Group Therapy Intervention Research Articles

The efficacy of Music for the mind applying on anxiety sensitivity among females with uterine, ovary, and breast cancer.

Introduction: The chronic and continuous aspect of anxiety can be seen as a source of failure, Uncompromising, and widespread despair that deprives a person from a major part of his or her potential. This research aimed to study the effects of music on mind to reduce the symptoms of anxiety of women with uterine, ovary, and breast cancer.Methods: The statistical Society of this study consisted of all women living in Tehran. Using a semi-experimental pattern and using the available sampling method among female volunteers, 28 women were selected with a standard deviation above the average score of perceived stress based on input-output criteria and randomized in two experimental and control groups (each Group of 14 people) were replaced. Initially, both groups by means of pre-exam were tested, then the music therapy intervention group (based on the music protocol for the mind) received. At the end, both groups responded to the research tool (post-test). Measurement tools in this study was Perceived anxiety control questionnaire (ACQ); Anxiety Sensitivity Index and (ASI-3) perceived stress scale (PSS).Results: In this study, data analysis using the twenty-fourth version of the SPSS software and the use of one-way and multi-way analysis of variance showed that music intervention for the mind to reduce perceived stress and sensitivity to anxiety and Increased perceptions of anxiety control in people with cancer in the experimental group compared to the control group (P <0.05). Conclusion: Therefore, it can be concluded that music intervention for the mind with the aim of reducing sensitivity to anxiety, as well as increasing the perception of anxiety control can have a positive effect on women with breast, uterine and ovarian cancer.Declaration of interest: None

Re-Envisioning School-Based Counseling: Sports-Based Group Therapy for Elementary School Students Exposed to Trauma

Mixed-methods were used to investigate treatment outcomes for youth enrolled in an innovative sports-based group therapy intervention. Chart review was conducted for 65 youth, aged 5 to 13 years over one academic year at an elementary school serving high-needs youth in an urban district. Analysis revealed symptom reduction for 72% of participants. For a subset of students ( n = 34) with available Child and Adolescent Needs and Strengths (CANS) Assessments, the average number of adverse experiences was 2.74 ( SD: 2.11). Qualitative coding of progress notes and discharge summaries was used to assess symptom presentation and treatment outcomes. This sports-based group therapy intervention promotes access to services while minimizing stigma.

Childhood Physical Abuse and Antisocial Traits: Mediating Role of Posttraumatic Stress Symptom Clusters.

Posttraumatic stress symptoms (PTSS) are associated with both childhood physical abuse (CPA) and antisocial (AS) traits, yet their potential as mediators of the CPA-AS traits link is understudied and the specific roles of individual symptom clusters in this relation is unknown. The current study aimed to examine the mediational role of PTSS in the relation between CPA and AS traits in a sample of low-income African American women with histories of intimate partner violence (IPV). It was hypothesized that avoidance would emerge as a significant mediator, whereas reexperiencing, numbing, and hyperarousal would not. Participants (N = 150) were recruited from a level-1 trauma public hospital and evaluated as part of a randomized controlled trial of a group therapy intervention for low-income, African American women suicide attempters with histories of IPV. The Childhood Trauma Questionnaire (CTQ), Posttraumatic Diagnostic Scale (PDS), and International Personality Disorder Examination-Screening Questionnaire (IPDE-SQ) were used to measure variables of interest. Using bootstrapping analyses, a parallel mediation model compared PTSS clusters as potential mediators of the CPA-AS traits relation, controlling for IPV. When reexperiencing, avoidance, numbing, and hyperarousal were entered simultaneously as potential mediators, only avoidance emerged as a significant mediator of the CPA-AS traits link. Avoidance symptoms may play a unique role in the link between early experiences of CPA and later AS traits among multiply traumatized African American women. Findings have implications for understanding AS traits in the context of early life trauma and suggest that targeting specific PTSS clusters (e.g., avoidance) may improve treatment outcomes for women in this population.

Duration of antibiotic treatment using procalcitonin-guided treatment algorithms in older patients: a patient-level meta-analysis from randomized controlled trials.

BackgroundOlder patients have a less pronounced immune response to infection, which may also influence infection biomarkers. There is currently insufficient data regarding clinical effects of procalcitonin (PCT) to guide antibiotic treatment in older patients.Objective and designWe performed an individual patient data meta-analysis to investigate the association of age on effects of PCT-guided antibiotic stewardship regarding antibiotic use and outcome.Subjects and methodsWe had access to 9,421 individual infection patients from 28 randomized controlled trials comparing PCT-guided antibiotic therapy (intervention group) or standard care. We stratified patients according to age in four groups (<75 years [n = 7,079], 75–80 years [n = 1,034], 81–85 years [n = 803] and >85 years [n = 505]). The primary endpoint was the duration of antibiotic treatment and the secondary endpoints were 30-day mortality and length of stay.ResultsCompared to control patients, mean duration of antibiotic therapy in PCT-guided patients was significantly reduced by 24, 22, 26 and 24% in the four age groups corresponding to adjusted differences in antibiotic days of −1.99 (95% confidence interval [CI] −2.36 to −1.62), −1.98 (95% CI −2.94 to −1.02), −2.20 (95% CI −3.15 to −1.25) and − 2.10 (95% CI −3.29 to −0.91) with no differences among age groups. There was no increase in the risk for mortality in any of the age groups. Effects were similar in subgroups by infection type, blood culture result and clinical setting (P interaction >0.05).ConclusionsThis large individual patient data meta-analysis confirms that, similar to younger patients, PCT-guided antibiotic treatment in older patients is associated with significantly reduced antibiotic exposures and no increase in mortality.

Participation in group music therapy: A preliminary study of the experiences and perceptions of adolescents who stammer

Music therapy and music-based interventions are increasingly used in the treatment of speech, language, and communication needs, and music therapy has been extensively applied to adolescent groups. To date, however, there has been no published work examining music therapy for adolescents who stammer. The aim of the current study was to explore adolescents’ experiences and perceptions of a group music therapy intervention. Four adolescents who stammer participated in semi-structured interviews examining their experience of group music therapy intervention. The music therapy group intervention consisted of five therapeutic sessions conducted at a summer camp for children and adolescents who stammer. Analysis of in-depth, semi-structured interviews revealed four main themes and several subthemes. Recurrent themes revealed a variety of psychosocial benefits related to the experience of group music therapy, such as developing new friendships and facilitating peer support, increasing self-confidence and self-expression. There was also an emphasis on fun and enjoyment. This paper highlights a number of key benefits of music therapy for adolescents who stammer. These preliminary results highlight the potential of music therapy for adolescents who stammer, and the role of addressing psychosocial aspects of stammering within this creative arts intervention.

683 Comparison of Telemedicine and In-Person Psychotherapy for CPAP Adherence in a population of Veterans

IntroductionObstructive sleep apnea (OSA) is the second most common sleep disorder among Veterans and carries risk of serious health complications when untreated. The gold standard for OSA treatment is Positive Airway Pressure (PAP). However, adherence to PAP therapy is chronically low. Interventions to enhance adherence include education, practical support, and psychotherapy. Cognitive behavioral therapy and motivational interviewing have been shown to improve CPAP usage by approximately 1 hour per night. Telemedicine-delivered CPAP education and telemonitoring-with-feedback has demonstrated improved adherence in patients with OSA. Our study evaluated the effectiveness of a telemedicine group psychotherapy intervention for Veterans diagnosed with OSA and found to be nonadherent to CPAP therapy. The intervention is delivered in four weekly 60-minute sessions.MethodsWe identified a cohort of 29 patients who participated in the intervention via telemedicine from April 2020 - September 2020 (Telemedicine Psychotherapy cohort). The cohort was compared to a historical control of 35 patients who participated in the in-person group psychotherapy from April 2019 - September 2019 (In-Person Psychotherapy cohort). Through retrospective chart review, we analyzed baseline and post-intervention data from both cohorts. Demographics collected included age, sex, BMI, ethnicity, zip code, as well as medical and mental health comorbidities. Data collected from the medical record included: OSA severity, pre- and post-psychotherapy 90-day average nightly CPAP usage (in minutes), number of psychotherapy classes attended (out of 4) and number of sleep clinic visits at 90-days post-psychotherapy. We used descriptive statistics to provide summary data of this sample and t-test to evaluate Veteran’s average CPAP usage per night and number of sleep clinic visits at 90-days post-psychotherapy between cohorts.ResultsCompared to a cohort of in-person group psychotherapy to improve CPAP adherence, a telemedicine-based cohort demonstrated improvement in 90-day average nightly CPAP usage by an average of 76 minutes per night. (p=0.08) Additionally, patient engagement with the sleep clinic at 90 days following completion of telemedicine psychotherapy was significantly higher compared to in-person psychotherapy (p<0.001).ConclusionIn a haphazardly-collected convenient sample of veterans during the COVID-19 pandemic, telemedicine psychotherapy led to improved CPAP usage. Veterans who underwent telemedicine intervention also significantly increased engagement with the sleep clinic.Support (if any):

PENGARUH TERAPI BERJEMUR TERHADAP PENURUNAN KADAR GLUKOSA DARAH PADA RESPONDEN TERINDIKASI DIABETES MELITUS

Background: Vitamin D deficiency could increase the risk of of cancer, autoimmune reaction, cardiovascular disorders, and diabetes mellitus. Objective: The aims of study is to determining effectivity of sunbathing therapy in the morning on blood glucose levels of respondents whose indicated diabetes mellitus type 2. Methods: The study was an quasy experimental study that used 20 respondents whose indicated diabetes mellitus type 2. Afterwards, respondents divided into two group such as control group with no therapy intervention and treatment group with intervention of sunbathing therapy in the morning. Blood glucose levels of each respondent was tested using point of care testing (POCT) on pre and post therapy. Member of treatment group did sunbathing therapy in the morning for 10 minutes in a week. Results: Based on this research showed that blood glucose levels on treatment group lower than control group. Treatment group obtained blood glucose levels from 316,1 ± 99,3 mg/dl decrease into 210,9 ± 81,9 mg/dl significantly (p &lt;0,05) after therapy carried out. But, on control group obtained blood glucose levels from 299,1 ± 75,2 increase into 373,1 ± 68,1 mg/dl significantly (p &lt;0,05). Conclusion: Sunbathing therapy in the morning for 10 minutes had effect to decrease blood glucose levels

The Effect of Sambiloto Extract on the Expression of β Estrogen Receptors in Ovaries and Lust Cycle in Mice Model PCOS - Insulin Resistance

Infertility was a serious problem in the reproductive period, one of the caused of infertility were common in women of childbearing age group is Polycystic Ovary Syndrome (PCOS).Sambiloto (Andrographis paniculata Nees), had been already known contain flavonoid and lactones. The purpose of this research had to determine the effect of various doses of sambiloto extract with the expression of β estrogen receptor and estrus cycle in the mice model of PCOS - insulin resistance. This research was an animal model experimental laboratory research with a completely randomized design (CRD).The results showed that sambiloto extract therapy in treatment group had an improvement estrus cycle compared with control group. Positive control group, almost 90% had persistent anestrus condition. In treatment group 1 and 2 in the last vagina smear obtained anestrus condition as much as 60% in diestrus and medestrus phase. Whereas treatment groups 3 all experimental animals in a estrus state by proestrus and estrus phase. β Estrogen receptor expression had tested by Kruskal Wallis test for overall treatment, obtained significantly different results (p ≤ 0.002) followed by Mann - Whitney, showed that immunoreactive cells score from highest to lowest occurred in each group Negative control (KN), P3, P2, P1 and Positive Control (KP).It could be concluded that sambiloto extract at dose 18mg/kgbb, 36mg/kgbb, and 72mg/kgbb had been given an overview of the differences expression of β estrogen receptor, could change the estrus cycle of female mice models of insulin resistance PCOS.

Clinical value of endobronchial ultrasound-guided aspiration and local isoniazid injection in the treatment of mediastinal tuberculous lymphadenitis.

This study aimed to investigate the value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) guided purulence aspiration and local isoniazid injection after lymph node puncture in the treatment of refractory mediastinal tuberculous lymphadenitis (MTLA) as compared to systemic anti-tuberculosis treatment. This was a retrospective study. A total of 92 patients with MTLA and suppurative lymphadenitis who were treated in the Shanghai Pulmonary Hospital between January 2015 and December 2018 were included into present study and divided into systemic chemotherapy (CT) group and interventional therapy (IT) group. In the CT group, patients received systemic chemotherapy alone; in the IT group, patients received EBUS-TBNA guided lymph node aspiration and local isoniazid injection besides systemic chemotherapy. The recovery of lymphadenitis and adverse effects were observed. Seventy patients were included for final analysis, 35 patients in each group. In the IT group, aspiration and local injection were done 137 times; 4R (53.1%) and 7 groups of lymph nodes (30.6%) were the most common site of aspiration; the median number of local treatment was 3 times, and the median duration of local injection was 29 days. The recovery rate of lymphadenitis was 88.6% (31/35) in the IT group and 57.1% (20/35) in the CT group, showing marked difference (χ2=8.741, P<0.05). The most common symptoms of patients with MTLA were cough, fever, dyspnea and anorexia, and the time to recovery of these symptoms in the IT group was 0.83±0.32, 0.89±0.29, 1.00±0.18 and 1.07±0.15 months, respectively, which were markedly shorter than in the CT group 2.60±0.74, 2.46±0.73, 2.70±0.40 and 2.67±0.43 months (t=7.608, P<0.05; t=6.442, P<0.05; t=6.755, P<0.05; t=5.237, P<0.05). All the patients received EBUS-TBNA under local anesthesia, and evident adverse effects were not observed. They were followed up for 2 years, and recurrence was not noted. As compared to systemic chemotherapy, EBUS-TBNA guided lymph node aspiration and local isoniazid injection combined with systemic chemotherapy may significantly improve the therapeutic efficacy, which provides a new, safe and reliable management for the refractory MTLA.

Live with your body – participants’ reflections on an acceptance and commitment therapy group intervention for patients with residual eating disorder symptoms

Acceptance and commitment therapy (ACT) is a transdiagnostic approach to human suffering that has been trialed in a range of different contexts. This study aimed to examine participants' view of helpful and hindering aspects of an in person ACT group intervention targeting body image in patients with residual eating disorder (ED) symptoms. Thirteen women who completed the intervention were interviewed, and transcripts were analyzed through thematic analysis. Nine themes were identified and sorted into three main themes. The first main theme, ”Taking the plunge”, pointed to the importance of participants own effort, and included subthemes of self-efficacy, self as description, and self-exploration. The second main theme, “A push towards valued ends”, indicated that content of the intervention was helpful, and included subthemes of commitment and behavioral change processes, mindfulness and acceptance processes, and assignments in and between sessions. The third main theme, “The context matters”, described the importance of the contexts of the intervention and life outside of treatment, and included subthemes of the group format, the context outside of treatment, and the timing of the intervention. Through the description of specific content, we conclude that ACT seems to help women with residual ED symptoms and body image issues by fostering motivation to engage in avoided situations and behaviors while striving to live a more valued life.

Adapting Clinical Skills to Telehealth: Applications of Affirmative Cognitive-Behavioral Therapy with LGBTQ+ Youth.

Online social work services (e.g., telemental health; telebehavioral health; virtual care; telehealth) present significant opportunities for clinical social workers to provide effective care to marginalized populations, such as LGBTQ+ youth. The COVID-19 pandemic has led to an increased focus on telehealth, and while there are excellent resources to guide ethics, standards, and legal decisions (NASW, n.d.), there is less guidance in the literature to specifically inform the adaptation of offline clinical skills to telehealth, particularly for LGBTQ+ youth. To address this gap, we present examples from our experience offering AFFIRM, an affirmative cognitive behavioral therapy (CBT) group intervention now being delivered through telehealth. Specifically, this paper will: (a) describe the key considerations for the delivery of CBT via telehealth to youth; (b) detail specific clinical skills and strategies to enable successful online implementation; (c) describe the adaptation approach through a case study of cognitive restructuring with a transgender youth; (d) and offer specific guidance to support clinicians to adapt their clinical skills to the virtual environment.

Investigation into the effectiveness of a ‘moving on from trauma’ group within a primary care setting

The aim of this service evaluation was to assess the effectiveness of a Cognitive Behavioural Therapy (CBT) group intervention for clients presenting with trauma-related difficulties within a part primary care, part ‘Improving Access to Psychological Therapies’ (IAPT) community service (Howells, 2004). Self-report measures were used to assess low mood, anxiety and trauma symptoms. This evaluation found that clients experienced a reduction in symptoms of anxiety and low mood; however, the difference in scores did not equate to a reliable change or improvement according to the IAPT reliable improvement index. Notwithstanding this, clients did report a change and improvement in trauma ‘symptoms’ by the end of this part of the intervention.

Is there adequate evidence to support the use of compassion focused therapy group interventions with forensic mental health service users? A rapid evidence assessment

Compassion focused therapy (CFT) is a model of psychotherapy based on cultivating the capacity for compassion to others and self. The evidence base has grown considerably in the last decade regarding CFT’s effectiveness for a range of mental health problems. However, the literature supporting CFT as a treatment provision for forensic service users with mental health needs is lacking despite the observed overlap in needs between this population and their non-offending clinical counterparts. This rapid evidence assessment (REA) sought to evaluate the current evidence of CFT’s effectiveness as a group therapeutic intervention with clinical populations to allow consideration of the use of CFT with individuals with both mental health and criminogenic needs. A search of electronic databases was undertaken and after a process of review and extraction 10 papers were included. These studies showed promising effects of group-level CFT for those with complex mental health needs. Some evidence emerged of CFT generating significant improvements compared to no treatment and treatment as usual (TAU), but insufficient evidence has been produced in respect of whether CFT can supersede traditional ‘gold-standard’ approaches such as Cognitive Behavioural Therapy (CBT). Tentative conclusions are made regarding the applicability of CFT interventions but the observed reductions in shame and self-criticism and a move towards more guilt-based motivational drives suggest that this approach shows some promise in being able to assist forensic service users in taking more responsibility for their harmful actions and foster social and affiliative processes with others. Further high quality RCTs are needed in order to make firm conclusions about the clinical utility of this therapy for forensic populations with mental health needs.

Pilot data from the Self-Blame and Perspective-Taking Intervention for eating disorders.

Eating disorders (EDs) are characterized by altered eating behaviors and valuation of self-image, as well as difficulty establishing supportive social relationships. This pilot study evaluated feasibility, acceptability, and clinical responses to a novel and brief group-therapy intervention for EDs, the Self-Blame and Perspective-Taking Intervention (SBPI). The SBPI consisted of four sessions of experiential art therapy activities in conjunction with psychoeducation targeting interpersonal attributions and mentalization. Twenty-four outpatient, treatment-seeking women with EDs participated in the SBPI, with 87.5% completing the intervention and 94% rating their participation positively. ED symptoms, depression, anxiety, self-attribution bias, and self-esteem were assessed before (T1) and after participation (N = 20 at T2; N = 18 at T3). Separate repeated measures MANOVAs were performed to assess these clinical and self-concept variables. Relative to baseline, participants demonstrated significant improvements in two all self-concept measures: self-attribution bias, trait self-esteem and state self-esteem at T2. ED, depression, and anxiety symptoms were significantly decreased at both T2 (1-4 weeks post) and T3 (3-5 months post). The SBPI altered self-concept targets acutely and led to sustained clinical improvements. Future work is needed to evaluate how self-concept and social constructs are related to clinical symptom expression in EDs.

Promoting Social-Emotional Development In Children Experiencing Economic Hardship Using TBRI® Nurture Group©

ABSTRACT The purpose of this study was to examine the effect of occupational therapy group intervention using Trust Based Relational Intervention® (TBRI®) Nurture Groups© on preschool children’s social, emotional, and behavioral development in a Head Start program. This study used a retrospective mixed method, quasi-experimental design with non-equivalent groups and pretest-posttest measures. The intervention site teaching staff participated in 16 hours of TBRI® Caregiver training and the children participated in 12 weeks of Nurture Group© interventions. The Strengths and Difficulties Questionnaire (SDQ) and Teaching Strategies GOLD® (TSG) assessment measured child development in social, emotional, and behavioral domains. The intervention site teaching staff participated in a focus group to determine their perceptions of the intervention’s effectiveness. This data was evaluated using grounded theory methodology. SDQ: The children experienced statistically significant changes in the emotional symptoms and prosocial behavior domains. TSG: Results indicated a statistically significant main effect of site on objectives of Forms Relationships with Adults, Responds to Emotional Cues, and Balances Needs & Rights of Self and Others. Themes identified from qualitative analysis illustrated how the teachers highly valued the TBRI® training and adapted their teaching strategies to incorporate the TBRI® principles of empowering, connecting, and correcting. Teaching staff reported increased perceived social-emotional skills in the children and detailed how the children’s behavior changed to demonstrate these skills. Occupational therapy group intervention supports the social-emotional development of children attending Head Start. Occupational therapy practitioners need to engage in universal and targeted approaches to promote resiliency in this population of at-risk children.

Cognitive Behavioral Therapy for Patients with Trigeminal Neuralgia: A Feasibility Study.

To test the feasibility and acceptability of a customized six-session cognitive behavioral therapy (CBT) group intervention for adults with recurrent trigeminal neuralgia (TN). Fifteen participants with TN were recruited from a specialist facial pain unit in London, United Kingdom. The effects of the group intervention were evaluated using validated self-report measures, which the participants completed before and after the intervention and at 1-month and 9-month follow-ups. A semi-structured interview was also used at the 1-year follow-up to gather qualitative feedback of the group intervention. Participants reported an increase in confidence in managing everyday tasks in the presence of TN symptoms, a reduction in negative beliefs about pain, and an increase in engagement in meaningful activity. All patients completed the group intervention (100% retention rate). Qualitative feedback highlighted that the group CBT intervention was helpful, and no participants reported a worsening of mood or experience as a result of the intervention. The trends for improvement in several domains, plus the positive experiences of the participants, suggest that a CBT management program is acceptable and feasible for this population and should be further developed and implemented on a larger scale to determine its clinical efficacy.

Group-based acceptance and commitment therapy to enhance graduate student psychological flexibility: Treatment development and preliminary implementation evaluation

Objective: Graduate student mental health is a growing concern and the need for interventions is well-documented. This manuscript outlines an Acceptance and Commitment Therapy group treatment for graduate students intended to promote psychological flexibility through the cultivation of six processes: contact with the present moment (mindfulness), freely chosen life direction (values), distance from thoughts (defusion), nonjudgmental acknowledgement of one’s internal experiences (acceptance), meta-awareness of one’s own experiences (self-as-context), and ongoing patterns of behavior in the service of values (committed action). Participants: The treatment was delivered to graduate students across academic disciplines with variable psychological concerns over several semesters. Method: Graduate students completed measures of preliminary acceptability. Results: Clients perceived the intervention positively and believed they benefited from participating. Conclusion: Treatment evaluation information support the social validity and acceptability of the treatment and justify future studies assessing treatment efficacy and effectiveness.

The Effects of Interpersonal Support on Treatment Outcomes Using Cognitive Processing Therapy

Although there has been research connecting PTSD and social support, there has been little research on effects of treatment, especially in military samples. The current study examined the relationship between these variables over the course of PTSD treatment and assessed differences based on treatment modality (i.e. group versus individual). Participants were 322 active duty service members in a randomized controlled trial comparing the effectiveness of group and individual Cognitive Processing Therapy (CPT) treatment modalities and were assessed for PTSD symptoms and social support both prior to and upon completion treatment. Cross-lagged regression models were used to examine stability and lagged effects between PTSD severity and dimensions of social support from pre- to post-treatment. Lower levels of pre-treatment PTSD severity were associated with higher levels of post-treatment social support across all three subscales (all b ’s at least -.15, p < .02). The only significant difference based on treatment modality was a stronger relationship between pre- and post-treatment PTSD severity for those who received group CPT compared to participants who received individual CPT, consistent with previous findings. Recommendations for improving social support during PTSD treatment through modalities, such as family-centered models or social skills training, are discussed.

Efficacy of Yoga therapy and strength -based group intervention on the level of depression, anxiety and stress among persons with alcohol dependence syndrome

Background: Alcohol is a chronic relapsing disorder. The disease is often progressive and fatal. It is characterized by continuous or periodic impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences and distortion of thinking most notably denial. There are various therapies for the treatment of alcohol dependence syndrome as yoga therapy and strength-based group intervention. Aims: To assess and examine the efficacy of yoga therapy and strength- based group intervention among the persons with alcohol dependence syndrome in pre-post and follow up stage. Tools: Semi- Structured Socio-demographic data sheet (especially designed for the study), was used for sociodemographic details, Depression, Anxiety and stress scale was applied for the assessment of depression, anxiety and stress on both groups. Results and Conclusion: that yoga therapy and strength -based group intervention leads better improvement.

Adapting group schema therapy for older adults with personality disorders: lessons learnt

Abstract A first empirical study into group schema therapy in older adults with mood disorders and personality disorder (PD) features has shown that brief group schema therapy has potential to decrease psychological distress and to change early maladaptive schemas (EMS). Effect sizes however were smaller than those found in similar studies in younger adults. Therefore, we set out to adapt the treatment protocol for older adults in order to enhance its feasibility and outcome in this age group. We examined this adapted protocol in 29 older adults (mean age 66 years) with PDs from four Dutch mental health institutes. The primary outcome was symptomatic distress, measured by the Brief Symptom Inventory. Secondary outcomes were measured by the Young Schema Questionnaire, the Schema Mode Inventory, and the short version of the Severity Indices of Personality Problems. Contrary to our expectations, the adapted treatment protocol yielded only a small effect size in our primary outcome, and no significant improvement in EMS, modes and personality functioning. Patients pointed out that they were more aware of their dysfunctional patterns, but maybe they had not been able yet to work on behavioural change due to this schema therapy treatment being too brief. We recommend more intensive treatment for older patients with PDs, as they might benefit from more schema therapy sessions, similar to the treatment dosage in younger PD patients. They might also benefit from a combination of group therapy and individual treatment sessions. Key learning aims (1) How to adapt group schema therapy for older adults. (2) How to explore feasibility and outcome. (3) Treat older personality disorder patients as intensively as younger adults.