Group Therapy Program Research Articles

Therapeutic Alliance and Group Cohesion in an Online Support Program for Adolescent and Young Adult Cancer Survivors: Lessons from "Recapture Life".

Psychological support services for adolescent and young adults (AYAs) with cancer are moving online and are increasingly peer based. It is unclear whether online service delivery impacts critical therapeutic elements such as collaborative patient-therapist rapport and group cohesion. AYA cancer survivors (N = 39) participating in a six-week online cognitive-behavioral therapy group program-"Recapture Life"-rated their perception of therapeutic alliance and group cohesion. Participant-rated alliance and group cohesion were high throughout the program, and therapist-rated participant openness, trust, and motivation strengthened over time. The findings provide further support for the expansion of AYA cancer support services to the online domain.

Group therapy for maintenance of speech in parkinson’s disease following LSVT LOUD: a pilot study

ABSTRACTThis study used a pre-post intervention research design to explore the feasibility and speech, communicative effectiveness, and quality of life outcomes of a group therapy programme (Loud and Proud) for people with Parkinson’s Disease following intensive speech treatment (LSVT LOUD). Four women and eight men diagnosed with PD and hypokinetic dysarthria participated in the research. Ten communication partners of people with PD also participated in the study. Participants were assessed twice on separate days pre- and post-intervention on acoustic measures of voice, perceptual ratings of speech intelligibility, a modified Communicative Effectiveness Index, and the Quality of Communication Life Scale. The intervention was eight 90-minute group therapy sessions, delivered once per week. Following intervention, participants demonstrated a statistically significant increase in sound pressure level (SPL) during conversation, monologue, reading and sustained vowel production tasks. However, mean SPL in conversation remained low following intervention. No significant improvements post-intervention were identified for maximum frequency range, duration of sustained vowel production, speech intelligibility, communicative effectiveness or quality of life. Refinements to Loud and Proud were recommended to better target intelligibility, communicative effectiveness, and quality of communication life.

Intensive Evening Outpatient Treatment for Patients With Personality Dysfunction: Early Group Process, Change in Interpersonal Distress, and Longer-Term Social Functioning

Objective: Entrenched interpersonal difficulties are a defining feature of those with personality dysfunction. Evening treatment—a comprehensive and intensive group-oriented outpatient therapy program—offers a unique approach to delivering mental health services to patients with chronic personality dysfunction. This study assessed change in interpersonal problems as a key outcome, the relevance of such change to future social functioning, and the influence of early group processes on this change. Method: Consecutively admitted patients (N = 75) to a group-oriented evening treatment program were recruited; the majority were diagnosed with personality disorder. Therapy outcome was represented by scores on the Inventory of Interpersonal Problems. Follow-up outcome was represented by the global score of the Social Adjustment Scale. Group climate, group cohesion, and the therapeutic alliance were examined as process variables. Results: Patients experienced substantial reduction in distress associated with interpersonal problems; early process factors that reflected a cohesive and engaged group climate and stronger therapeutic alliance were predictive of this outcome. Improvement in interpersonal distress was predictive of global social functioning six months later. The therapeutic alliance most strongly accounted for change in interpersonal problems at posttreatment and social functioning at follow-up. Conclusions: A comprehensive and integrated outpatient group therapy program, offered in the evening to accommodate patients’ real-life demands, can facilitate considerable improvement in interpersonal problems, which in turn influences later social functioning. The intensity and intimacy of peer interactions in the therapy groups, and a strong alliance with the program therapists, are likely interacting factors that are particularly important to facilitate such change.

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

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

The mindful path to compassion in an adult mental health group

A naturalistic study was undertaken within an NHS setting to explore the effectiveness and satisfaction with a Mindfulness-Based Cognitive Therapy and Mindful Self-Compassion group programme in an adult mental health population. Outcome measures and qualitative feedback suggested beneficial effects and high levels of satisfaction.

Targeting Heterogeneity and Comorbidity in Children with Autism Spectrum Disorder Through the Resilience Builder Group Therapy Program

Background Children with autism spectrum disorders (ASD) often carry co-morbid diagnoses and present with impairing heterogeneous symptomatology (Leyfer et al. in J Autism Dev Disord 36(7): 849–861, 2006. doi: 10.1007/s10803-006-0123-0). However, research from controlled laboratory settings often fails to examine the vast number of co-occurring clinical challenges that are seen in youth with ASD treated in “real-world” clinical service settings (Ehrenreich-May et al. in Adm Policy Ment Health 38(5): 398–411, 2011. doi: 10.1007/s10488-010-0328-6).

The effectiveness of an outpatient Acceptance and Commitment Therapy Group programme for a transdiagnostic population

BackgroundAlthough a growing number of studies have demonstrated the efficacy of Acceptance and Commitment Therapy (ACT) for the treatment of psychological disorders, the effectiveness of transdiagnostic group ACT programmes in an applied clinical setting requires further evaluation.MethodsThe current study examined the effectiveness of a 10‐week ACT transdiagnostic group programme delivered in a private psychiatric hospital. Pre‐ and post‐treatment outcomes were measured in 55 adults presenting with various psychiatric diagnoses. Treatment processes were also analysed.ResultsAt post‐intervention, participants demonstrated significantly greater valued living, cognitive defusion, and acceptance. No significant differences were evident in participants' mindfulness. Significant improvements were also evident on depression, anxiety, stress, functional disability, satisfaction with life, and personal well‐being. Reliable change indices were also calculated and revealed reliable improvements in a range of outcomes for 27% to 46% of participants. Participant attendance rates, clinician adherence to the manualised ACT content, and patient satisfaction were all high.ConclusionsCollectively, results provided support for the effectiveness of ACT in increasing psychological flexibility and improving psychological symptoms in a transdiagnostic population. However, the current study also showed that many patients did not respond to the intervention and further research is recommended to ascertain predictors of treatment response.

Estimating the Efficiency of Therapy Groups in a College Counseling Center

ABSTRACTCollege counseling centers are facing rapidly increasing demands for services and are tasked to find efficient ways of providing adequate services while managing limited space. The use of therapy groups has been proposed as a method of managing demand. This brief report examines the clinical time savings of a traditional group therapy program in a college counseling center. The savings were mixed from semester to semester, ranging from 5 individual therapy spots lost to 10 individual therapy spots gained depending on the estimation. Considerations are offered for the use of therapy groups to manage clinical demand based on this report.

Self-awareness rehabilitation after Traumatic Brain Injury: A pilot study tocompare two group therapies.

Background and Purpose: Deficits of self-awareness (SA) are very common after severe acquired brain injury (sABI), especially in traumatic brain injury (TBI), playing an important role in the efficacy of the rehabilitation process. This pilot study provides information regarding two structured group therapies for disorders of SA.Methods: Nine patients with severe TBI were consecutively recruited and randomly assigned to one SA group therapy programme, according either to the model proposed by Ben-Yishay & Lakin (1989) (B&L Group), or by Sohlberg & Mateer (1989) (S&M Group). Neuropsychological tests and self-awareness questionnaires were administered before and after a 10 weeks group therapy.Results: Results showed that both SA and neuropsychological functioning significantly improved in both groups.Conclusion: It is important to investigate and treat self-awareness, also to improve the outcome of neuropsychological disorders. The two group therapies proposed seem to be specific for impulsivity and emotional dyscontrol and for cognitive disorders.

The Mindfulness Perspective

ABSTRACTMindfulness-based cognitive therapy is a time-limited (eight-week) group therapy program designed to help participants manage depression, anxiety, and other forms of emotional distress. Research has shown it to be especially effective in reducing symptoms of depression and preventing relapse. In addition to attending the eight weekly group meetings, participants are expected to complete extensive daily assignments at home. While not for everyone, this program offers many potential benefits for those suffering from depression and anxiety, either on its own or in conjunction with other modes of treatment.

Group Counseling in the College Setting: An International Survey of Center Directors

ABSTRACTThe purpose of this study is to obtain updated descriptive statistics pertaining to group therapy programs at counseling centers accredited by the International Association of Counseling Services (IACS) as well as to explore potential factors that predict the success of group therapy programs in this setting. Surveys were sent to counseling center directors across the United States and Canada, yielding a response rate of 39.36% (n = 74). Results suggest that 91.9% of centers offer group counseling, most commonly theme or specialty groups. Items addressed staff, trainees, expertise, attitudes, and status of the group therapy program at the respondent’s counseling center, with an indication that hiring staff based on group expertise and providing staff with group training may be associated with greater program success.

Client Engagement with a Manualized Group Therapy Program

ABSTRACTA mixed-methods design was used to explore factors influencing client engagement, in a short-term, manualized, group therapy program for people with substance misuse problems. Associations between predictor variables and engagement with the group were explored. A number of pretreatment characteristics were found to be significantly related to client engagement. Thematic analysis of interviews with clients who dropped out of the group program revealed a number of other factors that influenced attrition among the sample. The results are worthy of consideration when assessing suitability of individuals for group treatment programs in addiction settings and more generally.

Evaluating a Brief Group Program for Women Victims of Intimate Partner Abuse

Objective: Despite high client satisfaction and excellent outcomes for completers of a 12-week dialectical behavior therapy (DBT) group program for women victims of intimate partner abuse (IPA), the dropout rate between initial contact and program completion has been as high as 70%. To establish better treatment engagement and retention, and thus to help more women, a two-day DBT group program, or “workshop” with a similar curriculum was developed and evaluated. Methods: The participants were 72 women who were referred from crisis centers, courts, local women`s shelters and agencies serving intimate partner abuse victims. Women who are or have been in an abusive relationship voluntarily participated in the research and received a 2-day intervention, which included baseline, post-treatment and 3-month follow-up assessment. Results: The 2-day workshop resulted in significantly higher attendance (69% vs. 43%) and completion rate (65% vs. 17%) compared with the 12-week standard group treatment program. From pre-treatment to 3 months follow-up, participants (N = 37, who completed both the treatment and the follow-up assessment) reported significant improvements across a range of outcome and process variables, including general psychological distress, depression, hopelessness, PTSD severity, self-compassion, self-efficacy, positive affect, negative affect, interpersonal effectiveness, emotion regulation, shame, mindfulness, and use of DBT skills. Results also showed that improved self-validation, emotion regulation, DBT skill use, mindfulness, and decreased emotional arousal were associated with most outcome variables (i.e., social adjustment, depression, general psychological distress, hopelessness, PTSD severity, and effective skill use). In addition, participants reported very high satisfaction with the intervention. Conclusions: These findings support the utility of the program`s effectiveness in increasing treatment engagement, reducing dropout, and enhancing psychological well-being of women victims of IPA. Further research on the long-term impact of this brief intervention is warranted. Suggestions for future research will be discussed.

Combining Cognitive Therapy With Acceptance and Commitment Therapy for Depression: A Group Therapy Feasibility Study.

Cognitive therapy (CT) and acceptance and commitment therapy (ACT) have been shown to be effective in treating depression. Although integrating ACT with CT is used for the treatment of anxiety, there is a paucity of integrated CT and ACT treatments for depression and/or dysthymia. The purpose of this study is to determine the feasibility of integrating CT and ACT into a manualized group therapy treatment for depression and/or dysthymia. Over a period of 2 years, 4 consecutive groups were held at a community clinic, with 24 completing the 15-week treatment. Posttreatment and follow-up data revealed satisfaction with the treatment, significant decreases in depression severity, and significant increases in quality of life over the 5 time points. The results support the acceptability and feasibility of a manualized integrated CT/ACT group therapy program for depression and dysthymia.

Effects of Group Mindfulness-Based Cognitive Therapy on Depression and Role Impairment in a Comorbid Psychiatric Population

Objective: Mindfulness-based cognitive therapy (MBCT) has demonstrated positive effects in reducing psychological symptoms associated with disorders such as anxiety and depression. The purpose of this study is to determine whether participating in a 10 week group program of Mindfulness-Based Cognitive Therapy (MBCT) would affect symptoms of depression and anxiety, as well as disability status of outpatients who present naturalistically with comorbid mood and anxiety disorders to a tertiary care centre. Methods: Outpatients were referred by a healthcare professional to the Mood and Anxiety Disorders Mindfulness-Based Cognitive Therapy group program. Individuals were assessed for psychiatric diagnoses using the MINI Neuropsychiatric Interview. Participants were randomized to an intervention group (n=30) or a waitlist control group (n=33) of outpatients. Participants completed packages of outcome measures including the BDI, BAI, SCL-90-R, DEQ, RSQ and SDI before, immediately following and three months after participation in the 10 week MBCT program. Results: Significant differences between groups were found for BDI depression severity scores (p<0.05) and for level of impairment in work (p<0.05) and social/leisure (p<0.05) activities as measured by the SDI. Differences across groups were not found on the SCL-90-R depression subscale, the SCL-90-R anxiety subscale or on the BAI. Likewise, differences between groups were not seen for both the rumination and distraction subscales of the RSQ. Conclusion: Group MBCT shows preliminary efficacy in reducing symptoms of depression and improving functional status in a highly comorbid psychiatric population, many of whom had not reached full remission from depressive symptoms prior to program participation. Overall a 9% reduction in BDI scores was observed in participants randomized to the intervention group. MBCT may also be a useful treatment for individuals with mild to moderate depression. Ultimately, when used as an adjunctive treatment to individual’s typical psychiatric treatment, MBCT may lead to improved management of mood and anxiety disorder symptoms and quality of life. Recommendations for future empirical inquiry are presented.

Group Therapy Program for Families with Transgender Member: Propelling Gender Differentiation

Group Therapy Program for Families with Transgender Member: Propelling Gender Differentiation

‘Give us something to do’: reflections on running a group therapy programme

‘Give us something to do’: reflections on running a group therapy programme

The Effects of Problem Solving Group Therapy Program on Depression among Clients with Depression Received Services at Primary and Secondary Care Unit

Background: Depression is more than feeling sad. It's a serious mental health condition that requires understanding and helping. Clients with depression experience symptoms of thinking, emotion, motivation, physical and behavioral disturbance. There are a variety of therapy options available for clients with depression. Problem solving therapy is a therapy option that usually improves the symptoms of depression Objective: To investigate the effects of problem solving group therapy program on depression among clients with depression received services at primary and secondary care unit. Methods: This study was quasi-experimental research, 89 clients with depression were purposively selected based on the inclusion criteria. The research instruments were 1) Problem Solving Group Therapy Program developed by researcher team, 2) Nine Q Depressive Screening Form. Descriptive statistics and repeated measures of one-way analysis of variance (ANOVA) were used for data analyses. Results: The result of this study revealed that the depression means score of clients with depression at the end of program and 3 months after receiving Problem Solving Group Therapy Program were significantly different from that before. Conclusion: Problem Solving Group Therapy Program could decline depression among clients who have depressive mood, as well. We found that it had sustainable effect when follow up 3 months, however, to confirm the effectiveness of this program, long term follow up should be done at least sixmonths after program finished.

CORE assessment of adult survivors abused as children:A NAPAC group therapy evaluation

AbstractPurposeThe aim of this study was to provide the first formal evaluation of a unique 12‐session group therapy programme developed by the UK‐based National Association for People Abused as Children (NAPAC).MethodThe therapy outcomes of this programme were assessed using the CORE‐OM tool. Clients comprised 26 individuals (7 males and 19 females), with an age range of 19–67 (mean = 41; SD = 12.76). Clients were survivors of sexual, physical, emotional or neglectful childhood abuse, or a combination of these, and were from four different locations: London (n = 9), Bury (n = 4), Belfast (n = 8) and prison (n = 5).FindingsAcross all CORE domains, improvements were shown from pre‐ to post‐therapy. No gender or age differences were revealed, and improvements were shown across both community members and prison inmates.ImplicationsA person‐centred approach to group therapy is beneficial to a wide range of adult clients within the community and prison settings that require therapy after historical sexual, physical, emotional or neglectful childhood abuse.

Feasibility and Acceptability of the 'HABIT' Group Programme for Comorbid Bipolar and Alcohol and Substance use Disorders.

We investigated the feasibility and acceptability of an integrated group therapy (called HABIT) for comorbid bipolar disorder (BD) and alcohol and substance use disorders (ASUD) (BD-ASUD), a disabling clinical presentation for which no specific treatment has been validated. The 14-session HABIT programme employs psychoeducation-oriented cognitive-behaviour therapy (CBT) followed by mindfulness-based relapse prevention (MBRP) therapy. Potential group participants were recruited from adult clients with a DSM-IV diagnosis of BD and an ASUD who were referred by their treating clinician. Observer-rated changes in mood symptoms and ASUD, attendance rates and subjective feedback are reported. Eight of 12 clients referred to the programme initially agreed to join the group, six attended the first group session and five clients completed the programme. Group mean scores for mood symptoms improved over time, with slightly greater reductions in depression during the first module. About 50% of individuals showed clinically significant improvement (≥30% reduction) in alcohol and substance use. Attendance rates showed some variability between individuals and across sessions, but the average attendance rate of the group was marginally higher for the first module (86%) as compared with the second module (77%). Most clients reported high levels of general satisfaction with a group specifically targeted at individuals with BD-ASUD. This small pilot study suggests our intensive group therapy is acceptable and feasible. If findings are replicated, we may have identified a therapy that, for the first time, leads to improvement in both mood and substance use outcomes in clients with difficult-to-treat comorbid BD-ASUD. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Comorbidity between bipolar and alcohol and substance use disorders (BD-ASUD) is frequent and highly disabling; Therapeutic research on approaches that can simultaneously help BD and ASUD is lacking; Previous research highlights the need for integrated treatment of both conditions but showed improvements limited to either element of the comorbid disorder; This pilot study supports the feasibility and acceptability of an intensive, 14-session group therapy programme that integrates CBT and mindfulness approaches.