Group Treatment Sessions Research Articles

Expanding the Psychological Wellness Threshold for Black College Women

Objectives: This study investigated the effectiveness of a culturally congruent group intervention program entitled “Claiming Your Connections (CYC)” aimed at reducing stress and enhancing psychosocial competence (i.e., locus of control and active coping) among Black college women. Method: Using an experimental design, a total of 96 undergraduate Black college women recruited from four predominantly White institutions and one historically Black college and university were randomly assigned to either the CYC group ( n = 49) or the wait-list control group ( n = 47). The CYC group attended 10-week group intervention sessions. Repeated measures analysis of variance was used to test intervention effects for the outcome variables. Results: After the intervention, the CYC group reported a significantly greater reduction in perceived stress and external locus of control compared to the control group. Conclusions: Counseling implications and directions for the development of future culturally relevant practice interventions with this population are discussed.

The effect of Kodály-based music experiences on joint attention in children with autism spectrum disorders

Abstract Background: Kodály approach is one of widely used methods in music education and music therapy. The method is based on singing activities that could facilitate young children’s social development. Thus, the application of Kodály approach may be appropriate to enhance the joint attention behaviors of children with autism. Objective: We examined the joint attention of individuals with autism spectrum disorders (ASD) during Kodály-based music experiences. Methods: The A-B-C-B single-case design was employed to investigate the effectiveness of Kodály-based music experiences on joint attention behaviors of three children, ranging from 7.8 to 11.5 years of age, with autism who had manifested joint attention problems. The experimental sessions consisted of baseline condition (A), group intervention (B), and individual invention session (C). The SCERTS assessment process (SAP) was used to measure joint attention behaviors. The findings were presented using visual inspection. Results: During baseline sessions, the three participants rarely engaged in joint attention with others. Their behaviors were stable during the first three sessions, with mean occurrence of 5, 9.3, and 4. In the course of the music intervention, they positively responded to the intervention. The frequencies of their behaviors continuously increased from the first group intervention sessions until the second group intervention sessions. Finally, the second group intervention sessions showed that most of the data points were above the mean of all previous sessions, with mean occurrence of 43.8, 34.1, and 18.8. Conclusion: The Kodály approach was found one of useful methods in music education that can apply to music therapy to enhance joint attention behaviors of the children with autism. The children were able to learn how to engage in a group setting through singing activities, folk music, and solfège learning.

Grief-processing-based psychological intervention for children orphaned by AIDS in central China: A pilot study

A group of 124 children orphaned by AIDS (COA), who resided in two orphanages funded by the Chinese government, participated in a study investigating the efficacy of a grief-processing-based psychological group intervention. This psychological intervention program was designed to specifically help COA process their grief and reduce their psychological distress. Six sessions of group intervention focused on processing grief, reducing traumatic symptoms and psychological distress, and fostering hope about the future. At the three-month post-test, children in both groups (intervention group and control group) reported significant reduction in trauma symptoms and demonstrated similar levels of hope. However, the intervention group reported significantly increased levels of grief processing and decreased levels of trauma symptoms, depression, and threat appraisal. The intervention group also reported subjective improvements in mood, relationships, individual growth, self-confidence, and perceived social support. These outcomes supported the potential efficacy of grief-processing-based psychological intervention to reduce the psychological distress among COA.

Individual, facility, and program factors affecting retention in a national weight management program.

BackgroundHigh attrition is a common problem for weight loss programs and directly affects program effectiveness. Since 2006, the Veterans Health Administration (VHA) has offered obesity treatment to its beneficiaries through the MOVE! Weight Management Program for Veterans (MOVE!). An early evaluation of this program showed that attrition rate was high. The present study examines how individual, facility, and program factors relate to retention for participants in the on-site MOVE! group program.MethodsData for all visits to MOVE! group treatment sessions were extracted from the VHA outpatient database. Participants were classified into three groups by their frequency of visits to the group program during a six month period after enrollment: early dropouts (1 – 3 visits), late dropouts (4 – 5 visits), and completers (6 or more visits). A generalized ordered logit model was used to examine individual, facility, and program factors associated with retention.ResultsMore than 60% of participants were early dropouts and 11% were late dropouts. Factors associated with retention were older age, presence of one or more comorbidities, higher body mass index at baseline, lack of co-payment requirement, geographic proximity to VA facility, addition of individual consultation to group treatment, greater program staffing, and regular, on-site physical activity programming. A non-completion rate of 74% for on-site group obesity treatment poses a major challenge to reducing the population prevalence of obesity within the VHA.ConclusionsGreater attention to individualized consultation, accessibility to the program, and facility factors including staffing and physical activity resources may improve retention.

Strategies Used by an Elite Curling Coach to Nurture Athletes’ Self-Regulation: A Single Case Study

Competition outcomes are a test of an athlete's ability to self-regulate; however, scant literature exists on how self-regulation processes are developed. This study investigated the strategies used by an elite curling coach to support co-regulation and help nurture his athletes’ self-regulation during a 16-week intervention involving multiple individual and group intervention sessions and interviews. The content analysis revealed that the coach utilized the following types of strategies to facilitate the athletes’ self-regulation: (a) preparatory strategies (e.g., anticipating/preparing for obstacles), (b) performance strategies (e.g., letting go of mistakes), and (c) self-reflection strategies (e.g., attributing errors to controllable aspects of performance).

Abstract P3-08-03: Establishing Japanese model “working ring” - Informational, emotional and problem-solving group intervention for working breast cancer survivors

Abstract Background: Due to advancement of cancer treatment, the number of cancer survivors is increasing and our society also needs to consider cancer survivorship. Especially the prevalence of breast cancer by age is much younger in Japan than in western countries. About half of them were diagnosed in 30-50’s, and they are considered strong working force in society. Cancer and its treatment largely affect their working status, therefore support system for workers with cancer is urgently required. Methods: We established support systems by 3 phases. We assessed the effect of breast cancer and informational needs in Japanese young breast cancer survivors for working with cancer (Phase 1). We also estimated economic impact due to such work force loss from cancer (Phase 2). Furthermore, we designed intervention model “Working Ring” by health care providers for cancer survivors to facilitate returning to work or keeping their job, and evaluated its effect (Phase3). Results: Among 42 young (less than 35 years old) breast cancer survivors who worked at the time of diagnosis, 33% of them had to changed their role at work after diagnosis of breast cancer. Focused interview revealed they needed informational and emotional support system. According to the Japanese Health Ministry of Health, Labor and Welfare database, we estimated total economic loss due to cancer treatment, $1569 million for women and $2959 million for men. Breast cancer is estimated as a number one cause of economic loss among cancer survivors in Japan. Finally, we introduced group intervention for working survivors provided by health care professionals (psycho-oncologist, nurse, and medical social worker) and labor and social security attorney. In this “Working Ring”, patients were given information about working status, practical issues provided by their companies and our society in order to maintain their work. We enrolled total 22 working breast cancer survivors divided in 3 groups; each group was given by 3 sessions of one-hour group intervention. All attendees of the group intervention showed increase in knowledge and problem solving technique concerning working, and QOL improvement by using POMS. Discussion: We noted that there are many unmet needs for working breast cancer survivors and loss of their job causes enormous impact for social economy. Surprisingly, breast cancer is estimated number one cause of economic loss from cancer diagnosis in Japan. It is urgently required to establish support systems for working cancer survivors. Our group interventional model “Working Ring” was very successful to improve their anxiety and informational needs. We are currently extending this model through entire Japan. Conclusions: Most of cancer survivors are considered to be potential working force. To establish a support system for them to maintain working ability and environment is necessary for societal reintegration. (This work is supported by a Grant-in-Aid for Cancer research from the Japanese Health Ministry of Health, Labor and Welfare, H24-Ganrinsho-ippan-011). Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-08-03.

Sleep Disturbance, Chronic Stress, and Depression in Hospice Nurses: Testing the Feasibility of an Intervention

To test the feasibility of a cognitive-behavioral therapy for an insomnia (CBT-I) intervention in chronically bereaved hospice nurses. Five-week descriptive correlational. Nonprofit hospice in central Texas. 9 agency nurses providing direct patient and family care. Direct care nurses were invited to participate. Two intervention group sessions occurred at the hospice agency and included identification of dysfunctional thoughts and beliefs about sleep, stimulus control, sleep hygiene, and relaxation techniques to promote sleep. Measurements were taken at baseline and three and five weeks postintervention. Sleep quality, depressive symptoms, and narrative reflections on the impact of sleep quality on self-care. Participants reported moderate-to-severe sleep disturbances and moderate depressive symptoms. The CBT-I intervention was well accepted by the participants, and on-site delivery increased participation. Additional longitudinal study is needed to investigate the effectiveness of CBT-I interventions to improve self-care among hospice nurses who are at high risk for compassion fatigue and, subsequently, leaving hospice care. Hospice nurses are exposed to chronic bereavement that can result in sleep disturbances, which can negatively affect every aspect of hospice nurses' lives. Cognitive-behavioral sleep interventions show promise in teaching hospice nurses how to care for themselves by getting quality sleep. Identifying the risks for sleep disturbances and depressive symptoms in hospice nurses will allow for effective, individualized interventions to help promote health and well-being. If hospice nurses achieve quality sleep, they may remain in the profession without suffering from chronic bereavement, which can result in compassion fatigue. A CBT-I intervention delivered at the agency and in a group format was feasible and acceptable by study participants.

Cost-effectiveness of an adjustment group for people with multiple sclerosis and low mood: a randomized trial

Objective: To evaluate the cost effectiveness of a psychological adjustment group shown to be clinically effective in comparison with usual care for people with multiple sclerosis. Design: Randomized controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. Setting: Community. Participants: People with multiple sclerosis were screened on the General Health Questionnaire 12 and Hospital Anxiety and Depression Scale, and those with low mood were recruited. Interventions: Participants randomly allocated to the adjustment group received six group treatment sessions. The control group received usual care, which did not include psychological interventions. Main measures: Outcomes were assessed four and eight months after randomization, blind to group allocation. The costs were assessed from a service use questionnaire and information provided on medication. Quality of life was assessed using the EQ-5D. Results: Of the 311 patients identified, 221 (71%) met the criteria for having low mood. Of these, 72 were randomly allocated to receive treatment and 79 to usual care. Over eight months follow-up there was a decrease in the combined average costs of £378 per intervention respondent and an increase in the costs of £297 per patient in the control group, which was a significant difference (p=0.03). The incremental cost-effectiveness ratio indicated that the cost per point reduction on the Beck depression inventory–II was £118. Conclusion: In the short term, the adjustment group programme was cost effective when compared with usual care, for people with multiple sclerosis presenting with low mood. The longer-term costs need to be assessed.

An intervention targeting service providers and clients for methadone maintenance treatment in China: a cluster‐randomized trial

This study examines the preliminary outcomes of an intervention targeting service providers in methadone maintenance therapy (MMT) clinics in China. The intervention effects on both service providers and clients are reported. The MMT CARE intervention pilot was developed and implemented collaboratively with local health educators. After three group intervention sessions, trained providers in intervention clinics delivered two individual motivational interviewing sessions with their clients. Six clinics in Sichuan, China, were randomized to either the MMT CARE intervention condition or a standard care condition. A total of 41 providers and 179 clients were sampled from the six clinics. At baseline and three-, six-, and nine-month assessments, providers completed self-administrated paper/pencil questionnaires regarding provider-client interaction, MMT knowledge, perceived job-related stigma and clinic support. Clients completed a face-to-face survey about their concurrent drug use and drug avoidance self-efficacy. Mixed-effects regression models with clinic-level random effect were used to assess the intervention effects. Significant intervention effects for providers were found in improved MMT knowledge, provider-client interaction and perceived clinic support. For clients, better improvements in drug avoidance self-efficacy and reduced concurrent drug use were observed for the intervention compared with the standard care group. The MMT CARE intervention targeting providers in methadone maintenance clinics can improve providers' treatment knowledge and their interaction with clients. The intervention can also reduce clients' drug-using behavior through motivational interviewing sessions conducted by trained providers.

Concurrent group treatment for hepatitis C: Implementation and outcomes in a methadone maintenance treatment program

Chronic hepatitis C virus (HCV) infection is highly prevalent among current and former drug users. However, the minority of patients enrolled in drug treatment programs have initiated HCV treatment. New models are needed to overcome barriers to care. In this retrospective study, we describe the implementation and outcomes of 42 patients treated in a concurrent group treatment (CGT) program. Patients participated in weekly provider-led group treatment sessions which included review of side effects; discussion of adherence and side effect management; administration of interferon injections; brief physical examination; and ended with brief meditation. Of the first 27 patients who initiated CGT, 42% achieved a sustained viral response. In addition, 87% (13/15) of genotype-1 infected patients treated with direct acting antiviral agent achieved an undetectable viral load at 24weeks. The CGT model may be effective in overcoming barriers to treatment and improving adherence and outcomes among patients enrolled in drug treatment programs.

Lifestyle modification for obesity: new developments in diet, physical activity, and behavior therapy.

Expert panels sponsored by both the World Health Organization and the National Institutes of Health have recommended that obese adults (ie, body mass index ≥30 kg/m2), as well as those who are overweight (body mass index of 25–29.9 kg/m2) and have comorbid conditions, lose 10% of their initial weight.1,2 A comprehensive program of lifestyle modification is considered the first option for achieving this goal.2 Lifestyle modification, also referred to as behavioral weight control, includes 3 primary components: diet, exercise, and behavior therapy.3 This narrative review examines weight losses achieved with this approach, as well as new developments with each of the 3 components. Comprehensive lifestyle modification programs typically provide weekly individual or group treatment sessions designed to modify eating and activity habits.4 This approach is exemplified by the Diabetes Prevention Program (DPP),5 which randomly assigned >3200 participants with impaired glucose tolerance to 1 of 3 groups: placebo, metformin, or lifestyle modification. Participants in the lifestyle intervention were provided 16 individual counseling sessions during the first 24 weeks and at least every-other-month sessions thereafter. They were prescribed a reduced calorie, low-fat diet of conventional foods (1200–2000 kcal/d, depending on body weight) and 150 min/wk of physical activity (typically brisk walking), with the goal of losing 7% of initial weight.5,6 After an average of 2.8 years, participants in the lifestyle intervention lost 5.6 kg in comparison with losses of 2.1 kg and 0.1 kg in the metformin and placebo groups, respectively. The risk in the lifestyle group of developing type 2 diabetes was reduced by 58% in comparison with placebo and by 31% in comparison with metformin.5 Ten years after randomization, lifestyle-treated participants had regained nearly to their baseline weight (with no significant differences in weight loss among groups). …

Language Outcomes of Contextualized and Decontextualized Language Intervention: Results of an Early Efficacy Study

The purpose of this early efficacy study (Fey & Finestack, 2009) was to determine whether a new contextualized language intervention (CLI) or an existing decontextualized language intervention (DLI) resulted in greater changes in children's language and narration in comparison to a no-treatment condition (CON). Sixteen children between the ages of 6;0 (years;months) and 9;0 were randomly assigned to the CLI and DLI groups. Eight similar-age children from the no-treatment phase of a separate study acted as a control group. Children in the CLI and DLI conditions received 50-min group intervention sessions 3 times per week for 6 weeks. Sentence-and discourse-level measures were administered to assess intervention outcomes. Both interventions were associated with statistically significant gains on sentence- and discourse-level measures when compared to a no-treatment condition. Effect size analyses demonstrated that the CLI group outperformed the DLI group on all outcome measures. The results revealed signs of efficacy in an intervention approach in which clinicians treated multiple linguistic targets using meaningful activities with high levels of topic continuity. With some minor revisions, this intervention should be ready to be tested in a larger, more costly, and more internally valid efficacy study.

Attendance at a psychological support group for people with multiple sclerosis and low mood

Purpose: A cognitive behavioural group promoting psychological adjustment for people with multiple sclerosis (MS) was found to reduce psychological distress. Not all those offered treatment attended the group sessions. The aims were to examine the rates of attendance and to evaluate feedback from participants. Method: Participants with MS and low mood were recruited to a randomized trial comparing attendance at a psychological support group with a usual care control group. The attendance at each session was determined and those who attended were compared with those who failed to attend using a Mann–Whitney U-test or chi-squared. A sample of participants completed a telephone feedback questionnaire to determine their views of the group. Results: The 44 participants who attended four or more sessions were not significantly different from the 28 who attended fewer than four sessions on demographic variables, disability, self-efficacy or quality of life, but significantly fewer men attended than women (p = 0.03). Participants’ feedback from the group was mainly positive, and no factors were identified associated with non-attendance. Conclusions: Men were less likely to attend group treatment sessions than women, but no other variables were associated with non-attendance. Attendance rates influence the effectiveness of interventions and reasons for non-attendance need to be determined.Implications for RehabilitationNot all people with multiple sclerosis (MS) and low mood offered psychological support will attend group sessions.Women are more likely to attend psychological support groups for people with MS than men.In clinical practice it may be possible to adjust the membership of groups to increase attendance more than in randomized trials.

Evaluation of an adjustment group forpeople with multiple sclerosis and lowmood: a randomized controlled trial

Background: Mood problems affect many people with multiple sclerosis (MS). The aim was to evaluate the effectiveness of a group treatment based on cognitive behavioural principles. Methods: People with MS were screened on the General Health Questionnaire 12 (GHQ-12) and Hospital Anxiety and Depression Scale (HAD). Those identified with low mood were invited to take part in a randomized trial comparing the effect of attending an adjustment group with a waiting list control. Patients allocated to the adjustment group received six 2 h group treatment sessions. Outcomes were assessed 4 and 8 months after randomization, blind to group allocation. Results: Of the 311 patients identified, 221 (71%) met the criteria for low mood and 151 (68%) agreed to take part. Hierarchical regression analyses were conducted to compare the two groups, correcting for baseline mood and disability. At 4 months, group allocation alone was a significant predictor of the primary outcome measure, the GHQ-12. At 8 months, group allocation alone was no longer a significant predictor for GHQ-12 scores, but it was when baseline GHQ-12 and Guy’s Neurological Disability Scale scores were controlled for. Comparison of the area under the curve revealed significant differences between the groups for GHQ-12 (p = 0.003), HAD Anxiety (p = 0.013), HAD Depression (p = 0.004), Beck Depression Inventory (p = 0.001), MS Self-efficacy (p = 0.037) and MS Impact Scale Psychological (p = 0.012). Conclusion: Patients receiving treatment were less distressed and had less depression and anxiety. There was some evidence of improved self-efficacy and a reduction of the impact of MS on people’s lives.

Individual and group pelvic floor muscle training versus no treatment in female stress urinary incontinence: a randomized controlled pilot study

ObjectiveTo compare the effects of pelvic floor muscle training (PFMT) performed during group treatment sessions (GT) and individual treatment sessions (IT) to a control group (CG) of women with stress urinary incontinence (SUI). HypothesisThe group treatment sessions would have better effects compared to individual treatment sessions. Study designThis randomized controlled pilot study included women aged over 18 years, who complained of urinary leakage on stress and who had not undergone physical therapy for SUI before. Forty-nine women were randomly allocated to the PFMT in group treatment session (GT) (n=17), PFMT in individual treatment session (IT) (n=17) and control group (CG) (n=15). The study was carried out in an outpatient physical therapy department in São Carlos, Brazil. Subjects on intervention groups were treated with the same PFMT protocol for 6 weeks, with two 1-h weekly sessions. The GT group carried out the PFMT in group treatment session and IT group in individual treatment session. The CG did not receive any treatment during the corresponding time. They were evaluated before and after treatment for primary outcome, urinary loss, and secondary outcomes, King's Health Questionnaire, pressure perineometry, pelvic floor muscle strength by digital palpation and subjective satisfaction. Participants, evaluator and the physical therapist were not blinded. Forty-five women completed the study and were included in the analysis. The statistical analysis was performed using Wilcoxon test for intragroup analysis and Kruskal–Wallis and Mann–Whitney test for intergroup analysis (p<0.05). ResultsIn intragroup analysis, there was a significant reduction in urinary loss measured by pad test only in the IT group. For primary outcome, there was a significant difference only after treatment between GT and CG (p<0.0001; effect size −0.91; 95% confidence interval from 0.56 to 5.80) as well as between IT and CG (p<0.0001; effect size −0.90; 95% confidence interval from 0.54 to 5.84). There were differences after treatment in GT and IT groups for secondary outcomes: perineometry, muscle strength and in the domains of the quality of life questionnaire. For the CG group, there were not significant differences in any variables. In intergroup analysis for all variables, there were no differences between GT and IT groups. The two treated groups had similar subjective satisfaction (86%). There were no complaints of adverse effects due to treatment from either group. ConclusionThe results indicated similar improvement in clinical variables and in satisfaction with the treatment between IT and GT.

The Role of Parental Motivation in Family‐Based Treatment for Childhood Obesity

This study investigated the role of parental motivation (importance, confidence and readiness) for predicting dropout and outcome from family-based behavioral treatment for childhood obesity. Parent and child demographics, adherence to treatment, and weight loss parameters were also explored as potential predictors. Eighty-four obese children (BMI-standard deviation scores (SDS) >2.14) and a participating parent with each child started treatment consisting of 12 weeks of group and individual treatment sessions (24 sessions total) delivered over a period of 18 weeks. Sixty-one families (73%) completed treatment and attended follow-up at 1 year after treatment. Child session attendance and completion of self-monitoring records served as measures of adherence. In regression analyses, parent reports (pretreatment) of confidence for doing well in treatment was the strongest predictor of treatment completion (P = 0.003) as well as early treatment response (weight loss at week 5) (P = 0.003). This variable remained a significant predictor of child weight loss at post-treatment (P = 0.014), but was not associated with child outcome at 1-year follow-up (P > 0.05). The only significant predictor of child weight loss at that point was child baseline weight (P = 0.001). However, pretreatment parent ratings of importance of and readiness for treatment did not predict dropout or weight loss at any point. The results underscore the importance of addressing parental motivation, specifically parental confidence for changing lifestyle related behaviors, early in the treatment process. Doing so may reduce treatment dropout and enhance treatment outcome.

Evaluating Culturally Responsive Group Work with Black Women

Purpose: This study examined the efficacy of a culturally congruent group treatment model, entitled “Claiming Your Connections” (CYC) aimed at reducing depressive symptoms and perceived stress, and enhancing psychosocial competence (i.e., locus of control and active coping) among Black women. Method: A total of 58 Black women recruited from health and human service community-based organizations were randomly assigned to either the CYC intervention or a wait-list control group. Women in the CYC program attended weekly group intervention sessions over a 10-week period, and the wait-list control group did not receive any treatment for the same duration. Results: At pretreatment both groups indicated moderate levels of depressive symptoms, perceived stress, and psychosocial competence. After the intervention, the CYC group reported a significant reduction in depressive symptoms and perceived stress. There was no statistically significant change on these variables for the control group. Implications: Results suggest that the CYC group intervention program is effective with Black women who report having difficulty managing stressors of daily life.

‘Pain on Top of Pain, Hurtness on Top of Hurtness’: Social Discrimination, Psychological Well-Being, and Sexual Risk Among Women Living With HIV/AIDS

ABSTRACT This qualitative study explored how a subsample (n = 26) of participants in Protect and Respect (N = 184), a safer-sex intervention for women living with HIV/AIDS (WLH/A), discussed their experiences of social discrimination and the impact of discrimination on their lives, psychological well-being, and risk behaviors during group intervention sessions. The majority of participants was Black (83%), earned less than $10,000 per year (80%), and acquired HIV through heterosexual sex (58%). Analyses demonstrated that social discrimination manifested in the women's lives as poverty, HIV/AIDS-related stigma, and gender inequality. These experiences caused intense psychological distress and limited WLH/A's ability to implement the safer-sex skills that they learned during the intervention. We discuss the applied and theoretical implications of our findings, advocating for HIV and sexual risk-reduction interventions that are based on an ecological framework that addresses holistically the individual, relational, and sociostructural factors that affect women's sexual risk behaviors.

The mindfulness-based relapse prevention adherence and competence scale: Development, interrater reliability, and validity

The present study describes the development of the Mindfulness-Based Relapse Prevention Adherence and Competence Scale (MBRP-AC), a measure of treatment integrity for mindfulness-based relapse prevention (MBRP). MBRP is a newly developed treatment integrating core aspects of relapse prevention with mindfulness practices. The MBRP-AC was developed in the context of a randomized controlled trial (RCT) of MBRP efficacy and consists of two sections: Adherence (adherence to individual components of MBRP and discussion of key concepts) and Competence (ratings of therapist style/approach and performance). Audio recordings from 44 randomly selected group treatment sessions (50%) were rated by independent raters for therapist adherence and competence in the RCT. Findings evinced high interrater reliability for all treatment adherence and competence ratings, and adequate internal consistency for Therapist Style/Approach and Therapist Performance summary scales. Ratings on the MBRP-AC suggested that therapists in the recent RCT adhered to protocol, discussed key concepts in each session, and demonstrated the intended style and competence in treatment delivery. Finally, overall ratings on the Adherence section were positively related to changes in mindfulness over the course of the treatment.

Self-development groups reduce medical school stress: a controlled intervention study

BackgroundHigh stress levels and mental health problems are common among medical students and there is a lack of studies on group interventions that aim to reduce such distress during medical school.MethodsA full class of students (n = 129) participated in group sessions during their third year of medical school in Bergen, Norway. The subsequent third-year class (n = 152) acted as control group, in order to create a quasi-experimental design. Two types of group intervention sessions were offered to the first class. One option was self-development groups led by trained group psychotherapists. Alternatively, students could choose discussion groups that focused on themes of special relevance to doctors, led by experienced general practitioners. The intervention comprised of 12 weekly group sessions each lasting 90 minutes. Data were gathered before the intervention (T1), and three months post intervention (T2). Distress was measured using the Perceived Medical School Stress (PMSS) and Symptom Check List-5 (SCL-5) assessments.ResultsThe intervention group showed a significant reduction in PMSS over the observation period. The subsequent year control group stayed on the same PMSS levels over the similar period. The intervention was a significant predictor of PMSS reduction in a multiple regression analysis adjusted for age and sex, β = -1.93 (-3.47 to -0.38), P = 0.02. When we analysed the effects of self-development and discussion groups with the control group as reference, self-development group was the only significant predictor of PMSS reduction, β = -2.18 (-4.03 to -0.33), P = 0.02. There was no interaction with gender in our analysis. This implicates no significant difference between men and women concerning the effect of the self-development group. There was no reduction in general mental distress (SCL-5) over this period.ConclusionA three-month follow-up showed that the intervention had a positive effect on perceived medical school stress among the students, and further analyses showed this was due to participation in self-development groups.