’une thérapie cognitive basée sur la pleine conscience (MBCT) appliquée à un groupe de patients phobiques sociaux

ObjectivesThe aim of this exploratory study is twofold: one the one hand present a Mindfulness-Based Cognitive group Therapy intervention, built on model of Segal and adapted to social phobic patients. One the other hand, provide short-term results from a first group of patients who benefited from this therapy. PatientsThe study involves 9 participants (2 men) aged 27–55years. Participants are social phobic outpatients who followed a Mindfulness-Based Cognitive group Therapy proposed in a health center. The goals of the therapy were: learn to better manage emotions, reduce anxiety, improve self-esteem, learn to know themselves better, to live in the moment and not to fear the judgment of the other. Before participation, all subjects were informed of the assessment procedure and gave their free and informed consent. Patients completed questionnaires before the start of treatment and after the treatment. The questionnaires administered assessed the depressive and anxious symptomatology assertiveness, self-esteem, strategies of emotional regulation, thoughts in social interaction, the tendency to perfectionism, positive and negative affectivity, and mindfulness skills. Psychotherapy was held over 8 sessions of 2hours per week and exercises between sessions. It was led by a psychologist trained in behavioral and cognitive therapies, and mindfulness, an occupational therapist also trained in behavioral and cognitive therapies, more two interns psychologists. Sessions focused on methods of learning the centering of attention on the present moment, body awareness and the use of cognitive tools. To evaluate the short-term effects of the treatment, we compared the questionnaires’ scores of patients to two stroke of the evaluation. ResultsThe first results are suggesting an improvement after surgery for several dimensions evaluated: anxiety, depression, assertiveness, ruminations, non-adaptive emotion regulation strategies, and mindfulness capacity of non-judgment. However, the results are less conclusive as regards mindfulness capabilities. We present and discuss the initial results in relation to the already published studies and in taking account the limitations of the study: small staff, no control group, sex ratio. ConclusionsThe first results are encouraging. They suggest to replicate the study with other social phobic patients to verify the effectiveness of MBCT on social phobia.

Effectiveness of mindfulness-based cognitive group therapy on cognitive emotion regulation of patients under treatment with methadone

ABSTRACTIntroduction: Effectiveness of mindfulness-based therapy on a variety of psychopathological disorders is well documented. The aim of this study was to evaluate the effectiveness of mindfulness-based cognitive group therapy on cognitive emotion regulation in patients with substance abuse disorder.Methods: The study had a quasi-experimental design, with pretest, posttest, and two groups (experimental and control). The population of this study included men with substance abuse disorder, who were under methadone maintenance therapy (MMT) in two outpatient methadone clinics in the city of Mashhad from 2014 to 2015. From among them, 60 were selected randomly and allocated to an experimental group and a control group (n = 30 per group). The experimental group underwent eight 1.5 hour sessions of therapeutic interventions held once a week. The tools for data collection consisted of cognitive emotion regulation questionnaire. The control and experimental groups were similar in terms of mean age, education level, and duration of abuse.Results: While similar in pretest, the two groups obtained significantly different scores in the posttest, suggesting the effectiveness of group therapy.Conclusion: Mindfulness-based cognitive group therapy can impact psychological factors involved in opiate addiction. Thus, we can use this approach as a nonpharmacological treatment for these patients.

Group cognitive remediation therapy for younger adolescents with anorexia nervosa: a feasibility study in a Japanese sample

ObjectiveCognitive remediation therapy (CRT) aims to increase patients’ cognitive flexibility by practicing new ways of thinking as well as facilitating bigger picture thinking, supporting patients with relevant tasks and encouraging an awareness of their own thinking styles. CRT has been applied in the treatment of adult anorexia nervosa (AN), and has been shown to be effective and acceptable. In adolescents, CRT has been piloted on both individual and group format. However, no studies are published in CRT for adolescents with AN in a Japanese sample. The objectives of this study were to assess the feasibility, to estimate effect sizes for the purpose of designing a larger study, and to assess the acceptability of a CRT group for younger adolescents with AN in a Japanese sample.MethodsGroup CRT interventions were carried out with a total of seven adolescents with AN. Neuropsychological and psychological assessments (motivation, self-efficacy and depression) were administered before and after the group intervention. The participants completed worksheets (documents of participants’ thinking about their thinking style and the relation of the skills that they learnt through each session to real-life) and questionnaires after the group.ResultsThere were small effect sizes differences between the part of the pre and post neuropsychological tests and the pre and post ability to change (motivation). There were medium effect sizes differences between the pre and post depressive symptoms and importance to change (motivation). There was a large effect size shown between the pre and post weights. All participants were able to reflect on their own thinking styles, such as having difficulty with changing feelings and the tendency to focus on details in real-life. Adolescents’ feedback was positive, and the rate of dropout was low.ConclusionCRT groups could be feasible and acceptable for younger adolescents with AN in a Japanese sample.Trial registration UMIN No. 000020623. Registered 18 January 2016

The Effectiveness of Mindfulness-Based Cognitive Group Therapy in Reducing Negative Automatic Thoughts and Dysfunctional Attitudes in Cancer Patients

Background: This study aimed to evaluate the effectiveness of mindfulness-based cognitive group therapy (MBCT) in reducing negative automatic thoughts and dysfunctional attitudes in cancer patients. Methods: The study was an applied and quasi-experimental research conducted by pre- and post-testing. The sample consisted of 30 cancer patients selected by purposive sampling and randomly placed in the control and the experimental group (15 individuals per group). The members of both groups filled out the automatic thoughts questionnaire (ATQ) and the dysfunctional attitudes scale (DAS-26) at the pre- and the post-test stage. The collected data were analyzed by the SPSS software and multivariate analysis of covariance (MANCOVA) tests. Results: The results indicated that MBCT significantly reduced negative automatic thoughts (F = 126.15, P < 0.01) and dysfunctional attitudes (F = 179.53, P < 0.01) in the experimental group at the post-test stage in comparison to the control group. Conclusions: Based on the results of this study, it is essential that therapeutic centers and support forums related to patients with refractory disorders use MBCT in their programs for reducing negative automatic thoughts and dysfunctional attitudes.

Exploring predictors of work competence in schizophrenia: The role of theory of mind

ABSTRACTIn schizophrenia employment rate is dramatically low, also among patients receiving job support interventions. Recent studies showed a direct relationship between neurocognitive deficits and work functioning, as well as proving the benefits of combined neurocognitive and work interventions. Current evidence also supports a role of Theory of Mind (ToM), on work functioning. However, the effect of integrated rehabilitation programmes including a social cognitive training on job outcome is still less explored. The aim of this pilot study is to investigate the relationship between work competence and clinical factors, neurocognitive and ToM abilities, as well as to explore the effect of neurocognitive and ToM treatments combined with work therapy.Thirty-seven outpatients with schizophrenia were assigned to either a Computer-assisted Cognitive Remediation (CACR) plus work therapy group (WTG) or to CACR and WTG added to ToM Intervention, both followed by a job support programme. All patients were assessed for psychopathology, neurocognition, ToM and work functioning.Work outcome was significantly predicted by age at onset, neurocognitive abilities and the degree of ToM improvement after the specific intervention.This study provides preliminary insight on predictors of work competence in schizophrenia, highlighting the importance of ToM abilities.

A cognitive and behavioural group therapy for binge eating disorder: An original 12 sessions design

The Binge Eating Disorder (BED) consists in binge eating with a loss of control and guilty feeling. Weigh excessive preoccupation, psychiatric comorbidities and psychosocial impairment are associated to BED. BED prevalence is 3 to 5%, which is the more frequent eating disorder. The efficacy of CBT is well-known with several publications.MethodWe have proposed 12 sessions of 1.30 hours for a 6 to 8 patients group, managed by a psychiatrist trained to CBT. Each session approaches a different topic (eating behavioural, self-esteem, problem resolution, stigmatization, emotion coping, cognitive therapy…).AssessmentPatients are evaluated before and after therapy with Eating Disorder Inventory version 2 and Rathus Scale for self-esteem. Thirty patients were included.ResultsPatients improve eating behavioural and other topics like self-esteem, social functioning, problem resolution and emotion coping. It appears that 12 sessions group CBT could be effective with patients who suffer of BED. Others studies are needed to evaluate the long-term outcome.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Feasibility, Acceptability, and Preliminary Effectiveness of a 4-week Mindfulness-Based Cognitive Therapy Protocol for Hospital Employees.

Hospital employees may experience occupational stress and burnout, which negatively impact quality of life and job performance. Evidence-based interventions implemented within the hospital setting are needed to promote employees' well-being. We offered a 4-week Mindfulness-Based Cognitive Therapy group program for hospital employees, and used a mixed-methods practice-based research approach to explore feasibility, acceptability, and effects on stress and burnout. Participants were 65 hospital employees (Mage = 44.06; 85% white) who participated between September 2015 and January 2016. Participants completed validated measures of stress and burnout before and after the program, and answered open-ended satisfaction questions after the program. Groups consistently enrolled at least 10 participants, but attendance rates declined across sessions (76% at session 2 vs. 54% at session 4) due primarily to work-related scheduling conflicts. The program content was acceptable as evidenced by high perceived value (M = 9.18 out of 10), homework compliance (51% practicing at least 3 times/week), and qualitative requests for program expansion. There were large, statistically significant decreases in stress (ΔM = 2.1, p < .001, d = .85) and medium decreases in burnout (ΔM = .46, p = .01, d = .57), which were supported by qualitative themes of improved self-regulation and mindfulness skills, stress reduction, emotional well-being, and improved work productivity and patient care skills. Findings suggest that 4-week MBCT is acceptable and useful for hospital employees, though research is needed to identify alternate delivery methods or strategies to enhance session attendance.