Short-term Group Therapy Research Articles

Improving Conversational Skills in Children with Autism Spectrum Disorders: A Pilot Study of the Teaching Interaction Procedure (TIP)

Children with Autism Spectrum Disorder (ASD) are often impaired in their ability to generate and maintain conversations with others (American Psychiatric Association, 2000). Poor conversational skills inhibit children with ASD from appropriately interacting with peers and family members, often prohibiting them from developing satisfying relationships with others. The teaching interaction procedure was utilized in the present intervention to improve conversational skills in four children with an ASD. Children ages 7-11 participated in an outpatient social skills group over a period of 10 weeks. Results suggest the teaching interaction procedure was effective in improving conversational skills for all participants. This study highlights issues related to conducting short-term group therapy with individuals with ASD.

Designing a group therapy program for coping with childhood weight bias.

Research indicates that the negative psychosocial consequences of childhood obesity may reflect the degree of weight bias and mistreatment affecting the child. Even though comprehensive practice models evolve over time, the intense distress of these children calls for more timely intervention. Using a modification of social research and development methodology, a short-term group therapy approach using cognitive and behavioral methods was designed. Questionnaires were developed to assess both the child's and the parents' perceptions of the frequency, circumstances, and responses to being teased. At the end of the program, all of the children and parents showed proficiency in describing and demonstrating the coping strategies in the curriculum. A two-year follow-up found that most of the children reported fewer episodes of teasing. This article demonstrates the use of intervention research methodology to rapidly design and implement a preliminary approach to help children with severe obesity cope with weight-related teasing. Although this program needs further empirical testing and refinement before it can be more widely deployed, it represents an important initiative in responding to the distress of children who are victimized because of obesity.

EPA-1021 - Peculiarities of emotional damages in patients with anxiety disorders

The aim of the study the development of a comprehensive system ofpsychotherapy and psychocorrection of anxiety disorders of neurotic case, based on the study of their clinical structure and peculiarities of emotional damages. Methodologies Clinical and psychological investigation, included the scales of anxiety and uneasiness CH.D. Spielberger, Eysenck Personality Questionnaire (EPQ), The Hamilton Rating Scale for Depression (HRSD), The studyof accentuation of personality by K.Leonhard. Scope and contributing research 100 patients with diagnostic categories: F41.0 - Panic disorder(episodic paroxysmal anxiety, F41.1-Generalized anxiety disorder, F41.2-mixedanxiety-depressive disorder who are on the examination and treatment at the psychiatric unit. A control group included 40 patients. We performed the explorationof the peculiarities of clinical anxietyand patterns of therapeutic effect, based on the influence of short-term groupand individual psychotherapy in the treatment of anxiety disorders, andevaluation the effectiveness of its reconition. The development of the methodology of applying a short-term group and individual psychotherapy in the treatmentof anxiety disorders based on combination relaxation, hypnosis, cognitive-behavioral teqniques in combination on with short-term group therapy. In fact, this is a new realmodel psychotherapy based on integrative principles. The higt efficacy was shown in 82% patients, compared with 54% efficacy in control group patients. We will offer a new comprehensive methodology in the treatment of anxiety disorders of neuroticcase that will improve the therapeutic efficacy of the treatment process, reduce the time of treatment, reduce the period of drug therapy

A time-lagged, actor–partner interdependence analysis of alliance to the group as a whole and group member outcome in overweight and obesity treatment groups.

A time-lagged design was used to examine how the perceptions of alliance to the group as a whole by the other group members at an earlier point in the group were related to an individual group member's perceptions of alliance to the group as a whole at a later point in the group. We also examined how treatment outcome moderated this relationship. Seventy-three patients diagnosed as overweight or obese participating in 10 short-term therapy groups provided data for analyses. Group members completed measures of cohesion to the group and alliance to the group as a whole at the third, sixth, and last session of 12-session groups as well as pre- and posttest ratings on Obesity-Related Well-Being and the Outcome Questionnaire-45. As hypothesized, earlier ratings of alliance to the group as a whole by the other group members were related to later ratings of alliance to the group as a whole by the group member. Also as hypothesized, when group members had a better outcome, there was a significant positive relationship between perceptions of alliance to the group as a whole by the other group members at an earlier point in the group and an individual group member's perceptions of alliance to the group as a whole at a later point in time. When members had a worse outcome, there was no relationship between perceptions of alliance to the group as a whole by the other group members at an earlier point in the group and an individual group member's perceptions of alliance to the group as a whole at a later point in the group.

Evaluation of a short-term group psychotherapy used as part of the rehabilitation process in nursing home patients

Purpose: The aim of this study was to assess the impact of a 4-week group psychotherapy on the efficacy of physiotherapy in patients rehabilitated in a nursing home (NH). Materials and methods: The study was performed on 28 women, aged 77.1 (±5.6) years. Thirty-six percent were rehabilitated due to orthopaedic injuries, 36% had undergone a stroke, 28% suffered from chronic diseases of old age. Subjects were divided into two groups: experimental (n = 13) and control (n = 15). In the experimental group, a short-term, goal-focused group psychotherapy was used. To assess cognitive impairment, mood and functional status the Mini Mental State Examination (MMSE), the Geriatric Depression Scale (GDS-15) and the Barthel Index (BI) were used. Results: In the experimental group a four times greater improvement in mood was observed and two times greater physiotherapy efficacy (PE) in the first month of stay in an NH as compared to the control group. The effects of psychotherapy were independent of the type of disease, the patients’ age, number of comorbidities and cognitive status (ranging from 15 to 30 points on the MMSE). Conclusions: Short-term group psychotherapy can be an effective method of supporting the process of rehabilitating older, disabled people rehabilitated in an NH.Implications for RehabilitationPsychotherapy can improve the efficacy of treatment and rehabilitation in different somatic illnesses despite the advanced age of respondents, high disability rate, and the presence of cognitive impairments.Even short-term (4 weeks) group psychotherapy can provide effective support for the rehabilitation in the elderly.

SCL-90-R Symptom Profiles and Outcome of Short-Term Psychodynamic Group Therapy

Background. Psychodynamic group psychotherapy may not be an optimal treatment for anxiety and agoraphobic symptoms. We explore remission of SCL-90-R Global Severity Index (GSI) and target symptoms in 39 sessions of psychodynamic group therapy. Methods. SCL-90-R “target symptom” profile and GSI remission according to Danish norms were identified in 239 patients and evaluated according to reliable and clinical significant change. Results. Four major groups of target symptom cases (depression, interpersonal sensitivity, anxiety, and phobic anxiety) covered 95.7% of the sample. As opposite to phobic anxiety and anxiety patients, patients with interpersonal sensitivity obtained overall the most optimal outcome. The phobic anxiety scale, social network support, and years of school education were independent predictors of GSI remission, and a low anxiety score and absence of phobic anxiety target symptoms were independent predictors of remission of target symptom pathology. Conclusions. The negative results as associated with the SCL-90-R phobic anxiety scale and the phobic anxiety target symptom group are largely in agreement with recent studies. In contrast, whatever the diagnoses, patients with interpersonal sensitivity target symptom may be especially suited for psychodynamic group therapy. The SCL-90-R subscales may allow for a more complex symptom-related differentiation of patients compared with both diagnoses and GSI symptom load.

Self-descriptions of socially phobic persons in short-term group psychotherapy

This paper explores how socially phobic persons exhibit their self-images through self-descriptions expressed in a naturalistic group therapy context. The data, which is analysed qualitatively, consists of videotaped therapy sessions, transcribed verbatim, from two groups of individuals (n = 17, mainly women) attending short cognitive–constructive psychotherapy. Seven categories of self-descriptions are found. Three categories –‘self as miserable,’ ‘self as insufficient’ and ‘self as transparent’ – relate to experiential self-images. Four categories – ‘self as adjusting and pleasing others,’ ‘self as demanding toward self,’ ‘self as outsider, different, isolated’ and ‘self as hiding and controlling some feelings and features in oneself’ – describe strategies of dealing with negative self-images. Three client subgroups are also identifiable; namely, ‘other-oriented,’ ‘isolated’ and ‘self-demanding’ terms that represent participants according to their use of coping strategy. The results of this study support the view that a negative self-image is central to social phobia, and highlight the diversity of manifestations of a negative self-image in group therapy conversations.

Five cases of sexual addiction under Short-term Psychodynamic Group Psychotherapy

, and because of this, psychodynamic psychotherapy is a good choice of treatment. We aim to report the evolution of five sex addicts, who underwent short-term psychodynamic group psychotherapy (STPGP). Our specific goal is investigate the effect of the STPGP on SC.The five patients also had impulse control disorder or drug/alcohol dependence, and were all Brazilian men over 18 years of the Institute of Psychiatry at Clinicas’ Hospital of University of Sao Paulo Medical School (HC-FMUSP). All of them met the Goodman’s criteria for sex addiction

Attachment Style Changes Following Intensive Short-term Group Psychotherapy

In this study, we examined changes in attachment style as measured by the Relationship Scales Questionnaire before and after six weeks of intensive group psychotherapy. We also investigated whether changes in attachment style were associated with changes in interpersonal functioning. Results indicated that participants showed increases in secure attachment and decreases in fearful attachment and, to a lesser degree, preoccupied attachment styles. Change was not found in the dismissive attachment style. Changes in Secure and/or Fearful (but not Preoccupied) attachment styles were related to changes in interpersonal functioning on seven of the eight subscales of the Inventory of Interpersonal Problems. Overall findings suggest intensive group psychotherapy programs show promise for reducing attachment pathology and improving interpersonal functioning. Assessing differential responsiveness to psychotherapy may help us align our interventions to better address differing attachment styles through modifications in focus and approach.

Structured Play Therapy Groups for Preschoolers: Facilitating the Emergence of Social Competence

Over the years, we have developed a working model of Structured Play Therapy Groups for Preschoolers, an innovative treatment approach designed to address the needs of young children ages 3 to 5 struggling to adjust to the social demands of their preschool classrooms. These short-term therapy groups facilitate development of the young child’s social competence and capacity to participate effectively in a classroom environment. Although the literature on therapy groups for children suggests that preschoolers are not yet evolved enough developmentally to engage actively in a group process, our experience indicates otherwise. The model of treatment presented here will therefore challenge that contention with the claim that not only can preschoolers participate in a structured therapy group of peers but they can, by virtue of that very participation, benefit in ways that will prepare them (as they transition from preschool to kindergarten) for the ever-increasing demands of their ever-expanding social milieus.

Effectiveness of Sand Tray Short Term Group Therapy with Grieving Youth

Losing a beloved person with whom one is deeply involved is like falling into an abyss of infinity leading to an undesirable feeling which in turn may cause mourning. The grief reactions differ from person to person depending on the circumstances of the occurred calamities, religious, social and cultural beliefs and in general the perceived meaning of the death for the bereaved. Adolescents are one of the vulnerable groups in facing the loss. Belongingness during adolescence is of an essence, as the adolescent seeks to shape ego identity in oneself. The grief process may nullify the personal assumptions regarding the world (spiritual assimilation), relations with others, and personal identity (inner world). Hence, it is indispensable to provide interventions for healing the wounds stemming from the loss. Among various approaches, play therapy is one of the best treatments for grief in the juveniles. Play therapy is the process of making conscious and verbalization of the unconscious and the nonverbal issues. Sand tray therapy is a sort of play therapy which provides people an opportunity to express themselves in a creative and nonverbal way. Currently this kind of therapy is considered as an effective method to work with children and adolescents. However, despite the high rate of mortality in Iran. there is not enough research conducted in this regard. In light of the great significance of cultural differences in the resolution of grief, it is essential to evaluate a variety of theories effective in resolving this process. on the other hand grief will change person‘s inner world, attitude, percept and the outer world. indeed dynamics of individual and social life survivors’ will be changed. Hence in this research will be studied Appraisal of effectiveness of sand tray Short term group therapy with grieving youth. For this purpose 20 person who had lost a close family member in the last two years were selected as the participations in the study through purposive sampling and then randomly placed in a control and an experimental group of 10 person each. first, as a pre- test, participation filled out the Grief Experience Inventory. The experimental group as intervention received 90minute twice in a week sand tray therapy sessions for six weeks. The control group was did not receive any intervention. All the test was again administrated on both groups upon termination of interventions. The data analysis was carried out using descriptive statistic and Mixed ANOVA. Results show that the mean values of experimental group on GEQ-34 and its subscales of search for somatic reaction, guilt feeling, and rejection feeling were reduced significantly on post test. So Sand Tray Short Term Group Therapy seem to be an effective and useful technique in reducing intensity of grief experience among adolescent; this is afforded through providing safe environment for modeling loss coping skills and making emotional catharsis possible.

Post-inpatient Attrition from Care “As Usual” in Veterans with Multiple Psychiatric Admissions

Disengagement from outpatient care following psychiatric hospitalization is common in high-utilizing psychiatric patients and contributes to intensive care utilization. To investigate variables related to treatment attrition, a range of demographic, diagnostic, cognitive, social, and behavioral variables were collected from 233 veterans receiving inpatient psychiatric services who were then monitored over the following 2 years. During the follow-up period, 88.0 % (n = 202) of patients disengaged from post-inpatient care. Attrition was associated with male gender, younger age, increased expectations of stigma, less short-term participation in group therapy, and poorer medication adherence. Of those who left care, earlier attrition was predicted by fewer prior-year inpatient psychiatric days, fewer lifetime psychiatric hospitalizations, increased perceived treatment support from family, and less short-term attendance at psychiatrist appointments. Survival analyses were used to analyze the rate of attrition of the entire sample as well as the sample split by short-term group therapy attendance. Implications are discussed.

Changes in Symptom Severity, Schemas and Modes in Heterogeneous Psychiatric Patient Groups Following Short‐term Schema Cognitive–Behavioural Group Therapy: A Naturalistic Pre‐treatment and Post‐treatment Design in an Outpatient Clinic

Schema therapy has proven to be an effective treatment for patients with borderline personality disorder. However, little is known of its merits in other psychiatric (personality) disorders. This study investigated whether schema therapy in a group setting (group schema cognitive-behavioural therapy [SCBT-g]) was associated with changes in symptom and schema and mode severity. Furthermore, the aim was to search for baseline predictors and possible mediators of treatment outcome. Sixty-three heterogeneous psychiatric outpatients who attended the SCBT-g were included as participants. In this naturalistic pre-treatment and post-treatment design, data were available on the Symptom Checklist 90, the Schema Questionnaire and the Young-Atkinson Mode Inventory. All outcome measurements showed changes with moderate to high effect sizes, with 53.2% of the patients showing a significant reduction in severity of psychiatric symptoms and schemas and modes. Higher pre-treatment levels of the schema domain Other Directedness predicted greater symptom reduction. Pre-treatment to mid-treatment changes in schema severity predicted subsequent symptom improvement, but change in symptoms and schemas proved to be strongly correlated. In this naturalistic study, SCBT-g was associated with reduced symptom and schema and mode severity in more than half of the psychiatric outpatients. Furthermore, the results suggest that changes in schemas and symptomatology mutually reinforce each other. Over 50% of ambulatory patients show clinical improvement after treatment in a short-term schema therapy group. Other Directedness seems to be a predictor of schema group therapy success. More randomized controlled trial studies and prediction and mediation studies on (short-term) schema group therapy are sorely needed.

Using Short-Term Group Psychotherapy as an Evidence-Based Intervention for First-Time Mothers at Risk for Postpartum Depression

The purposes were to (a) provide an 8-week, short-term, psychotherapy group as a nonpharmacologic, evidence-based intervention for first-time mothers at risk for postpartum depression (PPD) and (b) determine if women's scores in the Edinburgh Postnatal Depression Scale changed after participation in the intervention. The women who participated in the short-term group psychotherapy intervention experienced a decrease in their Edinburgh Postnatal Depression Scale scores, reducing their risk for PPD. Group psychotherapy is an effective, evidence-based intervention to reduce the risk for PPD and should remain a current competency of psychiatric advanced practice nurses.

Can the Clinician–Researcher Gap be Bridged? Experiences from a Randomized Clinical Trial in Analytic/Dynamic Group Psychotherapy

This article describes how four seasoned clinicians and group analysts working in public mental health services, experience their participation in a randomized trial of short-term versus long-term analytic group psychotherapy (20 or 80 sessions). The design makes it possible to integrate the research with regular clinical practice, and participation gives the institutions the opportunity to fulfil obligations of doing research, that are imposed on the Community Mental Health Centres. The experiences are mainly described from the clinicians’ position, but some comments from the research director are included. The collaboration across approximately five years is found to be interesting and rewarding. Based on the assumption that further steps are made to strengthen and develop the qualitative aspects of such projects, the clinicians recommend such collaboration as a feasible and useful way to build and maintain a bridge across the gap that too often seems to separate researchers and clinicians. This is assumed to be profitable for everyone involved, not least the patients.

P-1153 - The effectiveness of short- and long-term psychotherapy during a 7-year follow-up

Introduction The majority of studies on the effectiveness of psychotherapy have reported results for relatively short follow-up times. Aims In this study the effectiveness of short- and long-term psychotherapy was compared during a very long follow-up. Methods A total of 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy (12 sessions), short-term psychodynamic (20 sessions) and long-term psychodynamic psychotherapy (240 sessions) in Helsinki Psychotherapy Study. The patients were followed from start of treatment and assessed 11 times during a 7-year follow-up. Symptom Check List (anxiety, depression, and general symptom scale), Work-subscale of the Social Adjustment Scale, and use of auxiliary treatment (psychotherapy, psychotropic medication, and psychiatric hospitalization) were used as outcome measures. Results A reduction in psychiatric symptoms and improvement in work ability and functional capacity was noted in all treatment groups. The short-term therapies were more effective than long-term psychotherapy during the first year, whereas the long-term therapy was more effective after 3 years of follow-up. No significant differences were observed between long- and short-term therapies during the 4 last years of follow-up.A total of 80% of the patients in the short-term therapy groups and 60% in the long-term therapy group used auxiliary treatment. Conclusions Short-term psychotherapy gives faster benefits than long-term psychotherapy, but in the long run no notable differences in symptoms or working ability are seen. Considerably auxiliary treatments are taken after the end of the intervention implying further need of treatment. These findings should be repeated in other populations.

Change in Defense Mechanisms During Short-Term Dynamic and Cognitive Therapy in Patients With Cluster C Personality Disorders

The aims of this study were to examine whether a change in overall defensive functioning during treatment a) would predict change in symptom distress during the course of treatment and follow-up and b) would be greater in short-term dynamic therapy than in cognitive therapy. Patients (N = 50) who met criteria for cluster C personality disorders were randomized to 40 weekly sessions of short-term dynamic therapy or cognitive therapy. Video recordings of a pretreatment interview and therapy session 36 were evaluated using the Defense Mechanisms Rating Scales. Symptom distress was measured using the revised version of Symptom Checklist-90. Change in overall defensive functioning during treatment predicted change in symptom distress from pretreatment to 2 years after treatment. Both treatment groups showed significant changes in defensive functioning toward greater adaptability but without any significant differences between the short-term dynamic therapy and cognitive therapy groups in a sample of patients with cluster C personality disorders.

Use of auxiliary psychiatric treatment during a 5-year follow-up among patients receiving short- or long-term psychotherapy

The need for treatment is, despite of its obvious usefulness, a scarcely used measure of effectiveness in psychotherapy trials. This study considers changes in the need for auxiliary psychiatric treatment after starting short- and long-term psychotherapy and psychoanalysis. Altogether 326 psychiatric outpatients with mood or anxiety disorder were randomly assigned to solution-focused therapy (SFT), short-term psychodynamic psychotherapy (SPP), or long-term psychodynamic psychotherapy (LPP) while 41 self-selected patients were allocated to psychoanalysis (PA). The patients were followed for 5 years from start of treatment. Outcome measures were use of auxiliary psychotherapy, psychotropic medication, and hospitalization for mental reasons. About 60% of the patients used auxiliary treatment during the follow-up. It was most common in the short-term therapy groups and its incidence was highest during the first year after the start of therapy. The average numbers of all therapy sessions among patients starting the therapy were 60, 70, 240, and 670 in SFT, SPP, LPP, and PA, respectively, whereas the corresponding average numbers of study therapy sessions alone were 10, 19, 232, and 646. Over 50% of the patients receiving short-term therapy received on average 4-6 times more therapy sessions than initially assigned. Post-randomization withdrawal was uneven. Auxiliary treatment is usual among patients receiving short- and long-term therapies, and apparently becomes common shortly after the start of treatment. Auxiliary treatment can be used as an outcome measure indicating the need for treatment, should be monitored clinically and considered when interpreting the results of effectiveness studies.

Psychodynamic Group Psychotherapy: Impact of Group Length and Therapist Professional Characteristics on Development of Therapeutic Alliance

Little research has been done on therapeutic alliance in group psychotherapy, especially the impact of treatment duration and therapist professional characteristics. Therapeutic alliance was rated by patients on the Working Alliance Inventory-Short Form at three time points (sessions 3, 10 and 17) in a randomized controlled trial of short-term and long-term psychodynamic group psychotherapy. As predictors we selected therapist clinical experience and length of didactic training, which have demonstrated ambiguous results in previous research. Linear latent variable growth curve models (structural equation modeling) were developed for the three Working Alliance Inventory-Short Form subscales bond, task and goal. We found a significant variance in individual growth curves (intercepts and slopes) but no differential development due to group length. Longer therapist formal training had a negative impact on early values of subscale task in both treatments. There was an interaction between length of the therapists' clinical experience and group length on early bond, task and goal: therapists with longer clinical experience were rated lower on initial bond in the long-term group but less so in the short-term group. Longer clinical experience influenced initial task and goal positively in the short-term group but was unimportant for task or significantly negative for goal in the long-term group. There was no mean development of alliance, and group length did not differentially impact the alliance during 6 months. Early ratings of the three Working Alliance Inventory-Short Form subscales partly reflected different preparations of patients in the two group formats, partly therapist characteristics, but more research is needed to see how these aspects impact alliance development and outcome. Therapists should pay attention to all three aspects of the alliance, when they prepare patients for group therapy. In psychodynamic groups, length of therapy does not differentiate the overall level or the development of member-leader alliance. Within psychodynamic groups, each individual appear to have their unique perception of the member-leader alliance. Therapists with longer formal psychotherapy training may be less successful in establishing early agreement with patients on the tasks of psychodynamic group psychotherapy. Patients perceive a somewhat lower degree of early emotional bonding with the more clinically experienced therapists in long-term psychodynamics groups. Therapists with more clinical experience may contribute to a stronger degree of initial agreement with patients on the tasks and goals of short-term group psychotherapy.

Duration of Corticosteroid Tapering as First Line Treatment In Idiopathic Thrombocytopenic Purpura.

AbstractAbstract 3688 Background:Idiopathic Thrombocytopenic Purpura (ITP) is a relatively common benign hematologic disorder. Management of ITP is difficult as many treatment regimens present risks that may pose more harm than the disease itself. Typically, corticosteroid is used as first line treatment, but there is currently no evidence-based guideline to direct the optimal duration of therapy. Objective:To investigate the effectiveness and relative safety of various lengths of corticosteroid therapy. Methods:In a retrospective cohort study, charts of all ITP patients seen in the general hematology clinic at the London Health Sciences Centre (LHSC) from January 1, 2004 to December 31, 2009 were reviewed. Results: A total of 312 patients with ITP were reviewed. 128 of the patients (52 male, 76 female), age range 4–94 at time of diagnosis, required corticosteroid treatment. Of those, 35 patients were treated with short term steroid regimen (< 8 weeks); 32 patients had 8–16 weeks of therapy, and 64 patients received long term steroid tapering regimen (>16 weeks). Based on results, 63%, 56% and 39% of patients achieved complete response in each group respectively. The follow-up duration from diagnosis ranged from 1 month to 29 years (with median of 1 year).Duration of Corticosteroid Therapy< 8 weeks n = 358–16 weeks n = 32> 16 weeks n = 64Complete Response22 (63%)18 (56%)25 (39%)Partial Response7 (20%)7 (22%)9 (14%)No Response6 (17%)7 (22%)30 (47%)Relapse after Response12 (41%)8 (32%)17 (50%)Side Effects13 (37%)13 (41%)26 (41%)Interestingly, the same proportion of patients experienced side effects as a result of steroid use in all groups. However, frequency of serious complications such as avascular necrosis and infections, occurred at a higher rate in the long term therapy group (9%) compared to 0% in short term therapy group. Conclusions:Rapid corticosteroid taper is as effective as a slow corticosteroid taper and has less serious side effects. Disclosures:No relevant conflicts of interest to declare.