Integrated Group Therapy Research Articles

Hope for all? Investigating the moderating effect of social inhibition on the association between hope and outcome in an integrative group therapy program.

Existing research supports the therapeutic value of hope in different therapies and for diverse patient groups. Patients who are socially inhibited tend to have a particularly difficult time in group therapy, and the experience of hope in that context may be especially poignant for them. The present study investigated the impact of hope on the outcome of a group-based treatment and whether this impact differed for patients depending on their level of social inhibition. The sample consisted of 49 consecutively admitted patients who completed treatment in an intensive, integrative group therapy program. Patients completed four self-report measures to assess hope, social inhibition, quality of life, and depression. Regression with moderation analysis was employed. The analyses revealed that social inhibition significantly moderated the impact of hope on treatment outcome, indicating that hope had a more pronounced effect among those patients with relatively higher levels of social inhibition.

Integrative group psychotherapy for patients with somatic symptom disorder: A randomized controlled trial

Integrative group psychotherapy for patients with somatic symptom disorder: A randomized controlled trial

Spiritually Integrated Group Psychotherapy for First Responders: Forgiveness, Trauma, and Alcohol Use

ABSTRACT First responders (e.g. firefighters, law enforcement, paramedics, corrections officers) experience high rates of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Despite the relevance of both spirituality and forgiveness to PTSD and AUD among first responders, spiritually integrated group interventions for this population are rare. This article discusses a forgiveness session of a spiritually integrated group psychotherapy protocol for first responders (SPIRIT-FR) in acute psychiatric care. This brief group psychotherapy intervention includes (a) psychoeducation about the intersection of PTSD, AUD, and forgiveness (b) discussion of the relevance of forgiveness to PTSD and AUD, and (c) the integration of spiritual beliefs and behaviors to move toward forgiveness. We discuss relevant clinical theory as well as the potential clinical application of this protocol.

The Use of Psychotherapy for Refractory Irritable Bowel Syndrome: A Systematic Review.

Irritable bowel syndrome (IBS) is a common yet debilitating and chronic condition that consists of disturbances in bowel habits and abdominal pain that is frequently relieved with defecation. While the first line of treatment for IBS is pharmacological treatment, this has been shown to fail, leading to the patient being classified as having refractory IBS. The quality of life (QOL) of these patients is greatly hindered; in this case, there are rarely moments of relief. Additional modalities of treatment have been employed in classical cases of IBS, such as psychotherapy, and research has started to evaluate its effectiveness with refractory IBS. Both cognitive behavioral therapy (CBT) and gut-directed hypnotherapy (GDH) are effective in treating classical IBS as they restructure and bring a state of meditation to the patient, allowing them to work through the symptoms. The question is whether it remains successful in refractory cases. This systematic review was conducted with strict adherence to PRISMA guidelines with an initial inquiry resulting in 28,978 publications through PubMed, ScienceDirect, and ProQuest databases. Through automatic and manual screening processes, articles that were peer-reviewed experimental or observation publications done between 2003 and 2023 were included in this study, resulting in 21 publications. Across all studies evaluating CBT, it was consistently found to be successful in improving symptom severity and frequency, QOL, and extracolonic symptoms such as anxiety and depression. When broken down into delivery methods, minimal contact CBT was found to be just as, if not superior, to standard contact. Within this, telephone-delivered CBT was superior to web-delivered CBT. GDH and biofeedback therapy were found to also significantly improve all domains of IBS with no difference between them. Acceptance and commitment therapy were found only to improve associated symptoms. However, there was no significant improvement in their QOL, whereas integrative group therapy found no significant improvement in any domain. Because IBS is so common and crippling to those affected, its crucial to continuously improve QOL through advancement in treatment modalities. Further research should focus more on other modes of therapy as success has been shown in standard therapeutic techniques.

Effectiveness of online integrative trans-diagnostic treatment on internet addiction and high-risk behaviors in female adolescents with borderline personality disorder with comorbid depressive disorder.

Based on research, borderline personality disorder is associated with many behavioral and emotional problems, including Internet addiction and high-risk behaviors. On the other hand, integrative trans-diagnostic treatment, by targeting trans-diagnostic factors in emotional pathology, is considered a suitable treatment for comorbid psychological pathologies. Also, since in adolescence, the opinion of others about oneself is more important, online therapy has the advantage of protecting them from the fear of stigma and shame in the face of others' judgments. Therefore, the aim of the current research was to investigate the effectiveness of online integrative trans-diagnostic treatment on the internet addiction and high-risk behaviors in adolescents with borderline personality disorder. The current research was applied and quasi-experimental in a pre-test-post-test manner with a control group. The research sample included 40 female adolescents with borderline personality disorder who were randomly divided into two groups of 20 people, experimental and control groups. The criteria for entering the research included the age range of 12 to 18 years, female, confirmation of the disease by a psychologist, not receiving other psychological treatments in the last 3 months, and having a smartphone to participate in the online group. Substance abuse, any serious mental and physical illness/disorder that interferes with treatment, and failure to attend more than two sessions in therapy sessions were some of the exclusion criteria.The participants were tested on the scales of internet addiction and high-risk behaviors. Then, the treatment plan based on online integrative trans-diagnostic group therapy was presented to the participants of the experimental group online in 9 two-hour sessions. The control group was placed on the waiting list until the completion of the treatment sessions and the post-test implementation, and after the post-test implementation, they received the treatment. Then, their scores were measured, after completing the treatment, and a three-month follow-up period. Descriptive statistics and covariance test were used to analyze the data. Patients showed a clear improvement in the severity of internet addiction and high-risk behavior symptoms. So that the scores of internet addiction and high-risk behaviors in the experimental group after receiving the treatment, as well as after a three-month follow-up period, were significantly reduced (p < 0.001). These results show that online integrative trans-diagnostic therapy can be an effective treatment option for reducing some symptoms of risky behaviors and internet addiction in adolescents with borderline personality disorder and should be studied further. It is noteworthy that the limitations of this study were the available sampling method, the use of a unisex sample of female patients, and the short-term follow-up period, which makes it difficult to generalize the results.

Integrative group psychotherapy for patients with somatic symptom disorder: A randomized controlled trial

The study aimed to determine whether specific integrative group psychotherapy (IGPT), based on CBT, combined with techniques of psychodynamic therapy and mindful body and emotional awareness is more effective than non-specific supportive group psychotherapy (SGPT) and treatment as usual (TAU) alone. A total of 120 SSD patients were randomly assigned to IGPT, SGPT or TAU groups. Both IGPT and SGPT showed significantly lower SSD-12 scores at the 4, 8, and 12-week follow-ups compared to TAU. No significant differences were observed between IGPT and SGPT at any follow-up point. These findings highlight the potential benefits of group psychotherapy in SSD treatment.

Somatic symptom distress and gender moderate the effect of integrative group psychotherapy for functional vertigo on vertigo handicap: A moderation analysis of a randomised controlled trial

ObjectivePsychotherapeutic treatments for functional vertigo have shown promising results in recent years but it is still to be determined for whom these treatments work best. The aim of this study was to run a moderation analysis to identify which baseline factors may moderate the success of integrative psychotherapeutic group treatment (IPGT) as compared to a self-help group (SHG) active control. MethodsData from 159 patients included in a 16-week randomised controlled trial were analysed. The outcome was vertigo-related handicap at post-treatment and gender, age, baseline somatisation, depression and anxiety were taken as putative moderators. ResultsWe found that baseline somatic symptoms (i.e. PHQ-15 score, p = 0.04, ∆R2 = 0.02) and gender (p = 0.04, ∆R2 = 0.02) significantly moderated the effect of treatment type on post-treatment vertigo handicap. Patients with higher PHQ-15 scores at baseline and women reduced their vertigo handicap more in IPGT as compared to in the control condition. ConclusionA possible explanation for this result is that somatic symptom distress is the central aetiopathogenetic factor of functional vertigo, while depressiveness and anxiety are rather epiphenomena in the sense of comorbidity. Although the results are not entirely consistent, according to some studies, female gender seems to be a favourable predictor of better therapy outcome. Given the high impairment and healthcare costs in those with vertigo/dizziness and psychiatric comorbidity, it is important to effectively treat these patients as early as possible. This study provides a prescriptive tool for practitioners, allowing for more patient-tailored treatment decisions.

New Progress in Eye Movement Desensitization Reprocessing Integrated Group Therapy

New Progress in Eye Movement Desensitization Reprocessing Integrated Group Therapy

The Effectiveness of Integrated Group Therapy on Prolonged Grief Disorder of Bereaved People from COVID-19 Randomized Controlled Trial.

This study aimed to evaluate the integrated cognitive-behavioral group therapy and Gestalt empty chair technique on bereaved individuals with COVID-19-caused PGD (prolonged grief disease). Thirty-six patients with PGD resultant from COVID-19 were randomly assigned intervention and control groups. The intervention group underwent 16 90-minute integrated group therapy sessions twice a week. Both groups completed the BDI II depression, NAI anger, and GASP guilt scale before, after, and 2months after the study's conclusion. The intervention and control groups significantly differed in the depression, anger, and guilt indices after the therapeutic intervention (p < .001). This difference remained in the follow-up phase. Integrated group therapy in treating could help with some of the symptoms of PGD resulting from the corona-caused loss of loved ones. This reduction in symptoms was also stable over time.

Integrating Spirituality in Group Psychotherapy with First Responders: Addressing Trauma and Substance Misuse

First responders (e.g., fire fighters, law enforcement, paramedics, corrections officers) are at disproportionately high risk of experiencing posttraumatic stress and engaging in substance misuse. Spirituality is a potential source of resilience and recovery in the context of trauma and substance misuse; however, evidence-based clinical protocols integrating spirituality into group psychotherapy with first responders are rare. This article describes the adaptation of an existing and previously examined spiritually integrated group psychotherapy clinical protocol to address substance misuse among first responders with posttraumatic stress. This brief (90-min) and stand-alone group psychotherapy intervention includes (a) psychoeducation about the co-occurrence of trauma syndromes and substance misuse among first responders, (b) discussion of the relevance of spirituality to both posttraumatic stress and substance misuse, and (c) the integration of spiritual beliefs and behaviors to cope with symptoms related to trauma exposures and substance misuse. We discuss relevant clinical theory behind the development of this intervention as well as the potential clinical application of this protocol.

Effects of an Integrated Treatment Program on Grief and Distress Among Parentally Bereaved Young Adults.

This study examined the effectiveness of an 18-session manualized integrative group psychotherapy intervention for parentally bereaved young adults with grief complications. Participants, 63 young adults aged 20-27years, completed questionnaires assessing symptoms of prolonged grief, PTSD, depression and anxiety prior to and following treatment. Treatment effectiveness was assessed by comparing outcomes for the intervention group to a waitlist comparison group. Results revealed a statistically significant reduction in symptoms of grief (large effects size), PTSD (medium effect sizes), and depression (medium effect size). The treatment did not result in a significant reduction in anxiety symptoms. The study provided preliminary support for this intervention for parentally bereaved young adults.

Integrative Group Psychotherapy for Patients with Somatic Symptom Disorder in China: A Randomized Controlled Trial

Integrative Group Psychotherapy for Patients with Somatic Symptom Disorder in China: A Randomized Controlled Trial

A qualitative analysis of sacred moments in religiously integrated group therapy

ABSTRACT The aim of this study was to qualitatively explore sacred moments in religiously integrated group therapy for Danish Pentecostals who were experiencing a personal crisis (n = 18). This was a follow-up study based on data from 2009 and 2018. An interpretative phenomenological analytical approach was used to generate and analyze the data material. Three themes emerged: 1) Relationship with God, 2) Relationship with therapist, and 3) Relationship with group members. The participants’ experiences of sacred moments in these relationships were primarily facilitated by a strong therapeutic alliance, trust in the therapist, and therapeutic exercises. The study indicates that trust may be a prerequisite to clients’ experience of spiritual qualities in therapy. The interrelationships in group settings can facilitate sacred moments if led by a spiritually legitimated and trustful therapist. Our findings emphasise the value of working therapeutically with sacred relational aspects in psychotherapy in highly secularised countries as Denmark.

Predictors of Patients' Responses to Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT).

Spiritual Psychotherapy for Inpatient, Residential, and Intensive Treatment (SPIRIT) is a flexible clinical protocol for delivering spiritually integrated group psychotherapy within acute psychiatric settings. The authors evaluated SPIRIT's feasibility by examining patients' perceptions of its benefits and clinical and spiritual predictors of observed effects associated with this intervention. Over a 1-year period, 22 clinicians stationed on 10 clinical units provided SPIRIT to 1,443 self-referred patients with a broad range of demographic, clinical, and spiritual and religious characteristics. Overall, patients' perceptions of benefit from SPIRIT were not associated with demographic factors. Clinical factors similarly did not predict treatment responses, suggesting that SPIRIT is equally suitable for patients with mood, anxiety, traumatic, substance use, psychotic, feeding or eating, or personality disorders and for patients with high levels of acuity. Patients with high levels of religious belief responded better to treatment, but patients with low levels of spiritual and religious identity also reported significant benefits. Patients responded better to SPIRIT when it was delivered by clinicians who reported not being affiliated with a religion than did patients receiving the SPIRIT intervention through clinicians who reported a religious affiliation. Results indicate that SPIRIT is feasible in providing spiritually integrated treatment to diverse patients across multiple levels of acute psychiatric care.

Addressing negative psychosocial factors linked to severe injury in professional rugby players: An introduction to a group psychotherapy approach.

Negative psychosocial sequelae of severe rugby injury (SRI) in professional rugby players are well documented. Unaddressed, these issues can leave players vulnerable to persistent common mental disorders (CMD) and negatively affect injury recovery processes. To introduce a psychotherapeutic group intervention aimed at addressing negative psychosocial sequelae linked to SRI in professional rugby player cohorts. Literature aimed at clarifying the potential efficacy of an integrative group therapy model, the Recovery Mastery Group (RMG), is discussed after which component parts of the intervention are presented. A case illustration is presented comprising examples of how the RMG framework addressed psychosocial recovery issues in a professional South African rugby team during 2019. The proposed Recovery Mastery Group (RMG) is presented as a cost- and time- effective psychotherapeutic intervention that integrates well-researched psychotherapeutic techniques. The RMG appears able to address multiple facets of psychosocial injury recovery, while possibly offering protection from the onset of CMD. This introduction to the RMG can be a forerunner of similar research across larger cohorts, in different team sports, to determine wider therapeutic intervention efficacy.

Take me back to move me forward: Re-enactment of the family system as a pathway to better quality of life for alexithymic patients in group therapy.

Despite much attention in the clinical literature, research on alexithymia in the treatment setting has only recently gained traction. While several reports indicate limited benefit from therapy amongst patients with high alexithymia, this seems to be less so in the context of group therapy. This study considers a specific aspect of the group therapy process - family re-enactment - in facilitating improvement in overall quality of life for patients with high levels of alexithymia. Family re-enactment was examined as a potential mediator of the relationship between alexithymia and change in quality of life among 50 patients who completed treatment in an intensive, integrative group therapy programme. Patients completed three self-report measures: Toronto Alexithymia Scale-20 (baseline), Quality of Life Inventory (baseline, post-therapy), and Therapeutic Factors Inventory-Short Form (week 8). Regression with mediation analysis was employed using the change score for the QOLI as the dependent variable, alexithymia scores as the independent variable, and the family re-enactment score as the mediator; baseline quality of life was included in the model as a control variable. Family re-enactment emerged as a significant mediator of the relationship between alexithymia and treatment outcome, implicating it as a contributing mechanism of change for alexithymic patients who participate in group therapy. Patients with higher levels of alexithymia (in particular, difficulty identifying and describing feelings) were more likely to positively endorse aspects of family re-enactment during group therapy, which in turn were significantly associated with greater improvement in patients' overall quality of life.

Improving self-esteem through integrative group therapy for personality dysfunction: Investigating the role of the therapeutic alliance and quality of object relations.

We aimed to investigate change in self-esteem through intensive group treatment for personality dysfunction, by exploring: (a) the relationship between patients' experience of therapeutic alliance and improvement in self-esteem during treatment, including patients' quality of object-relations (QOR) as a possible moderator; and (b) the association between improvement in self-esteem during treatment, and depressive symptoms 9 months later. Eighty patients with personality dysfunction, consecutively enrolled in a group-oriented treatment program, were assessed at pretreatment, posttreatment, and 9 months follow-up. Especially for patients with lower QOR, alliance predicted self-esteem change during treatment. In addition, change in self-esteem during treatment predicted follow-up depression severity, even when controlling for within-treatment symptom change. Patients with impoverished inner relational representations may benefit more from a secure alliance in terms of improving their self-esteem. Change in self-esteem may also be important in preventing relapse of depressive symptoms in people with personality dysfunction.

Change of postural control in patients with vertigo and dizziness symptoms after integrative group psychotherapy

Change of postural control in patients with vertigo and dizziness symptoms after integrative group psychotherapy

Reactance and engagement in integrative group psychotherapy for personality dysfunction.

Reactance and engagement in integrative group psychotherapy for personality dysfunction.

Integrated Group Psychotherapy Program [IGPP] for Multi-Diagnosed Clients

ABSTRACTThis article describes a group therapy–centered program geared toward the treatment of individuals with co-occurring disorders, including addictive disorders, borderline personality disorder and other mental health issues which involve difficulties with emotion regulation. Group therapy plays a vital role in their recovery. Over 18 years, the author has developed a treatment model that offers an integrative approach to group therapy and individual treatment encompassing psychodynamic and other empirically based therapies, especially dialectical behavior therapy (DBT). Its value lies in its therapeutic effectiveness with hard to reach clients, in its practice-based evidence, its team-building and management approach, its training component and its capacity for replication.