Psychoeducational Group Intervention Research Articles

Using evidence-based psychotherapy to tailor treatment for patients with functional neurological disorders.

Functional neurological disorder (FND) frequently presents with comorbid psychopathology (e.g., anxiety, depressive, post-traumatic stress disorders (PTSD), somatic symptom and pain syndromes, and dissociative and personality disorders). It can become chronic and lead to unemployment and disability for many patients. Psychosocial factors play an important role in the onset and perpetuation of symptoms. Consequently, psychotherapy is recommended for the treatment of FND in general, and especially for the single symptom-based subtype of functional seizures (FS). Some of the psychotherapy approaches that have been utilized for FND include cognitive-behavioral therapy (CBT), third wave approaches, and psychodynamic psychotherapies as well as group therapeutic and psychoeducational interventions. For patients with FS and PTSD, prolonged exposure therapy, a CBT-based treatment has been implemented. The purpose of this manuscript is to describe and analyze specific elements (e.g., theoretical foundations, tools, targets, definitions of success) of the main psychotherapeutic approaches used in patients with FND. Our premise is that these modalities will overlap considerably in some respects. We will conclude by discussing how discrete differences may render them more suitable for subgroups of patients with FND or for patients at different timepoints of their recovery process.

Supporting Female Survivors of Gender-Based Violence Experiencing Homelessness: Outcomes of a Health Promotion Psychoeducation Group Intervention.

Homelessness is an important risk factor for gender-based violence (GBV), particularly among youth, and disproportionally affects women and girls. Survivors of GBV experience enduring and severe physical, psychological, and sexual health problems. Although key elements in service delivery for survivors of GBV have been identified, little is known about outcomes of community-based programs aiming to assist homeless and unstably housed youth experiencing GBV. This longitudinal study aimed to quantitatively evaluate changes in mental health and well-being outcomes in female identified youth experiencing GBV and homelessness, 12 months after enrolment in a community-based, trauma-informed, brief group psychoeducation intervention. Standardized survey measures were administered at baseline, 6 and 12 months for 70 participants, recruited between February 2017 and April 2019, assessing quality of life, psychological distress, traumatic symptoms, substance use, resilience, victimization, and sense of mastery. Linear mixed models were used to examine longitudinal changes in quality of life as well as secondary outcomes among study participants. After 12 months, quality of life increased significantly among participants (p = 0.009), and the 12-month victimization score was significantly decreased relative to baseline (p = 0.05). Changes in other outcomes were not statistically significant. Findings suggest that community-based brief group psychoeducation interventions may be a promising approach to improving outcomes for this disadvantaged population.

A Pilot Study of a Psychoeducational Group Intervention Delivered at Asylum Accommodation Centers-A Mixed Methods Approach.

Asylum seekers suffer high levels of distress but have restricted access to mental health care. This paper constitutes an evaluation of a psycho-educational group intervention, called AMIN, which was provided at two asylum accommodation centers in Sweden. A mixed-methods approach was used. To assess potential effectiveness, acceptability, and feasibility, quantitative outcome measures were combined with qualitative information from interviews with both intervention participants and staff providing the intervention. Potential effectiveness in reducing symptoms of distress and insomnia and in increasing physical quality of life was found, even though the intervention participants suffered from more severe distress than expected. In general, the intervention seemed to be acceptable to both participants and staff, with concrete strategies seeming more meaningful than abstract psychological techniques. Finally, regardless of the asylum process itself being a complicating factor, the intervention seemed feasible to deliver to individuals with different backgrounds and conditions. Taken together, these results indicate that some sessions may need further elaboration, but also that the transition to a randomized control trial is reasonable.

Feasibility of a psychoeducational group intervention to improve parental reflective functioning and bonding in pregnancy: a randomised trial

ABSTRACT Objective To develop and evaluate Baby CHAT, a single-session psychoeducational intervention for expectant parents. Baby CHAT aims to improve parental reflective functioning (RF) and bonding. Background The early years of a child’s life, including pregnancy, are vital for healthy physical and emotional development. Caregivers who provide responsive parenting, enhanced through strong bonds and good RF, can aid healthy development.. However, limited interventions exist to enhance RF and bonding in expectant parents. Methods Feasibility of Baby CHAT was assessed using a mixed methods randomised controlled trial design. It evaluated uptake and retention of participants, effect size calculations, and acceptability and satisfaction with Baby CHAT. Results Participants (N = 20) were aged 30–39 years (n = 17) in their third trimester of pregnancy (n = 12). Nine males and 11 females were recruited. Content analysis of qualitative feedback after the intervention resulted in four themes; positive group aspects, group improvements, 4D scan footage and relating content to my baby. Conclusions Baby CHAT can help expectant parents think about their baby as a separate person and has potential to improve prenatal RF and bonding. However, further research is required to assess the effectiveness of Baby CHAT to improve bonding and RF.

Optimising Psychoeducation for Transient Ischaemic Attack and Minor Stroke Management (OPTIMISM): Protocol for a feasibility randomised controlled trial

Background: A transient ischaemic attack (TIA) and minor stroke are medical emergencies and often a warning sign of future strokes if remain untreated. Few studies have investigated the long-term psychosocial effects of TIA and minor stroke. Secondary prevention and medical management are often the primary focus with limited access offered for further psychosocial support. Psychoeducational interventions can provide education and advice to people with physical health conditions and, with suitable tailoring, could be appropriate for people after TIA and minor stroke. This study aims to develop a group psychoeducational intervention for people after TIA and minor stroke and to test whether it is acceptable and feasible. Methods: This mixed-methodology study involves two phases: Phase 1) A qualitative study to determine the content of a suitable intervention; Phase 2) A single-centre feasibility randomised controlled trial to evaluate the acceptability of this intervention. The overall study has ethical approval. Stroke survivors have been involved in designing and monitoring the trial. The aim is to recruit 30-40 participants from a Stroke/TIA Service, within 6 months following their diagnosis. Participants will be randomly allocated to either the usual care control group or the intervention group (psychoeducational programme). The programme will consist of six group sessions based on providing education, psychological and social support. The primary outcomes will relate to the feasibility aims of the study. Outcomes will be collected at 3 and 6 months to assess mood, quality of life, knowledge and satisfaction, and resource use. Discussion: There is a need to develop and evaluate effective interventions that enhance the education provided to people after TIA and minor stroke and to promote their psychosocial wellbeing. Findings will indicate the acceptability of the intervention and parameters needed to conduct a definitive trial. Registration: ClinicalTrials.gov ID NCT02550392; registered on 15 September 2015; status: completed.

Is cultural adaptation needed beyond using Christian-accommodated reach forgiveness psychoeducational group intervention in Ghana? An efficacy study comparing a Christian-accommodated version against a version accommodated by Christian and cultural adaptations.

Is cultural adaptation needed beyond using Christian-accommodated reach forgiveness psychoeducational group intervention in Ghana? An efficacy study comparing a Christian-accommodated version against a version accommodated by Christian and cultural adaptations.

Couples coping with cancer together: Successful implementation of a caregiver program as standard of care.

The couples coping with cancer together program (CCCT) is used to illustrate practical strategies to implement, evaluate, and grow a successful couples-based program in an NCI-designated CCC. CCCT is multimodal program utilizing psychoeducational, strategic, strengths-based, and problem-solving theoretical frameworks. CCCT integrates multiple intervention modalities, as the standard of care: patients/partners biopsychosocial screening, a standardized psychoeducational session, group intervention, and short-term couples counseling. Implementation strategies included: (a) identifying Values-Benefits-Outcomes for key stakeholders, (b) recruiting an interdisciplinary team, (c) utilizing a concurrent development model (implementing program components in small iterations), (d) integrating program into existing institutional processes, and (e) collecting data and credibility. CCCT prospectively screened 1995 patients/partners simultaneously for biopsychosocial distress and 913 patient/partner completed program evaluations. Program satisfaction was extremely high: "I recommend this program, for other patients/partners (Patients 95.4% Partners 96.4%)." Ten of the 11 participating physicians anonymously surveyed responded and indicated 100% likely/very likely "to recommend the program to other physicians." Couples-based programs are underutilized and have been shown to be important for adjustment and increased longevity. Despite barriers in the healthcare environment, implementing couples-based programs into standard of care are feasible. These strategies may be applicable to develop supportive care programs in various health-care settings.

Therapeutic factors during a psychoeducational group intervention aiming to promote school adjustment in first grade students

The present study examined the therapeutic factors operating during a psychoeducational group intervention designed to promote school adjustment in first-grade students. The group members completed the Critical Incidents Questionnaire at home after every group session. The therapeutic factors were classified according to Bloch, Reibstein, Crouch, Holroyd, and Themen’s taxonomy, although additional categories of critical incidents were applied. Results showed that guidance and acceptance were the most valued therapeutic factors. Cognitive factors were reported more often than behavioral or emotional ones. In addition, the presence of the therapeutic factors was more intense during the beginning and middle stage of the program, gradually giving their place to other categories of critical incidents. Overall, the emergence of therapeutic factors appears to be affected by the program’s educational aspect. We suggest that a wider classification of factors is required to reflect the variety of critical incidents occurring during a psychoeducational group intervention.

Efficacy of a Short Psychoeducational Group Intervention for the Prevention of Cardiovascular Risk in Patients With Severe Mental Disorder: A Randomized Trial.

Psychoeducational interventions to improve healthy habits regarding cardiovascular risk (CVR) in people with a severe mental disorder showed scarce results in the literature. In this article, we showed the results of a randomized clinical trial including 80 adult outpatients (mainly psychosis spectrum) with moderate to very high CVR. A short-term psychoeducational group intervention to improve healthy habits regarding CVR was added to their as-usual individual psychoeducational schedule. With an intention-to-treat analysis, we expected improvements in the different parameters. Baseline and 1-year follow-up included CVR factors and indexes (REGICOR, SCORE, and DORICA). Basal characteristics did not show statistically significant differences between the groups. No significant improvements in any of the variables studied were observed in the intervention enriched group compared with the control individual group. Compliance with the sessions was scarce. The satisfaction with the intervention and the acquisition of knowledge were adequate. Moreover, the benefits of both interventions were weak.

Does forgiving in a collectivistic culture affect only decisions to forgive and not emotions? REACH forgiveness collectivistic in Indonesia

According to some theorising, in collectivistic societies, forgiveness is mainly enacted to maintain relationships, not engender emotional transformation. This present study was designed to explore whether forgiveness affects decisional and emotional forgiveness in Indonesia, a country categorised as collectivistic. The evidence-based REACH Forgiveness psychoeducational group intervention was adapted to collectivistic culture (REACH forgiveness collectivistic; REACH-FC), and its efficacy was assessed in a randomised controlled trial. Undergraduates in Indonesia (N=97; 24 male; 73 female; ages 16-21) were randomly assigned within a 2 × 3(S) quasi-experimental repeated-measures design comparing immediate treatment (IT) and waiting list (WL) conditions [Condition (IT, WL) × Time ([S] 3 time points). Harmonious value, a personality variable assessing the strength of participants' desire for group harmony, was the covariate. The condition × time (S) interactions for both decisional and emotional forgiveness were significant, challenging some previous literature. Clearly, not all forms of collectivism have similar effects when individuals and communities deal with transgressions.

A Randomized Controlled Study of a Psychoeducation Group Intervention for Patients With Borderline Personality Disorder

The objective of this study was to assess the impact of a 6-session psychoeducational group (PEG) intervention for borderline personality disorder (BPD) in an underserved community-based outpatient setting. The study was conducted between July 2015 and January 2017. Of 96 outpatients who met DSM-IV criteria for BPD, the first 48 received the experimental treatment, whereas the next 48 were assigned to a wait list. All received non-intensive treatment as usual. The primary outcome measure, the Zanarini Rating Scale for DSM-IV Borderline Personality Disorder (ZAN-BPD), was administered at baseline, at the end of treatment, and 2 months after the end of treatment. The PEG intervention was associated with a significant improvement on all sectors of BPD (P < .001). Improvements were greater for the PEG on all sectors except impulsivity. Benefits remained stable during 2-month follow-up. The PEG intervention had a large effect size (Cohen d = -1.16), whereas the wait list effect size was small (Cohen d = -0.18). The between-arms effect size was 0.80 after treatment and 0.90 at follow-up. With full response defined as a decrease of ≥ 50% from baseline in ZAN-BPD total score, 22 patients (46%) in the psychoeducation group and 3 (6%) in the wait list group were considered full responders. This study shows that a PEG intervention can be an effective treatment for patients with BPD. The overall cost benefits of group interventions and the the applicability of a PEG intervention to underserved patients demonstrate its potential to address significant public health needs.

Role of Executive Function in Response to a Problem Solving Based Psychoeducational Intervention in Adolescents with Psychosis: The PIENSA Trial Revisited.

An improvement in negative symptoms and a reduction in the number of visits to the emergency department have been reported in a problem solving based psychoeducational group intervention (PE) for adolescents with psychosis relative to a nonstructured group (NS). One of the factors that may play a role on the response to PE treatment is executive function (EF), a crucial cognitive domain for problem-solving performance. We aimed to examine the role of EF in response to PE treatment versus an NS group. We examined the associations between changes in cognition and in clinical/functional variables within each treatment group using Spearman-ranked and partial correlation analyses. A total of 22 individuals (mean age: 16.3) were randomized to PE (N = 10) and NS (N = 12). We found an association between improvements in EF performance and a reduction in positive symptoms (rs = –0.756, p = 0.030 for semantic fluency), reduction in negative symptoms (r = 0.758, p = 0.029 for semantic; rs = –0,733, p = 0.025 for verbal fluency), and reduction in the number of visits to the emergency department (r = –0,743, p = 0.035 for semantic fluency) in the PE group. No associations were found in the NS group. Our results suggest that EF may play a role in the specific improvements observed in the PE group. This may have implications in the development of new areas of clinical intervention focusing on the role of cognitive functioning in response to psychosocial treatments in psychosis.

A Group Treatment for Displaced Survivors of Persecution: A Reflective Account Through a Psychosocial Lens

Millions of displaced survivors of persecution are navigating the impacts of both human rights violations and being forced to flee their homes, communities and nations. Their broad, pervasive, and complex psychosocial needs can develop into chronic and severe issues if they are not addressed. There is limited literature on clinical interventions and approaches that have a primary goal of promoting psychosocial health of displaced survivors of targeted persecution. The Orientation Group, developed by the Bellevue/NYU Program for Survivors of Torture in New York City, is one brief psychoeducational and skills-based group intervention aiming to support the psychosocial wellbeing of displaced survivors of torture, political oppression and other forms of persecution. Although not yet empirically studied, this group intervention has more than a decade of anecdotal support. This paper provides a reflective account of the Orientation Group and offers recommendations for enhancing the intervention.

Promoting the Resiliency of African American Teens Experiencing Ambiguous Loss

ABSTRACTA disproportionate number of African American youth experience childhood adversity and situations of loss, including parental incarceration and divorce, while navigating racial discrimination. Ambiguous loss theory offers a conceptual framework to understand these experiences as losses of relationships, stability, and social validation due to parental behaviors. Theoretically and culturally informed interventions are needed to help adolescents cope with ambiguous loss. This article describes a psychoeducational group intervention for female African American adolescents experiencing ambiguous loss that aims to promote resilience and coping rather than promote closure following loss.

Pre-treatment Class Attendance and Outcomes in Head & Neck Cancer Patients Undergoing Radiation

The pre-treatment (“Prehab”) class at our center is a psychoeducational group intervention offered to all patients starting radiotherapy for head & neck cancers (HNC). It focuses on symptom management, psychosocial support, swallowing, and nutrition during treatment. The purpose of this study is to investigate any relationship of class attendance with treatment outcomes. In this retrospective cohort study, records of patients with HNC receiving radiotherapy (RT) as part of curative intent treatment from September 2013 to December 2017 were retrieved from our prospective quality assurance tool, the Anthology of Outcomes, and cross referenced with class attendance. Overall survival (OS), locoregional recurrence free survival (LRFS), and locoregional recurrence (LRR) were compared between prehab attendees (PA) and non-attendees (PNA). There were 864 PA and 1128 PNA. For PA and PNA, OS was 88% vs 80% (p<0.001), LRFS was 84% vs 75% (p<0.001) and LRR was 11.7% vs 16% (p=0.016) respectively at 2 years. At baseline, PA were less frequently ECOG performance status ≥2 (3% vs 5%, p = 0.002), current smokers (29% vs 40%, p <0.001), heavy drinkers (14% vs 18%, p = 0.035), P16 negative oropharynx cancers (17 vs 25%, p = 0.003), T3/T4 (41% vs 48%, p=0.001), and N2/3 (51% vs 55%, p<0.001). On univariable analysis, baseline characteristics significantly associated with worse OS were (HR, 95%CI): ECOG ≥2 (6.34, 4.25 – 9.46), current smoking (1.96, 1.56 – 2.47), heavy drinking (1.67, 1.26 – 2.21), PNA (1.59, 1.26 – 2.03), age≥62 (1.67, 1.33 – 2.11), and RT alone (2.04,1.5-2.77). On multivariable analysis (MVA), OS and LRFS were independently and unfavorably associated with PNA, as were current smoking, ECOG ≥2, T3/4, and N2/3. Treatment other than concurrent chemoRT was also associated with worse OS, LRFS, and LRR on MVA. Patients with poor performance status, current smokers, heavy drinkers, and those with more advanced cancers were less likely to attend Prehab. However, class attendance remains independently associated with better cancer outcomes. Whether the class itself influences outcomes or serves as a marker of favorable prognosis patients cannot be determined from this study design, but merits future study.Abstract 2867; Table 1MVA Results: HR and 95% CIOSLRFSLRRPNA1.41 (1.09 – 1.82)1.37 (1.11 – 1.70)Nonsignificant(NS)Current smoking1.48 (1.15 – 1.91)1.44 (1.15 – 1.79)NSECOG ≥24.65 (3.02 – 7.16)3.56 (2.40 – 5.28)1.84 (1.08 – 3.12)T3/T42.22 (1.7 – 2.89)2.39 (1.91 – 3.0)1.94 (1.48 – 2.54)N2/N32.52 (1.82 – 3.48)1.7 (1.31 – 2.21)NSTreatment*RT alone2.35 (1.64 – 3.36)2.49 (1.82 – 3.41)1.72 (1.18 – 2.49)Surgery+chemoRT3.87 (2.27 – 6.59)4.05 (2.56 – 6.41)2.72 (1.49 – 4.94)Surgery+ RT2.43 (1.54 – 3.85)2.38 (1.62 – 3.5)1.66 (1.05 – 2.64)*relative to concurrent chemoRT Open table in a new tab

Effectiveness of a mindfulness-based psychoeducation group programme for early-stage schizophrenia: An 18-month randomised controlled trial

Current psychosocial interventions in schizophrenia are evidenced to improve patients' illness-related knowledge, mental status and relapse rate, but substantive benefits to patients, such as their functioning and insight into the illness, remain uncertain. This multi-centre randomised clinical trial aimed to examine the effects of mindfulness-based psycho-education group intervention for adult patients with early-stage schizophrenia over an 18-month follow-up. The controlled trial was conducted with a repeated-measure, three-arm design at two psychiatric outpatient clinics in Jilin (China) and Hong Kong. A stratified random sample of 180 outpatients with schizophrenia spectrum disorders (60/group) was randomly assigned to a mindfulness-based psycho-education group programme, psycho-education group and treatment-as-usual group. The primary outcomes on patients' psychosocial functioning and other patient outcomes, such as psychotic symptoms, in the three groups were compared over the 18-month follow-up (baseline and 1-week, 9-month and 18-month post-intervention). One hundred and sixty (89%) patients completed at least two post-tests. Their mean age and duration of illness were 25–28 years (SD = 6.1–7.8) and 2.1–2.5 years (SD = 1.3–2.0; range 4–54 months), respectively. Compared with the two other groups, the mindfulness-based group exhibited a significantly greater improvement with moderate to large effect sizes (Cohen's d = 0.49–0.98) in functioning (p = 0.005), duration of psychiatric re-hospitalisations (p = 0.007), psychotic symptoms (p = 0.008) and illness insight (p = 0.001) over the 18-month follow-up. Supplementary MRI findings indicated that the mindfulness-based intervention resulted in significant changes in gray matter volume and density in brain regions concerning attention and emotional regulation. Mindfulness-oriented psycho-education group intervention can be an effective intervention for adults with early-stage schizophrenia and exert long-term effects on patients' functioning and mental conditions.

Psychoeducational intervention improves Chinese mothers' parenting and symptoms of their autistic children

In China, mothers of children with autism spectrum disorder struggle with parenting, often becoming depressed. This can harm the well-being and sociocognitive development of their children. We determined whether a psychoeducational group intervention increases the frequency of mothers' positive speech patterns and alleviates their depression, and, in turn, whether these changes improve the behavior of their children. Mothers (8 from Shanghai, 8 from Taiwan) participated in a 12-week intervention of a weekly counseling session. At the end, analysis of transcripts of the mothers' speech showed that the frequency of positive emotional words increased and negative emotional words decreased, and their scores on the Beck Depression Inventory and Beck Anxiety Inventory decreased significantly. Children also showed a significant reduction in scores on the Childhood Autism Rating Scale. These results demonstrate that counseling via a semistructured group intervention can improve mothers' parenting and coping skills, and help to alleviate their children's autism symptoms.

Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity: study protocol for a randomized, controlled trial

BackgroundDepressive disorders are the third leading cause of consultation in primary care, mainly in patients with chronic physical illnesses. Studies have shown the effectiveness of group psychoeducation in reducing symptoms in depressive individuals. Our primary aim is to evaluate the effectiveness of an intervention based on a psychoeducational program, carried out by primary care nurses, to improve the remission/response rate of depression in patients with chronic physical illness. Secondarily, to assess the cost-effectiveness of the intervention, its impact on improving control of the physical pathology and quality of life, and intervention feasibility.Methods/designA multicenter, randomized, clinical trial, with two groups and one-year follow-up evaluation. Economic evaluation study.SubjectsWe will assess 504 patients (252 in each group) aged > 50 years assigned to 25 primary healthcare centers (PHC) from Catalonia (urban, semi-urban, and rural). Participants suffer from major depression (Beck depression inventory: BDI-II 13–28) and at least one of the following: type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma, and/or ischemic cardiopathy. Patients with moderate/severe suicide risk or severe mental disorders are excluded. Participants will be distributed randomly into the intervention group (IG) and control (CG).InterventionThe IG will participate in the psychoeducational intervention: 12 sessions of 90 min, once a week led by two Primary Care (PC) nurses. The sessions will consist of health education regarding chronic physical illness and depressive symptoms.Main measurementsClinical remission of depression and/or response to intervention (BDI-II).Secondary measurementsImprovement in control of chronic diseases (blood test and physical parameters), drug compliance (Morinsky-Green test and number of containers returned), quality of life (EQ-5D), medical service utilization (appointments and hospital admissions due to complications), and feasibility of the intervention (satisfaction and compliance). Evaluations will be blinded, and conducted at baseline, post-intervention, and 12 months follow-up.DiscussionResults could be informative for efforts to prevent depression in patients with a chronic physical illness.Trial registrationNCT03243799 (registration date August 9, 2017)

Development of a psychoeducational intervention for people affected by pancreatic cancer

BackgroundPancreatic cancer has one of the highest mortality rates of any malignancy, placing a substantial burden on patients and families with high unmet informational and supportive care needs. Nevertheless, access to psychosocial and palliative care services for the individuals affected is limited. There is a need for standardized approaches to facilitate adjustment and to improve knowledge about the disease and its anticipated impact. In this intervention-development paper guided by implementation science principles, we report the rationale, methods, and processes employed in developing an interdisciplinary group psychoeducational intervention for people affected by pancreatic cancer. The acceptability and feasibility of implementation will be evaluated as a part of a subsequent feasibility study.MethodsThe Schofield and Chambers framework for designing sustainable self-management interventions in cancer care informed the development of the intervention content and format. The Consolidated Framework for Implementation Research served as an overarching guide of the implementation process, including the development phase and the formative evaluation plan of implementation.ResultsA representative team of stakeholders collaboratively developed and tailored the intervention content and format with attention to the principles of implementation science, including available resourcing. The final intervention prototype was designed as a single group-session led by an interdisciplinary clinical team with expertise in caring for patients with pancreatic cancer and their families and in addressing nutrition guidelines, disease and symptom management, communication with family and health care providers, family impact of cancer, preparing for the future, and palliative and supportive care services.ConclusionsThe present paper describes the development of a group psychoeducational intervention to address the informational and supportive care needs of people affected by pancreatic cancer. Consideration of implementation science during intervention development efforts can optimize uptake and sustainability in the clinical setting. Our approach may be utilized as a framework for the design and implementation of similar initiatives to support people affected by diseases with limited prognoses.

The influence of socio-demographic similarity and difference on adequate attendance of group psychoeducational cognitive behavioural therapy

Aim: The study aimed to investigate the impact of socio-demographic similarity on the probability of attending an adequate dose of a psychoeducational group intervention (≥4 of 6 sessions). Method: The sample comprised 2071 patients (63% female, 93% White, 15% unemployed, mean age 43) who received the Stress Control intervention in the UK’s national Improving Access to Psychological Therapies (IAPT) programme. Similarity indices were constructed to measure each patient’s similarity to the rest of their group on four characteristics: age, gender, ethnicity, and neighbourhood deprivation (Index of Multiple Deprivation; IMD). Results: Multilevel analysis found that patients with greater IMD similarity to their group had significantly higher probabilities of attending an adequate dose of intervention (p = .026, controlling for absolute IMD). A cumulative effect of age similarity, ethnic similarity, and group size was also found, such that patients who were similar in age and ethnicity to their group had higher probabilities of adequate attendance in larger groups (p = .006). Conclusions: These results suggest that socio-demographic comparison (a.k.a. relational demography) may consciously or unconsciously impact on patients’ attendance at group psychoeducational interventions, particularly regarding indicators of socio-economic similarity. Clinical implications include structuring group composition and/or intervention content to maximise attendance and therefore clinical effectiveness.