Cognitive-behavioral Group Treatment Research Articles

Work-Anxiety and Sickness Absence After a Short Inpatient Cognitive Behavioral Group Intervention in Comparison to a Recreational Group Meeting.

The aim of this study was to study the effects of a short-term cognitive behavior therapy on work-anxiety and sickness-absence in patients with work-anxiety. Three-hundred forty-five inpatients who suffered from cardiologic, neurological, or orthopedic problems and additionally work-anxiety were randomly assigned into two different group interventions. Patients got four sessions of a group intervention, which either focused on cognitive behavior-therapy anxiety-management (work-anxiety coping group, WAG) or unspecific recreational activities (RG). No differences were found between WAG and RG for work-anxiety and subjective work ability. When looking at patients who were suffering only from work-anxiety, and no additional mental disorder, the duration of sickness absence until 6 months follow-up was shorter in the WAG (WAG: 11 weeks, RG: 16 weeks, P = 0.050). A short-term WAG may help return to work in patients with work-anxieties, as long as there is no comorbid mental disorder.

Development and Evaluation of Cognitive Behavioral Group Treatment to Reduce Psychological Stress of Emotion Labor Workers: A Preliminary Study

The current study aims to develop and evaluate cognitive behavioral group treatment to reduce psychological stress of emotion labor workers, considering lack of interventions for emotion labor workers in South Korea. The participants were social workers (N=26) and intra-company telemarketers (N=22) who are considered as representative emotion labor workers. A two day treatment based on Cognitive Behavioral Therapy targeting depression, anxiety, anger, and stress level was developed. Assessments were done pre-to-post treatment. As a result, perceived stress, anger, and anxiety decreased significantly and participants reported high satisfaction with the program. Limitations and suggestions for further study were included. (Korean J Str Res 2016;24:35∼ 45)

The health belief model and number of peers with internet addiction as inter-related factors of Internet addiction among secondary school students in Hong Kong.

BackgroundStudents are vulnerable to Internet addiction (IA). Influences of cognitions based on the Health Belief Model (HBM) and perceived number of peers with IA (PNPIA) affecting students’ IA, and mediating effects involved, have not been investigated.MethodsThis cross-sectional study surveyed 9518 Hong Kong Chinese secondary school students in the school setting.ResultsIn this self-reported study, the majority (82.6 %) reported that they had peers with IA. Based on the Chinese Internet Addiction Scale (cut-off =63/64), the prevalence of IA was 16.0 % (males: 17.6 %; females: 14.0 %). Among the non-IA cases, 7.6 % (males: 8.7 %; females: 6.3 %) perceived a chance of developing IA in the next 12 months. Concurring with the HBM, adjusted logistic analysis showed that the Perceived Social Benefits of Internet Use Scale (males: Adjusted odds ratio (ORa) = 1.19; females: ORa = 1.23), Perceived Barriers for Reducing Internet Use Scale (males: ORa = 1.26; females: ORa = 1.36), and Perceived Self-efficacy for Reducing Internet Use Scale (males: ORa = 0.66; females: ORa = 0.56) were significantly associated with IA. Similarly, PNPIA was significantly associated with IA (‘quite a number’: males: ORa = 2.85; females: ORa = 4.35; ‘a large number’: males: ORa = 3.90; females: ORa = 9.09). Controlling for these three constructs, PNPIA remained significant but the strength of association diminished (‘quite a number’: males: multivariate odds ratio (ORm) = 2.07; females: ORm = 2.44; ‘a large number’: males: ORm = 2.39; females: ORm = 3.56). Hence, the association between PNPIA and IA was partially mediated (explained) by the three HBM constructs. Interventions preventing IA should change these constructs.ConclusionsIn sum, prevalence of IA was relatively high and was associated with some HBM constructs and PNPIA, and PNPIA also partially mediated associations between HBM constructs and IA. Huge challenges are expected, as social relationships and an imbalance of cost-benefit for reducing Internet use are involved. Perceived susceptibility and perceived severity of IA were relatively low and the direction of their associations with IA did not concur with the HBM. Group cognitive-behavioral interventions involving peers with IA or peers recovered from IA are potentially useful to modify the HBM constructs and should be tested for efficacy.

The AFFIRM open pilot feasibility study: A brief affirmative cognitive behavioral coping skills group intervention for sexual and gender minority youth

This pilot study sought to evaluate the feasibility and effectiveness of a brief, eight module affirmative cognitive behavioral coping skills group intervention (AFFIRM) with sexual and gender minority youth (SGMY) developed through community partnerships. A diverse sample of SGMY (n=30) participated in the AFFIRM pilot and completed reliable measures of depression, reflective coping, and stress appraisal at three time points. Over the study duration, significant reductions were found in depression and appraising stress as a threat. Significant increases were found in reflective coping and perceiving stress as a challenge. Participants found the intervention to be valuable and reported high levels of acceptability and skills acquisition. These promising findings suggest that AFFIRM has potential effectiveness as a community-based intervention for SGMY. Implications for practice and research are provided.

A pilot trial of brief group cognitive-behavioral treatment for insomnia in an adult cancer survivorship program.

Cognitive-behavioral therapy for insomnia (CBT-Insomnia) is effective, yet rarely available for cancer survivors. This is unfortunate because survivors are at elevated risk for insomnia, which is associated with significant health consequences in this already at-risk population. Barriers to delivering CBT-Insomnia in oncology settings include a lack of trained providers, distance to cancer centers, and treatment duration. To address insomnia treatment barriers, we adapted standard CBT-Insomnia treatment and evaluated a pilot group-based approach for feasibility and efficacy in an adult cancer survivorship program. Thirty-eight cancer survivors (mean age = 52.2 years) enrolled in our three-session program delivered over 1 month. They were primarily diagnosed with breast cancer (58.6%) and were an average of 6.0 years post-diagnosis and 3.6 years post-treatment. Participants completed sleep logs throughout the study and measures of sleep at baseline and week 4. Participants reported experiencing insomnia symptoms an average of 2.4 years, with 89.7% indicating that the cancer experience had caused/exacerbated symptoms. Significant pre/post-intervention group improvements in sleep efficiency (77.3% to 88.5%), sleep quality, and insomnia symptoms were reported (all ps < .01). Less than 1 in 3 had discussed insomnia symptoms with their oncology providers in the prior year. Pilot data indicate that a brief, group-based CBT-Insomnia intervention in a survivorship setting is both feasible and efficacious. There is a need to increase awareness about insomnia and its treatment among both cancer survivors and oncology providers. If validated in future studies, this novel approach can improve cancer survivors' access to much needed insomnia treatment. Copyright © 2016 John Wiley & Sons, Ltd.

Short-Term Cognitive-Behavioural Group Treatment for Hoarding Disorder: A Naturalistic Treatment Outcome Study.

A 12-week group programme delivered in a community setting was effective for helping with hoarding symptoms with a large effect size. Hoarding beliefs (emotional attachment and responsibility) and depression were reduced, with moderate effect sizes. A third of all participants who completed post-treatment questionnaires experienced clinically significant change. Suggests that hoarding CBT treatment can be effectively translated into real-world settings and into a brief 12-session format, albeit the study had a moderate assessment completion rate.

Effectiveness of a school-based early intervention CBT group programme for children with anxiety aged 5–7 years

AbstractEarly manifestations of anxiety in childhood confer significant distress and life interference. This study reports on the first controlled trial of the Get Lost Mr Scary programme, a Cognitive Behavioural Therapy group intervention for children with anxiety aged 5–7 years. Participants were 134 children (65 males and 69 females) drawn from 23 public schools located in Western Sydney, Australia. A non-randomised control group design was used to assign schools to an intervention group or wait-time control group. Post-intervention results obtained from parent and teacher measures indicated that children who received the intervention showed significant reductions in their anxiety and behaviour symptoms compared to children in the wait-time group who showed no significant change. After receiving the intervention, the wait-time group showed a similar pattern of improvement. At 12-month follow-up, the intervention gains for anxiety were maintained. Clinical implications for the school setting and future ...

Cognitive-behavioral group treatment for veterans diagnosed with PTSD: Design of a hybrid efficacy-effectiveness clinical trial

Despite significant advances in individual treatment approaches for PTSD, knowledge of group approaches has lagged behind. Much of the reason knowledge about group treatment for PTSD has been limited is due to the complexity of conducting randomized controlled trials in the group treatment context. This limited empirical knowledge is unfortunate given the frequency with which group treatment for PTSD is used in clinical settings, including the Department of Veteran Affairs. The goal of this study is to examine the efficacy of a group cognitive-behavioral treatment (GCBT) for PTSD relative to group supportive counseling approach (i.e. group present centered treatment; GPCT). The sample consists of 196 veterans diagnosed with PTSD who are randomly assigned to either GCBT (n=98) or GPCT (n=98). Both treatments are administered by two therapists over the course of 14 sessions. Assessments take place at baseline, mid-treatment, post-treatment and 3-, 6-, and 12-month follow-up. The primary outcome measure is the PTSD symptom severity assessed with a semi-structured diagnostic instrument. Given the substantial rise of veterans presenting for PTSD treatment services, identifying an efficacious group treatment approach is invaluable.

Group cognitive behavioural treatment for insomnia in primary care: a randomized controlled trial

Insomnia disorder is common and often co-morbid with mental health conditions. Cognitive behavioural therapy (CBT) for insomnia is effective, but is rarely implemented as a discrete treatment. The aim of this study was to evaluate the effectiveness of brief CBT groups for insomnia compared to treatment as usual (TAU) for insomnia delivered by mental health practitioners in a primary-care mental health service. A total of 239 participants were randomized to either a five-session CBT group or to TAU. Assessments of sleep and of symptoms of depression and anxiety were carried out at baseline, post-treatment and at 20 weeks. Primary outcome was sleep efficiency post-treatment. Group CBT participants had better sleep outcomes post-treatment than those receiving TAU [sleep efficiency standardized mean difference 0.63, 95% confidence interval (CI) 0.34-0.92]. The effect at 20 weeks was smaller with a wide confidence interval (0.27, 95% CI -0.03 to 0.56). There were no important differences between groups at either follow-up period in symptoms of anxiety or depression. Dedicated CBT group treatment for insomnia improves sleep more than treating sleep as an adjunct to other mental health treatment.

Short-term group cognitive behavioral intervention in cancer patients

Objective To explore the effect of cognitive behavioral intervention on quality of life and distress of cancer patients. Methods The research was a random control study, and computer randomized grouping, the experimental group and control group contained 64 cases, 66 cases, respectively. The control group only accepted health education, while experimental group accepted cognitive behavioral intervention twice a week. Before and after the research, the patients were investigated with quality of life and distress scale. Results After the study of cognitive behavioral intervention, quality of life of experimental group scored (71.7±17.5) points which showed greater improvement than the control group scored (63.9±18.3) points (t=2.2, P<0.05), the distress score of experimental group was (2.6±0.6) points which was significant lower than the control group scored (3.9±0.7) points (t=11.8,P<0.05), and the proportions of distress problems contained anxiety [42.2% (27/64)], pain [29.7% (19/64)], depression [35.9% (23/64)] and sleep [23.4% (15/64)] in the experimental group were all significant lower than the control group [60.6% (40/66), 47.0% (31/66), 53.0% (35/66), 39.4% (26/66)](χ2=4.4, 4.1, 3.9, 4.5,P<0.05). Conclusions Short-term group cognitive behavioral intervention can alleviate the distress and pain, improve their negative emotions and sleep, eventually improve the quality of life of cancer patients. Key words: Neoplasms; Quality of life; Cognitive therapy; Distress

Comparison of a Cognitive-Behavioral Coping Skills Group to a Peer Support Group in a Brain Injury Population

ObjectiveTo compare the efficacy of 2 group treatments for persons with brain injury (BI) and their caregivers in promoting perceived self-efficacy (PSE) and emotional and neurobehavioral functioning. DesignRandomized controlled trial. SettingOutpatient BI rehabilitation. ParticipantsSubjects (N=38), including 19 with BI and 19 caregivers, participated in a BI coping skills group or a support group. InterventionsBI coping skills is a manualized cognitive-behavioral treatment (CBT). CBT was compared with a structurally equivalent support group. Main Outcome MeasuresBrain Injury Coping Skills Questionnaire (PSE), Brief Symptom Inventory-18 ([BSI-18]; emotional distress), and Frontal Systems Behavior Scale (neurobehavioral functions). ResultsThere were no significant differences between survivors and caregivers on the Brain Injury Coping Skills Questionnaire and BSI-18; therefore, groups were combined during final analyses. Frontal Systems Behavior Scale caregiver data were used for analysis. Both groups showed significantly improved PSE between baseline and follow-up on repeated-measures analysis of variance, with the CBT group showing greater stabilization of change. There was no significant group by time interaction on measures of neurobehavioral functions, but the CBT group showed significant improvements at 3-month follow-up. No significant effects were found on the BSI-18. ConclusionsTo our knowledge, no studies to date have been published comparing a CBT intervention with a support group in a BI population with caregiver participation. This study showed that given equivalent group structure, individuals with BI and caregivers may benefit from either type of intervention in enhancing PSE or maintaining emotional stability. However, there was a trend for individuals who received CBT to maintain the effects of improved PSE, whereas support group participants showed a trend for decline. This study offers a new conceptualization that with certain group dynamics and support, individuals with BI and caregivers may benefit similarly from either a support group or CBT intervention. However, because our sample did not include individuals in clinically significant emotional distress, we cannot rule out the possibility that those with more significant challenges in PSE or emotional functions may show greater benefits with a CBT group.

Does cue exposure treatment improve outcomes in smoking cessation treatment? A controlled trial

Aims: Cue exposure techniques (CET) consist of controlled and repeated exposure to cues that provoke craving in order to extinguish the urge to smoke. Previous studies showed that cigarette craving can be reduced through CET. However, very few studies have explored the efficacy of CET for smoking cessation. This randomized clinical trial explored the effectiveness of a CET procedure when added to a Cognitive Behavioral Treatment (CBT) for smoking cessation among treatment-seeking smokers. Methods: The sample was made up of 102 treatment-seeking smokers with current DSM-IV nicotine dependence. Participants were randomly assigned to oneof two treatment conditions: CBTor CBT+CET. The CBT intervention involved group-based sessions during 6 weeks. In addition to CBT, participants in CBT+CET condition received 5 individual sessions of CET through virtual reality. Results: Of the patients in the CBT+CET group, 78% attended all treatment sessions compared to 73.1% in the CBT group (p = .56). At the end of the treatment, 56% of the patients in the CBT+CET condition achieved abstinence, versus 51.9% in the CBT condition (p = .68). At one month follow-up, 38% in the CBT+CET condition were abstinent compared to 38.5% in the CBT condition (p = .87). Lastly, 24% of patients treatedwith CBT+ CETwere abstinent at sixmonth follow-up compared to 25% who received CBT alone (p = .90). Conclusions: Results showed that neither abstinence levels nor treatment retention rates were better in the CET+CBT compared to CBTalone. TheCETproceduredoesnot appear to improveoutcomes in a smoking cessation program. Results from this randomized clinical trial suggest that CET is not an effective strategy for smoking cessation. Financial support: This work was supported by the Spanish Ministry of Science and Innovation (MICIIN) (Ref. PSI200805938/PSIC) and the predoctoral grant from the Spanish Ministry of Economy and Competitiveness (Ref. BES-2012-053988).

GROUP-BASED SYMPTOM TRAJECTORIES IN INDICATED PREVENTION OF ADOLESCENT DEPRESSION.

Adolescent depression prevention research has focused on mean intervention outcomes, but has not considered heterogeneity in symptom course. Here, we empirically identify subgroups with distinct trajectories of depressive symptom change among adolescents enrolled in two indicated depression prevention trials and examine how cognitive-behavioral (CB) interventions and baseline predictors relate to trajectory membership. Six hundred thirty-one participants were assigned to one of three conditions: CB group intervention, CB bibliotherapy, and brochure control. We used group-based trajectory modeling to identify trajectories of depressive symptoms from pretest to 2-year follow-up. We examined associations between class membership and conditions using chi-square tests and baseline predictors using multinomial regressions. We identified four trajectories in the full sample. Qualitatively similar trajectories were found in each condition separately. Two trajectories of positive symptom course (low-declining, high-declining) had declining symptoms and were distinguished by baseline symptom severity. Two trajectories of negative course (high-persistent, resurging), respectively, showed no decline in symptoms or decline followed by symptom reappearance. Participants in the brochure control condition were significantly more likely to populate the high-persistent trajectory relative to either CB condition and were significantly less likely to populate the low-declining trajectory relative to CB group. Several baseline factors predicted trajectory classes, but gender was the most informative prognostic factor, with males having increased odds of membership in a high-persistent trajectory relative to other trajectories. Findings suggest that CB preventive interventions do not alter the nature of trajectories, but reduce the risk that adolescents follow a trajectory of chronically elevated symptoms.

Bounce back: Effectiveness of an elementary school-based intervention for multicultural children exposed to traumatic events.

To evaluate the feasibility and acceptability of a school-based intervention for diverse children exposed to a range of traumatic events, and to examine its effectiveness in improving symptoms of posttraumatic stress, depression, and anxiety. Participants were 74 schoolchildren (Grades 1-5) and their primary caregivers. All participating students endorsed clinically significant posttraumatic stress symptoms. School clinicians were trained to deliver Bounce Back, a 10-session cognitive-behavioral group intervention. Children were randomized to immediate or delayed (3-month waitlist) intervention. Parent- and child-report of posttraumatic stress and depression, and child report of anxiety symptoms, were assessed at baseline, 3 months, and 6 months. Bounce Back was implemented with excellent clinician fidelity. Compared with children in the delayed condition, children who received Bounce Back immediately demonstrated significantly greater improvements in parent- and child-reported posttraumatic stress and child-reported anxiety symptoms over the 3-month intervention. Upon receipt of the intervention, the delayed intervention group demonstrated significant improvements in parent- and child-reported posttraumatic stress, depression, and anxiety symptoms. The immediate treatment group maintained or showed continued gains in all symptom domains over the 3-month follow-up period (6-month assessment). Findings support the feasibility, acceptability, and effectiveness of the Bounce Back intervention as delivered by school-based clinicians for children with traumatic stress. Implications are discussed.

Project PRIDE: A Cognitive-Behavioral Group Intervention to Reduce HIV Risk Behaviors Among HIV-Negative Young Gay and Bisexual Men

Young gay and bisexual men are at increased risk for human immunodeficiency virus (HIV) infection. Research suggests that the stress associated with being a stigmatized minority is related to negative mental health outcomes, substance use, and condomless sex. However, interventions aimed at reducing HIV risk behaviors in young gay and bisexual men have failed to address these important variables. The purpose of the present paper is to assist cognitive and behavioral therapists who work with young gay and bisexual men to conduct therapy for stress management and HIV prevention. This paper provides an overview of the research on stress and coping among gay and bisexual men and its relation with condomless sex among young gay and bisexual men. The treatment described here integrates minority stress theory (e.g., Meyer, 2003) and stress and coping theory (e.g., Lazarus, 2000) in a small group counseling framework that uses psychoeducation, cognitive reframing, and role plays to help young gay and bisexual men to manage stress, reduce substance use, and reduce condomless sex. The application of empirically supported theory and a combination of cognitive and behavioral techniques to reduce both psychological distress and HIV risk behavior for young gay and bisexual men is illustrated using three case examples. The present treatment may help therapists working with young HIV-negative gay and bisexual men who engage in condomless sex and who wish to remain HIV-negative by decreasing their HIV risk behavior.

Cognitive behavioral group therapy for anxiety: recent developments

Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious consequences. This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CBT programs are available for individuals who suffer from different anxiety disorders, enabling them to be treated together in groups.

Efeitos de Intervenção Cognitivo-Comportamental sobre Fatores de Risco Psicológicos em Cardiopatas

RESUMODiminuir fatores de risco para cardiopatias pode melhorar a qualidade de vida e reduzir a mortalidade e morbidade relacionadas a elas.O presente estudo avaliou a eficácia de uma intervenção cognitivo-comportamental em grupo sobre ansiedade, depressão, estresse e saúde cardiovascular em cardiopatas. Foram avaliados 91 pacientes antes e após participação nos grupos, com entrevistas semiestruturadas, Inventários Beck (Ansiedade e Depressão) e Inventário de Sintomas de Stress para Adultos de Lipp. Coletaram-se medidas fisiológicas para cálculo do escore de Framingham. A participação no grupo resultou em redução dos sintomas de ansiedade, depressão, estresse e melhora do enfrentamento ao estresse. Não houve diferença no escore de Framingham. A intervenção se mostrou eficaz para a redução dos fatores de risco psicológicos nessa amostra.

The Development of Acceptance of Chronic Tinnitus in the Course of a Cognitive-Behavioral Group Therapy.

Cognitive-behavioral treatment (CBT) is an effective treatment for tinnitus distress. Recently, acceptance-based approaches have received growing attention within the treatment of chronic tinnitus. The development of tinnitus acceptance within CB treatment remains unclear. This study investigates the efficacy of a CBT group therapy and the corresponding change in tinnitus acceptance. 68 outpatients took part in a CBT group therapy over a 3-month period. Effect sizes and paired t-tests were used to evaluate the effectiveness of the CBT treatment and to investigate the development of acceptance. Results showed a significant decrease in tinnitus distress and an increase in tinnitus acceptance. Improvements were maintained over a 6-month follow-up period in which large effect sizes were observed. CBT is considered an effective treatment for tinnitus distress in patients with chronic tinnitus. Acceptance of chronic tinnitus clearly improved within a CBT group therapy.

Performance of a Culturally Tailored Cognitive-Behavioral Intervention Integrated in a Public Health Setting to Reduce Risk of Antepartum Depression: A Randomized Controlled Trial.

Cognitive-behavioral group interventions have been shown to improve depressive symptoms in adult populations. This article details the feasibility and efficacy of a 6-week, culturally tailored, cognitive-behavioral intervention offered to rural, minority, low-income women at risk for antepartum depression. A total of 146 pregnant women were stratified by high risk for antepartum depression (Edinburgh Postnatal Depression Scale [EPDS] score of 10 or higher) or by low-moderate risk (EPDS score of 4-9) and randomized to a cognitive-behavioral intervention or treatment as usual. Differences in mean change of EPDS and Beck Depression Inventory (BDI)-II scores for low-moderate and high-risk women in the cognitive-behavioral intervention and treatment as usual for the full sample were assessed from baseline (T1), posttreatment (T2), and one-month follow-up (T3), and for African American women in the subsample. Both the cognitive-behavioral intervention and treatment-as-usual groups had significant reductions in the EPDS scores from T1 to T2 and T1 to T3. In women at high risk for depression (n = 62), there was no significant treatment effect from T1 to T2 or T3 for the EPDS. However, in low-moderate risk women, there was a significantly greater mean change in the BDI-II scores from significant decrease in the BDI-II scores from T1 to T2 (4.92 vs 0.59, P = .018) and T1 to T3 (5.67 vs 1.51, P = .04). Also, the cognitive-behavioral intervention significantly reduced EPDS scores for African American women at high risk (n = 43) from T1 to T2 (5.59 vs 2.18, P = .02) and from T1 to T3 (6.32 vs 3.14, P = .04). A cognitive-behavioral intervention integrated within prenatal clinics is feasible in this sample, although attrition rates were high. Compared to treatment as usual, the cognitive-behavioral intervention reduced depressive symptoms for African American women at high risk for antepartum depression and for the full sample of women at low-moderate risk for antepartum depression. These promising findings need to be replicated in a larger controlled clinical trial that incorporates methods to maintain greater participant engagement.

Protocol for a randomised controlled trial for Reducing Arthritis Fatigue by clinical Teams (RAFT) using cognitive–behavioural approaches

IntroductionRheumatoid arthritis (RA) fatigue is distressing, leading to unmanageable physical and cognitive exhaustion impacting on health, leisure and work. Group cognitive–behavioural (CB) therapy delivered by a clinical psychologist demonstrated large...