Group Cognitive Behavior Therapy Program Research Articles

Changes in Resting-State Brain Activity After Cognitive Behavioral Therapy for Chronic Pain: A Magnetoencephalography Study

Cognitive behavioral therapy (CBT) is believed to be an effective treatment for chronic pain due to its association with cognitive and emotional factors. Nevertheless, there is a paucity of magnetoencephalography (MEG) investigations elucidating its underlying mechanisms. This study investigated the neurophysiological effects of CBT employing MEG and analytical techniques. We administered resting-state MEG scans to 30 patients with chronic pain and 31 age-matched healthy controls. Patients engaged in a 12-session group CBT program. We conducted pretreatment (T1) and post-treatment (T2) MEG and clinical assessments. MEG data were examined within predefined regions of interest, guided by the authors’ and others’ prior magnetic resonance imaging studies. Initially, we selected regions displaying significant changes in power spectral density and multiscale entropy between patients at T1 and healthy controls. Then, we examined the changes within these regions after conducting CBT. Furthermore, we applied support vector machine analysis to MEG data to assess the potential for classifying treatment effects. We observed normalization of power in the gamma2 band (61–90 Hz) within the right inferior frontal gyrus (IFG) and multiscale entropy within the right dorsolateral prefrontal cortex (DLPFC) of patients with chronic pain after CBT. Notably, changes in pain intensity before and after CBT positively correlated with the alterations of multiscale entropy. Importantly, responders predicted by the support vector machine classifier had significantly higher treatment improvement rates than nonresponders. These findings underscore the pivotal role of the right IFG and DLPFC in ameliorating pain intensity through CBT. Further accumulation of evidence is essential for future applications. PerspectiveWe conducted MEG scans on 30 patients with chronic pain before and after a CBT program, comparing results with 31 healthy individuals. There were CBT-related changes in the right IFG and DLPFC. These results highlight the importance of specific brain regions in pain reduction through CBT.

Adapting, Implementing, and Maintaining a Group Cognitive Behavioral Therapy Program at an Inpatient Addiction Treatment Facility.

Quality training is an oft-cited barrier to effective implementation and ongoing delivery of high-quality evidence-based practice (EBP) across fields. This is especially true in the addiction field, but there is little cited evidence for optimal methods to improve EBP in inpatient addiction facilities with minimal resources. The current paper focuses on evaluating the state of our facility's group CBT manual and clinical training on the manual in a "realistic" (ie, non-RCT, non-grant-funded) inpatient addiction treatment setting. Five full-time clinicians volunteered to take part in the study (woman = 60%; Mage = 36.20 years). The study involved a mix of semi-structured interviews and surveys designed to measure seven outcomes (barriers, feasibility, useability, appropriateness, acceptability, burden, trialability). Three themes emerged from the data that impacted the group CBT manual: training, timing, and functionality. Addressing these themes allowed for a new, optimal manual and training procedure to be put into place. The current study highlights that under-resourced inpatient addiction facilities can still methodically utilize implementation approaches to study their EBP, namely CBT. Such an approach will ensure that the highest quality care is being delivered to patients and actively addresses known training barriers that prevent proper EBP delivery.

Effects of Cognitive-Behavioral Group Therapy on Reducing Levels of Internet Addiction, Depression, Anxiety, and Stress Among Nursing Students in Morocco

Background: Internet addiction (IA) has emerged as a serious threat to the mental health of young individuals. Objectives: The present study aimed to test the effects of cognitive-behavioral group therapy (CBGT) on controlling Internet addictive behaviors and improving levels of depression, anxiety, and stress among nursing students in Morocco. Methods: A total of 60 nursing students participated in the study based on convenience sampling and were then randomly assigned to the intervention group (n = 30) and control group (n = 30). The intervention group received 8 sessions of CBGT, unlike the control group. The Internet Addiction Test and the Depression, Anxiety, and Stress Scale were used as the pretest, posttest, and 3-month follow-up tests to determine participants’ levels of IA, depression, anxiety, and stress. Analysis of covariance (ANCOVA) was applied to assess the effects of this therapeutic intervention. Results: The results showed that following the CBGT program, the intervention group showed a reduction in IA (P < 0.05), depression (P < 0.05), anxiety (P < 0.05), and stress (P < 0.05) scores. Conclusions: Cognitive-behavioral group therapy was observed to be more effective in improving the cognitive, psychological, and behavioral skills of Internet-dependent nursing students, thereby reducing levels of depression, anxiety, and stress. This outcome opens up important perspectives in the field of health sciences education by considering this approach as a preferred way to promote students’ mental health in this context.

A comparison of two group cognitive behavioral therapy protocols for anxiety in urban schools: appropriateness, child outcomes, and cost-effectiveness.

Cognitive behavioral therapy (CBT) for pediatric anxiety is efficacious for reducing anxiety symptoms and improving functioning, but many children are unable to access CBT for anxiety in community settings. Schools are an important setting in which children access mental health care, including therapy for anxiety. In this setting, therapy is usually delivered by Masters-level therapists. Friends for Life (FRIENDS), a 12-session, manualized, group CBT program for anxiety has demonstrated effectiveness when implemented in schools. However, prior research has also found challenges regarding feasibility and cultural fit when delivering FRIENDS in the urban school context. To address these challenges, we adapted FRIENDS for implementation in the school setting so that it might be more feasible and culturally appropriate for low-income, urban schools in the United States, while maintaining the core components of treatment. The current study uses a mixed-method approach to compare the effectiveness, cost-effectiveness, and perceived appropriateness of FRIENDS and CATS when delivered by Masters-level therapists with train-the-trainer support. First, we compared change scores for student outcomes (i.e., child-report MASC-2 total score, parent-report MASC-2 total score, teacher-report Engagement and Disaffection subscale scores) from pre- to post- treatment between students receiving FRIENDS and students receiving CATS to assess whether the two conditions resulted in equivalent outcomes. Second, we compared the cost and cost-effectiveness between the groups. Finally, we used an applied thematic analysis to compare appropriateness of the interventions as perceived by therapists and supervisors. The mean change score for the child-reported MASC-2 was 1.9 (SE = 1.72) points in the FRIENDS condition and 2.9 (SE = 1.73) points in the CATS condition; results indicated that the conditions were similar in their treatment effects, and symptom reductions were small in both groups. The modified protocol, CATS, was shown to cost significantly less to implement compared to FRIENDS and showed greater cost-effectiveness. Finally, compared to therapists and supervisors in the CATS condition, therapists and supervisors in the FRIENDS condition more strongly described aspects of the intervention that were not appropriate for their context and in need of more extensive adaptations. Relatively brief, group CBT for anxiety, with adaptations to improve cultural fit, is a promising approach to treat youth anxiety symptom when delivered by school-based therapists with train-the-trainer implementation support.

Neural Predictors of Improvement With Cognitive Behavioral Therapy for Adolescents With Depression: An Examination of Reward Responsiveness and Emotion Regulation.

Earlier depression onsets are associated with more debilitating courses and poorer life quality, highlighting the importance of effective early intervention. Many youths fail to improve with evidence-based treatments for depression, likely due in part to heterogeneity within the disorder. Multi-method assessment of individual differences in positive and negative emotion processing could improve predictions of treatment outcomes. The current study examined self-report and neurophysiological measures of reward responsiveness and emotion regulation as predictors of response to cognitive-behavioral therapy (CBT). Adolescents (14-18years) with depression (N = 70) completed monetary reward and emotion regulation tasks while electroencephalogram (EEG) was recorded, and self-report measures of reward responsiveness, emotion regulation, and depressive symptoms at intake. Adolescents then completed a 16-session group CBT program, with depressive symptoms and clinician-rated improvement assessed across treatment. Lower reward positivity amplitudes, reflecting reduced neural reward responsiveness, predicted lower depressive symptoms with treatment. Larger late positive potential residuals during reappraisal, potentially reflecting difficulty with emotion regulation, predicted greater clinician-rated improvement. Self-report measures were not significant predictors. Results support the clinical utility of EEG measures, with impairments in positive and negative emotion processing predicting greater change with interventions that target these processes.

Social Support and Parental Conflict as Predictors of Outcomes of Group Cognitive Behavioral Therapy for Adolescent Depression.

Group cognitive behavioral therapy (CBT) is an effective treatment for adolescent depression, but outcomes vary. Our goal was to examine interpersonal factors that predict response to group CBT for adolescent depression using a broad range of outcomes, including depressive symptoms, session attendance, treatment completion, engagement, and improvement. Seventy adolescents (age 14-18) with depression completed self-report measures of social support and parental conflict and were offeredan established 16-session group CBT program. Correlation and regression analyses were conducted for interpersonal predictors and CBT outcomes. Accounting for pre-treatment depressive symptoms, fewer social supports predicted lower likelihood of finishing treatment and less clinician-rated improvement. Greater pre-treatment parental conflict predicted fewer sessions attended, lower clinician-rated engagement, and less clinician-rated improvement. Results highlight the need to consider interpersonal difficulties in CBT, as they may present a barrier to treatment attendance, engagement, and improvement.

The experiences of depressed pregnant women participating in a cognitive behavioral therapy program via video communication: an exploratory qualitative study.

This study explored the experiences of pregnant women with depressed mood participating ina group cognitive behavioral therapy (CBT) program using video communication, based on Beck's cognitive theory. The participants were six pregnant women out of 13 women who had participated in an 8-session group CBT program using video communication for women with depressed mood (EdinburghPostnatal Depression score of ≥9). Data were collected from February 20 through March 25, 2021. Indepth individual interviews were conducted through a video conferencing platform at 1 month post-baseline. Thematic analysis was done. Three themes, 10 subthemes, and 38 concepts were derived from experiences of participating inthe 4-week group CBT program (twice a week). The first theme, entitled "continuing realization" hadsubthemes of "a negative and instable self," "a selfish judgment that excludes others," and "a strong beliefin self-control." The second theme, entitled "attempt to change for restoration" had subthemes of "shift torational thinking," "freedom from suppressed beliefs," "tolerance of other people," and "courage for self-expression." The third theme, entitled "departure for a positive life," had subthemes of "emotional healing,""faith in oneself," and "reestablishing the criteria for happiness." Pregnant women with depressed mood expressed that continuing realizations and attemptsto change supported their transition toward a positive direction of healing. Thus, they were able to changetheir distorted thinking into rational thinking through CBT using video communication. These findingssupport the use of group CBT using video communication with pregnant women who have depressedmood.

A specific cognitive behavioral group therapy program for stimulant use disorder.

Stimulant use is an important health issue. In the US in 2018, 2.8% of males and 1.5% of females older than 18 had used cocaine in the preceding 12 months. To intervene in a specific targeted group of Stimulant Use Disorder (SUD) patients according to CBT and relapse prevention theories, and to determine the program's feasibility and attendance. Stimulant Use Disorder patients in addiction care were evaluated for addictive, psychological and psychiatric dimensions at baseline and conclusion in a 9-session CBT group program with several themes: define SUD, enhance motivation, involve close companions, cope with craving, decline a proposal, solve problems, invite expert patients, invest time and money, and review content. In total, 41 patients attended at least one session. They were mainly poly dependent, primarily cocaine users. Sixty percent of the population also suffered from another psychiatric comorbidity. Median attendance for participants was 7/9 sessions. A specific targeted CBT group for stimulant dependent highly comorbid patients is feasible. These findings suggest that peers should be included in addiction care services.

Benchmarked effectiveness of family and school involvement in group exposure therapy for adolescent anxiety disorder

Although cognitive-behavioral therapy (CBT) is an effective treatment for adolescents with anxiety disorders, the majority remain impaired following treatment. We developed a group CBT program (RISK) with high degrees of exposure practice and family and school involvement delivered in a community-based setting and investigated its effectiveness. The treatment involved adolescents (N = 90), with a primary diagnosis of anxiety disorder (82%) or obsessive-compulsive disorder (18%), and their families who received 38 hours of group treatment over 10 weeks. Diagnostic status and symptom severity were assessed at pre- and post-treatment, and a 12-month follow-up and benchmarked against previous effectiveness studies. Our results showed that, at post-treatment, the RISK-treatment was comparably effective as benchmarks on measures of diagnostic status, parent-rated measures, adolescent-rated measures, and clinician-rated measures. At 12-month follow-up all outcomes were superior to benchmarks, including the proportion of participants in remission (79.5%, 95% Highest Posterior Density Interval [74.7, 84.2]), indicating that the RISK-treatment enhanced effectiveness over time. The combination of group format, a high degree of exposure practice, and school and family involvement is a promising format for real-world settings that may help sustain and increase treatment effectiveness. Trial registered at helseforskning.etikkom.no (reg. nr. 2017/1367).

The effectiveness of a group cognitive behavioral therapy program in

the purpose of this study is to investigate the effectiveness of a group therapy program to reduce depression among tramadol addicts in Jeddah, Saudi Arabia. The study population consisted of a sample of tramadol addicts who visited a private clinic in Jeddah. The total number of the sample was 24 addicts who voluntarily agreed to participate in the study

The effects of a group cognitive behavioral therapy program using video communication for pregnant women with depressed mood in Korea: a pilot study.

PurposeThis study presents the development of a group video communication-based cognitive behavioral therapy (CBT) program for depressed pregnant women. It also provides the results of a preliminary test of its effects on their depression, automatic thoughts, and dysfunctional attitudes. MethodsIn this quasi-experimental single-group pre- and posttest design study, 13 pregnant women participated in a 4-week, eight-session group CBT program, based on Beck’s cognitive theory and using video communications from November 2020 to January. Pregnant women between 14 and 32 weeks who were members of an online maternity and parenting community and residing in the cities of Changwon and Gimhae, Korea, were invited to voluntarily participate. Trained nurses led CBT sessions of 3–4 participants per group via video communication. Participants were assessed pre- and postintervention with self-report questionnaires for measurement of depression, automatic thought, and dysfunctional attitude after normality test according to the Shapiro-Wilk test of the variables. The data were analyzed using paired t-test and Pearson correlation coefficients.ResultsDepression (t=7.90, p<.001), automatic thoughts (t=4.89, p<.001), and dysfunctional attitudes (t=2.42, p=.032) significantly decreased after the 4-week online program. There were statistically significant correlations among the three variables.ConclusionThis program was found to be effective in reducing depression, automatic thoughts, and dysfunctional attitudes. Above findings suggest that a group CBT program using video communication can be an effective therapeutic modality that helps pregnant women at risk for depression alleviate their negative emotions related to depression.

Working together: An investigation of the impact of working alliance and cohesion on group psychotherapy attendance.

Group psychotherapy holds considerable potential for cost-effective treatment delivery. However, issues with client attendance can compromise the efficacy of such treatments. To date, client specific factors are amongst the most researched predictors of attendance in psychotherapy, with much less of a focus given to process factors, particularly in the group therapy context. This study aimed to determine which process factors influenced attendance in the context of a group therapy programme for adults with anxiety. It was hypothesized that (1) the working alliance and group cohesion would be moderately correlated, (2) both the working alliance and group cohesion would explain unique variance in session attendance, and (3) the working alliance would act as a moderator for attendance, when group cohesion was low. The study utilized a within participants design. Participants were 91 adults (aged 18-74 years) who took part in a 9-week, transdiagnostic cognitive behavioural group therapy programme for the treatment of anxiety disorders. Working alliance and group cohesion were significantly, but only moderately correlated (rs ranging .41 to .55). Together, working alliance and group cohesion significantly predicted total session attendance (17.70% variance explained). Working alliance did not moderate the relationship between group cohesion and session attendance. The importance of individual and group processes in influencing group therapy engagement is highlighted, including the role of fostering bonds within the group and between clients and therapists. A complex array of process factors has been argued to influence treatment outcomes in group therapy The quality of the relationship between group therapy clients, as well as the relationship between a client and the therapist, predict session attendance. The quality of the relationship between the client and the therapist may be the most important predictor of session attendance. Therapists should foster positive relationships between each client and the therapist in group therapy, as well as assisting each client to foster positive relationships with other group members.

Increasing Access and Reach: Implementing School-Based CBT for Anxiety in Students with ASD or Suspected ASD

ABSTRACT Youth with Autism Spectrum Disorder (ASD) are at high risk for experiencing clinical anxiety, interfering with friendships, family functioning, and school performance. Many children with ASD and anxiety have difficulty accessing appropriate mental health care and schools are often the ideal location to receive services. The implementation of evidence-based practices to manage anxiety in students with ASD in schools is just beginning. The primary purpose of the current study was to train interdisciplinary school providers to effectively deliver a 13 session evidence-based, group cognitive behavioral therapy (CBT) program adapted for schools [Facing Your Fears – School-Based program (FYF-SB)], to students with anxiety and ASD, or suspected ASD, using a quasi-experimental design. Provider CBT knowledge, feasibility, and effectiveness of FYF-SB were examined. Twenty-five interdisciplinary school providers, from nine elementary/middle urban public schools were trained to deliver FYF-SB. Twenty-nine students (aged 8–14), with clinically significant anxietyASD, or ASD characteristics, participated. Provider CBT knowledge significantly improved following FYF-SB training. Six of 9 school teams exceeded the minimum standard for acceptable treatment adherence (80%) and 8 of the 9 participating teams delivered adequate intervention dosage for student sessions, although parent attendance was more variable. School providers indicated that FYF-SB was feasible, acceptable, and appropriate for participating students. Parents and students reported significant reductions in student anxiety following program participation. Implementation and treatment outcomes are encouraging and suggest that traditionally underserved students with ASD or ASD characteristics may be able to access much needed mental health interventions in their own communities.

The efficacy of group cognitive behavioural therapy in improving adaptive cognitive emotion regulation in Nigerian breast cancer patients

AbstractThe burden of cancer and psychological distress resulting from cancer‐related experiences may have an impact on women's cognitive emotion regulation. The study investigated the efficacy of a 12‐week group cognitive behavioural therapy (GCBT) programme in enhancing adaptive cognitive emotion regulation (CER) in women with breast cancer at a tertiary healthcare institution in Nigeria. Thirty‐one (31) women with breast cancer were randomly allocated to the treatment group (TG, N = 16) and a control group (CG, N = 15). The TG received a 12‐week course of 90‐min GCBT sessions, while the CG received a booklet containing information on cancer and how to deal with cancer. Assessments were carried out for both groups at the baseline (pretest), post‐test and 2‐month follow‐up with the Cognitive Emotion Regulation Questionnaire. Data were analysed with the independent‐samples t test and the chi‐square test for continuous and categorical variables, respectively. The results showed that participants in the TG had a significant increase in adaptive CER and decrease in maladaptive CER compared with the CG both at post‐treatment and at 2‐month follow‐up. Cognitive behavioural therapy is effective in the improvement of adaptive CER in women with breast cancer. The use of psychotherapy (such as CBT) as complementary treatment to standard oncology care in the management of breast cancer patients in Nigeria is therefore emphasised.

Improving Maternal Mental Health as a Pathway to Economic Mobility in the TANF System.

The authors sought to evaluate the acceptability, feasibility, and initial outcomes of the delivery of a group cognitive-behavioral therapy (CBT) mental health intervention for mothers in the Temporary Assistance for Needy Families (TANF) program. An 8-week group CBT program was made available to parenting women (N=40) in a large, urban TANF system from April to August 2019. Participants completed baseline and endpoint measures to assess depressive symptoms, perceived stress, social support, employment, and program acceptability. TANF administrative data were examined to assess TANF engagement. TANF staff were successfully trained to deliver CBT. The participants reported significantly reduced depressive symptoms and perceived stress; perceived social support significantly increased from the beginning to the end of the intervention. A model that fully embedded CBT delivery in a TANF system was acceptable to low-income parenting women and TANF staff and reduced depressive symptoms among the women. The scalability of interventions to address maternal depression among low-income women has presented a challenge. Delivering mental health interventions in the U.S. TANF system may offer a scalable method to reduce depression and increase employment in a population bearing a high mental health burden.

Effectiveness of transdiagnostic group cognitive-behavioural therapy for anxiety disorders in a naturalistic clinical setting

ABSTRACT Objective: The present study evaluated the effectiveness of a transdiagnostic group-based cognitive-behavioural therapy (CBT) programme for treating anxiety, comorbid depression, and functional impairments in a hospital outpatient specialist anxiety disorders clinic. Method: 107 adult outpatients with a primary anxiety disorder completed an eight-session transdiagnostic group CBT program. Participants also completed self-report measures assessing general anxiety, anxiety disorder-specific symptoms, comorbid depression symptoms, and functional impairments. Data were collected at pre - and post-treatment, and at follow-up. Results: Significant pre- to post-treatment reductions were found on measures of state and trait anxiety, impairment in work and social functioning, comorbid depression, social anxiety, and worry severity. These treatment gains were maintained at follow-up. Limitations: There was no comparison control group in the present study given that it was conducted in a hospital setting. Some diagnostic groups were also underrepresented in the sample, which limits the conclusions that can be drawn about the effectiveness of the group treatment across anxiety disorders. Conclusions: The present findings provided preliminary support for the effectiveness and generalisability of an eight-session transdiagnostic group-based CBT delivered at a public health service, indicating its potential as a cost-effective and clinically efficient alternative to individual therapy or diagnosis-specific treatments for anxiety disorders. KEY POINTS What is already known about this topic: (1) Transdiagnostic group CBT is efficacious for treating anxiety disorders. (2) Very few studies to date have examined the effectiveness of transdiagnostic group CBT in naturalistic settings. (3) Few of the existing effectiveness studies have included disorder-specific and daily functioning measures, or conducted follow-up assessment. What this topic adds: (1) An eight-session transdiagnostic group CBT for anxiety disorders appears sufficient in leading to improvements in general and specific anxiety symptoms, work and social functioning, and comorbid depression for patients from a hospital outpatient clinic. (2) Treatment gains were maintained at follow-up. (3) Transdiagnostic group CBT is an effective, potentially cost- and resource-efficient, and easily accessible alternative to individual therapy or diagnosis-specific treatments in a naturalistic setting.

Effectiveness of Cognitive Behavioral Group Therapy Program Based on Relapse Prevention for Patients with Gambling Disorder: Focusing on the Improvement of Gambling Behavior and Adaptation

Effectiveness of Cognitive Behavioral Group Therapy Program Based on Relapse Prevention for Patients with Gambling Disorder: Focusing on the Improvement of Gambling Behavior and Adaptation

Treatment outcomes of a CBT-based group intervention for adolescents with Internet use disorders.

Background and aimsInstances of Internet use disorders (IUD) including Internet gaming disorder (IGD) and non-gaming pathological Internet use (ng-PIU) have the extent that they are now a growing mental health issue. Individuals suffering from IUD show a large range of symptoms, high comorbidities and impairments in different areas of life. To date there is a lack of efficient and evidence-based treatment programs for such adolescents. The present registered single-arm trial (ClinicalTrials.gov: NCT03582839) aimed to investigate the long-term effects of a brief manualized cognitive behavioral therapy (CBT) program for adolescents with IUD.MethodsN = 54 patients (16.7% female), aged 9–19 years (M = 13.48, SD = 1.72) received the CBT group program PROTECT+. IUD symptom severity (primary outcome variable) as well as comorbid symptoms, risk-related variables and potentially protective skills (secondary outcome variables) were assessed at pretest, posttest, as well as 4 and 12 months after admission.ResultsPatients showed a significant reduction in IUD symptom severity at the 12-month follow-up. Effect sizes were medium to large depending on the measure. Beyond the statistical significance, the clinical significance was confirmed using the reliable change index. Secondary outcome variables showed a significant reduction in self-reported depression, social anxiety, performance anxiety and school anxiety as well as in parental-reported general psychopathology.Discussion and conclusionsThe present study shows long-term effects of a manual-based CBT treatment for adolescents suffering from IUD. The results indicate that even a 4-session brief intervention can achieve a medium to large effect over 12 months. Future work is needed to confirm the efficacy within a randomized controlled trial (RCT).

Effectiveness of a modified group cognitive behavioral therapy program for anxiety in children with ASD delivered in a community context

BackgroundYouth with autism spectrum disorder (ASD) experience high rates (approximately 50–79%) of comorbid anxiety problems. Given the significant interference and distress that excessive anxiety can cause, evidence-based intervention is necessary in order to reduce long-term negative effects. Cognitive behavioral therapy (CBT) has demonstrated efficacy for treating anxiety disorders across the lifespan, both in individual and group formats. Recently, modified CBT programs for youth with ASD have been developed, showing positive outcomes. To date, these modified CBT programs have primarily been evaluated in controlled research settings.MethodsThe current community effectiveness study investigated the effectiveness of a modified group CBT program (Facing Your Fears) delivered in a tertiary care hospital and across six community-based agencies providing services for youth with ASD. Data were collected over six years (N = 105 youth with ASD; ages 6–15 years).ResultsHospital and community samples did not differ significantly, except in terms of age (hospital M = 10.08 years; community M = 10.87 years). Results indicated significant improvements in anxiety levels from baseline to post-treatment across measures, with medium effect sizes. An attempt to uncover individual characteristics that predict response to treatment was unsuccessful.ConclusionsOverall, this study demonstrated that community implementation of a modified group CBT program for youth with ASD is feasible and effective for treating elevated anxiety.

Pilot trial of a group cognitive behavioural therapy program for comorbid depression and obesity

BackgroundDepression and obesity are significant global health concerns that commonly occur together. An integrated group cognitive behavioural therapy program was therefore developed to simultaneously address comorbid depression and obesity.MethodsTwenty-four participants (63% women, mean age 46 years) who screened positively for depression with a body mass index ≥25 were recruited from a self-referred general population sample. The group therapy program (10 two-hour weekly sessions) was examined in a single-arm, before-after pilot trial, conducted in a behavioural health clinic in Adelaide, Australia. Primary outcomes included survey and assessment-based analyses of depression, anxiety, body image, self-esteem, and weight (kg), assessed at four time-points: baseline, post-intervention, three-months and 12-months post program. Eighteen participants (75%) completed the program and all assessments.ResultsSignificant improvements in depression, anxiety, self-esteem and body shape concern scores, several quality of life domains, eating behaviours and total physical activity (among others) – but not weight – were observed over the course of the trial.ConclusionsResults from this pilot trial suggest that combining interventions for depression and obesity may be useful. Further development of the program, particularly regarding the potential for physical health benefits, and a randomised controlled trial, are warranted.Trial registrationTrial registration: ANZCTR, ACTRN12617001079336, 13 July 2017. Retrospectively registered after date of the first consent (6 July 2017), but before the date of the first intervention session (20 July 2017).