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Dialogues in Clinical Neuroscience Sep 2015Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious... (Review)
Review
Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious consequences. This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CBT programs are available for individuals who suffer from different anxiety disorders, enabling them to be treated together in groups.
Topics: Anxiety; Humans; Psychotherapy, Group
PubMed: 26487815
DOI: 10.31887/DCNS.2015.17.3/lwolgensinger -
Canadian Journal of Psychiatry. Revue... Nov 2014Nonsuicidal self-injury (NSSI), the deliberate, self-inflicted damage of bodily tissue without the intent to die, is associated with various negative outcomes. Although... (Review)
Review
OBJECTIVE
Nonsuicidal self-injury (NSSI), the deliberate, self-inflicted damage of bodily tissue without the intent to die, is associated with various negative outcomes. Although basic and epidemiologic research on NSSI has increased during the last 2 decades, literature on effective interventions targeting NSSI is still emerging. Here, we present a comprehensive, systematic review of existing psychological and pharmacological treatments designed specifically for NSSI, or including outcome assessments examining change in NSSI.
METHOD
We conducted a systematic search of PsycINFO, MEDLINE, and ERIC databases to retrieve relevant articles that met inclusion criteria; specifically, uncontrolled and controlled trials that 1) presented quantitative outcome data on NSSI, and 2) clearly differentiated NSSI from suicidal self-injury (SSI). Consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, definition of NSSI, we excluded studies examining populations with developmental or intellectual disabilities, or with psychotic disorders.
RESULTS
Several interventions appear to hold promise for reducing NSSI, including dialectical behaviour therapy, emotion regulation group therapy, manual-assisted cognitive therapy, dynamic deconstructive psychotherapy, atypical antipsychotics (aripiprazole), naltrexone, and selective serotonin reuptake inhibitors (with or without cognitive-behavioural therapy). Nevertheless, there remains a paucity of well-controlled studies investigating treatment efficacy for NSSI.
CONCLUSIONS
Structured psychotherapeutic approaches focusing on collaborative therapeutic relationships, motivation for change, and directly addressing NSSI behaviours seem to be most effective in reducing NSSI. Medications targeting the serotonergic, dopaminergic and opioid systems also have demonstrated some benefits. Future studies employing controlled designs as well as a clear delineation of NSSI and SSI will improve knowledge regarding treatment effects.
Topics: Adolescent; Adult; Borderline Personality Disorder; Cognitive Behavioral Therapy; Combined Modality Therapy; Humans; Outcome Assessment, Health Care; Psychotherapy; Psychotherapy, Group; Psychotropic Drugs; Randomized Controlled Trials as Topic; Self-Injurious Behavior; Suicide, Attempted; Theory of Mind; Young Adult
PubMed: 25565473
DOI: 10.1177/070674371405901103 -
Journal of Affective Disorders Apr 2023Over the last 20 years, compassion focused therapy (CFT) has gained popularity as an emerging 'third wave' intervention. Although previous reviews indicated its... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Over the last 20 years, compassion focused therapy (CFT) has gained popularity as an emerging 'third wave' intervention. Although previous reviews indicated its potential benefits, a systematic review and meta-analysis of CFT in those with mental health difficulties has yet to be conducted.
METHODS
A systematic search of five databases was undertaken, focusing on randomised controlled trials and randomised pilot/feasibility studies of CFT only. No language restrictions were implemented. A narrative synthesis was conducted. Random effects meta-analyses were measured on levels of self-compassion, self-criticism/self-reassurance, fears of compassion and clinical symptomology.
RESULTS
Fifteen studies from 2013 to 2022 were included. Findings suggested that CFT was effective in improving compassion-based outcomes and clinical symptomology from baseline to post-intervention and compared to waitlist control. A range of small to large effect sizes were reported for improvements in self-compassion (0.19-0.90), self-criticism (0.15-0.72), self-reassurance (0.43-0.81), fear of self-compassion (0.18), depression (0.24-0.25) and eating disorders (0.18-0.79). Meta-analyses favoured CFT in improving levels of self-compassion and self-reassurance than control groups.
LIMITATIONS
The methodological quality of many of the included studies (7/15) was rated as 'unclear' due to a lack of information. There was a distinct gender gap, with 74.88% identifying as female participants.
CONCLUSIONS
This review was the first to examine the effectiveness of CFT in clinical populations. The results indicate that CFT has promising clinical implications, suggesting that the intervention increases compassion-based outcomes and reduces clinical symptomology in those with mental health difficulties. However, future research is required into the long-term effects of CFT.
Topics: Humans; Female; Empathy; Psychotherapy, Group; Fear; Self-Assessment; Feeding and Eating Disorders
PubMed: 36649790
DOI: 10.1016/j.jad.2023.01.010 -
Danish Medical Journal Oct 2016Health anxiety is prevalent (5-9%) in all healthcare settings and in the general population, may have an early onset, and a poor prognosis is seen in severe cases if... (Review)
Review
Health anxiety is prevalent (5-9%) in all healthcare settings and in the general population, may have an early onset, and a poor prognosis is seen in severe cases if untreated. Research shows that health anxiety is rarely diagnosed though it causes great suffering for the individual and constitutes a substantial socio-economic burden. Studies have shown that individual cognitive behavioural therapy can relieve health anxiety, but these studies are affected by methodological problems, among others, struggling with patients declining participation, high dropout rates, and some patients not responding to the treatment. Moreover, the impact of health anxiety on sick leave is only scarcely examined. This thesis examines the effect of a new treatment approach, group-based Acceptance & Commitment Therapy (ACT-G) for patients with severe health anxiety in an uncontrolled pilot study and a randomised controlled study (RCT) on ACT-G compared with a 10-month waitlist control condition (paper I and II). Also, the thesis comprises a study on sick leave in patients with health anxiety compared with the general population during a 5-year period and the effect of ACT-G on sick leave. The findings from this study are described in paper III. Patients (age 20-60 years) consecutively referred from general practitioners from Jutland and Funen in the period of March 2010 - April 2012 (approx. 2.5 million citizens) to the Research Clinic for Functional Disorders and Psychosomatics, Aarhus University Hospital, were included. The pilot study included 34 patients, the RCT on ACT-G included 126 patients. In the RCT, patients were block-randomised to either ACT-G and received treatment in 7 groups of each 9 patients in the period of December 2010 - October 2012, or to a 10-month waitlist control group. The primary outcome measure was the Whiteley-7 paper and pencil index for illness worrying. The last paper is based on data on sickness-related benefits from the DREAM social register of transfer benefits and also includes a matched general population register control cohort (n=12,600). In this thesis, we wish to answer the following questions: 1) Is ACT-G an acceptable, feasible and effective treatment approach for patients with severe health anxiety? 2) Can ACT-G improve severe illness worry compared with a waitlist control condition, and are the recently introduced diagnostic criteria for health anxiety acceptable for the patients? 3) Do patients with health anxiety show more sick leave than the general population during a 5-year period, and can ACT-G reduce sick leave measured by transfer benefits (weeks on sickness-related benefits) at 1-year follow-up? As ACT has not previously been examined as treatment approach for health anxiety, we initially conducted an uncontrolled pilot study to test the newly developed manualised program (ACT-G). The study included 34 patients with severe health anxiety and showed very low dropout and high treatment satisfaction. Significant improvements in self-reported illness worry were demonstrated post-treatment, and the results were sustained and further improved at 3- and 6-months follow-up compared to baseline. The subsequent RCT found high acceptance of the diagnosis of health anxiety. All patients (except 1) accepted the diagnosis as the right diagnosis to fit their ailment, and the majority of the patients found that the diagnosis helped them to better understand their symptoms. In an intention-to-treat analysis, ACT-G showed significant effect in the improvement of self-reported illness worry and other secondary measures compared with a waitlist control condition, both post-treatment and at 10-month follow-up (6 months post-treatment). The results were considered clinically significant as 2/3 of the patients in ACT-G at follow-up had demonstrated a pre-defined treatment response, and ¼ of the patients were considered to no longer have clinical case status. Furthermore, the number needed to treat was found to be 2.4. Patients with severe health anxiety showed significantly more weeks on sickness-related benefits than matched individuals from the general population during the 5 years prior to entering the RCT. This difference was stable until an estimated cut-point at 1 year before enrolment, where patients with health anxiety showed further increase in sickness-related-benefits. At one-year follow-up (8 months post-treatment), we did not find a significant difference between ACT-G and the waitlist group in weeks on sickness-related benefits. Post-hoc analysis, however, revealed a significant decrease in weeks on sickness-related benefits for ACT-G during the 2 years after randomisation. In conclusion, the thesis suggests that ACT-G is both an acceptable and effective treatment approach for patients with severe health anxiety. Hopefully, these findings can contribute to the future research and identification of which treatment approaches are the most effective and for which patients and contribute to tailored, early interventions. This may possibly prevent development of otherwise chronic symptoms, increase the quality of life for the patients, and potentially reduce socio-economic costs.
Topics: Anxiety; Cognitive Behavioral Therapy; Humans; Patient Compliance; Psychotherapy, Group; Quality of Life
PubMed: 27697138
DOI: No ID Found -
Journal of Psychoactive Drugs 2019Contemporary research with classic psychedelic drugs (e.g., lysergic acid diethylamide (LSD) and psilocybin) is indebted to the twentieth-century researchers and...
Contemporary research with classic psychedelic drugs (e.g., lysergic acid diethylamide (LSD) and psilocybin) is indebted to the twentieth-century researchers and clinicians who generated valuable clinical knowledge of these substances through experimentation. Several recent reviews that highlight the contributions of this early literature have focused on psychedelic-assisted individual psychotherapy modalities. None have attempted to systematically identify and compile experimental studies of psychedelic-assisted group therapy. In therapeutic settings, psychedelics were often used to enhance group therapy for a variety of populations and clinical indications. We report on the results of a systematic review of the published literature in English and Spanish on psychedelic-assisted group therapies. Publications are characterized by their clinical approach, experimental method, and clinical outcomes. Given the renewed interest in the clinical use of psychedelic medicines, this review aims to stimulate hypotheses to be tested in future research on psychedelic-assisted psychotherapy, group process, and interpersonal functioning.
Topics: Hallucinogens; Humans; Lysergic Acid Diethylamide; Psilocybin; Psychotherapy; Psychotherapy, Group
PubMed: 30950777
DOI: 10.1080/02791072.2019.1593559 -
Journal of Clinical Psychology Dec 2020There exists a dearth of research focused explicitly on predictors of attrition, particularly in the area of group therapy, where both attrition and attendance becomes...
OBJECTIVES
There exists a dearth of research focused explicitly on predictors of attrition, particularly in the area of group therapy, where both attrition and attendance becomes of primary concern. The present study examined both pretreatment and treatment-specific variables in the prospective prediction of attendance and attrition in group therapy.
METHOD
Fifty-two participants were randomized to one of two 12-week group treatments. Participants completed baseline interviews and questionnaires, as well as weekly assessments of treatment-specific factors.
RESULTS
No pretreatment factors predicted attendance or drop out, although men attended a larger amount of sessions and were less likely to drop out. Cross-lagged panel analyses supported bidirectional, causal relationships both treatment-specific predictors (therapeutic alliance and number of therapeutic techniques) and attendance.
CONCLUSIONS
Successful retention in group therapy may be less predictable from pretreatment factors and instead lie in increasing alliance and fostering the practice of therapeutic strategies.
Topics: Adolescent; Adult; Canada; Female; Humans; Male; Patient Compliance; Prospective Studies; Psychotherapy, Group; Students; Surveys and Questionnaires; Universities; Young Adult
PubMed: 32830326
DOI: 10.1002/jclp.23042 -
Addictive Behaviors Dec 2021Gender-specific literature focused on gambling disorder (GD) is scarce, and women with GD have been understudied. Therefore, the aim of this study was to estimate the...
BACKGROUND
Gender-specific literature focused on gambling disorder (GD) is scarce, and women with GD have been understudied. Therefore, the aim of this study was to estimate the short-term effectiveness in women with GD (n = 214) of a group standardized cognitive-behavioral therapy (CBT) and to identify the most relevant predictors of the primary therapy outcomes (dropout and relapse).
METHODS
The manualized CBT consisted of 16 weekly outpatient group sessions. Women were provided with resources to obtain a better understanding of the GD, to improve self-control and to manage risk situations.
RESULTS
The dropout risk was higher for women with lower GD severity and higher psychopathological distress. Among other factors, lower education levels were a significant predictor of the relapse risk and and the frequency of relapses was higher for divorced women with a preference for non-strategic gambling and with substances consumption.
CONCLUSIONS
Our findings evidence women-specific predictors of the primary therapy outcomes. The results highlight the need to design psychological interventions that address dropout and relapse risk factors in women.
Topics: Cognition; Cognitive Behavioral Therapy; Female; Gambling; Humans; Psychotherapy, Group; Recurrence
PubMed: 34425460
DOI: 10.1016/j.addbeh.2021.107085 -
BMC Psychiatry Apr 2022Major depressive disorder is a common psychological condition that can lead to negative individual and social consequences, the management of which is very important in... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Major depressive disorder is a common psychological condition that can lead to negative individual and social consequences, the management of which is very important in treating the patients. The present study aimed to determine the effect of cognitive-behavioral group therapy on self-esteem and optimism in patients with major depressive disorder.
METHODS
This is a single-blinded, randomized controlled trial in which a total of 64 patients with major depressive disorder were recruited using convenience sampling and then randomly assigned to two groups of Cognitive-Behavioral Group Therapy (CBGT) and Treatment-As-Usual (TAU). Data collection tools consisted of a demographic questionnaire, the Rosenberg Self-Esteem Scale (RSES), and the Revised Life Orientation Test (LOT-R). In the pretest stage, participants in both groups completed the above questionnaires before the intervention. Patients in the CBGT group received eight 90-min sessions of cognitive-behavioral therapy during four weeks (two sessions a week). Then participants re-completed RSES and LOT-R immediately, three months, and six months after the intervention. Data were analyzed with SPSS software version 16.0 using chi-squared test, independent-samples t-test, and repeated measures Analysis of Variance. The significance level (p-value) was considered to be less than 0.05.
RESULTS
It was indicated that there was a statistically significant difference in the mean scores of self-esteem and optimism between the two groups immediately, three months, and six months after the intervention (p < .05). The mean scores of self-esteem and optimism in the CBGT group increased significantly after the intervention compared to before it, although these scores gradually decreased over the three measurement time points after the intervention.
CONCLUSIONS
Based upon the results, it was concluded that the level of optimism and self-esteem increased significantly in the CBGT group after the intervention, although the levels of the above variables dropped again in the long run after the intervention due to the discontinuity of CBGT sessions. Therefore, it is necessary to take particular measures to regularly hold the sessions of CBGT for patients with major depressive disorder.
TRIAL REGISTRATION NUMBER
IRCT20140212016564N15 , The date of registration: 20-09-2021, Retrospectively registered.
Topics: Cognition; Cognitive Behavioral Therapy; Depressive Disorder, Major; Humans; Psychotherapy, Group; Self Concept
PubMed: 35484528
DOI: 10.1186/s12888-022-03918-y -
Revista Brasileira de Psiquiatria (Sao... Jun 2010The aim of this study was to assess whether the results obtained with 12 sessions of cognitive-behavioral group therapy with obsessive-compulsive patients were...
OBJECTIVE
The aim of this study was to assess whether the results obtained with 12 sessions of cognitive-behavioral group therapy with obsessive-compulsive patients were maintained after two years, and whether the degree of symptom remission was associated with relapse.
METHOD
Forty-two patients were followed. The severity of symptoms was measured at the end of cognitive-behavioral group therapy and at 18 and 24 months of follow-up. The assessment scales used were the Yale-Brown Obsessive-Compulsive Scale, Clinical Global Impression, Beck Depression Inventory, and Beck Anxiety Inventory.
RESULTS
The reduction in symptom severity observed at the end of treatment was maintained during the two-year follow-up period (F = 57.881; p < 0.001). At the end of the treatment, 9 (21.4%) patients presented full remission, 22 (52.4%) presented partial remission, and 11 (26.2%) had unchanged scores in the Yale-Brown Obsessive-Compulsive Scale. After two years, 13 patients (31.0%) presented full remission, 20 (47.6%) had partial remission, and 9 (21.4%) had unchanged Yale-Brown Obsessive-Compulsive Scale scores. The full remission of symptoms at the end of the treatment was a protective factor against relapse (chi2 = 4,962; df = 1; p = 0.026).
CONCLUSION
Our findings underscore the importance of attaining full remission of obsessive-compulsive symptoms during treatment and the need for new therapeutic strategies to achieve this.
Topics: Adult; Analysis of Variance; Cognitive Behavioral Therapy; Female; Follow-Up Studies; Humans; Longitudinal Studies; Male; Obsessive-Compulsive Disorder; Psychiatric Status Rating Scales; Psychotherapy, Group; Recurrence; Remission Induction; Severity of Illness Index; Time Factors; Treatment Outcome
PubMed: 20658055
DOI: 10.1590/s1516-44462010000200012 -
The American Journal on Addictions Jan 2022This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND AND OBJECTIVES
This thematic analysis of qualitative interviews from participants in Stage II randomized controlled trial examined women's and men's experiences in group therapy for substance use disorders (SUDs).
METHODS
Interviews were conducted with 77 women and 38 men after completion of either the gender-specific Women's Recovery Group (WRG) or mixed-gender Group Drug Counseling (GDC). Interviews were coded for themes using a deductive approach with a coding scheme modified from the Stage I trial. Satisfaction was measured quantitatively posttreatment.
RESULTS
Participants had high satisfaction scores with no significant differences between groups. Women in GDC rated group gender composition as less helpful than those in WRG. In the GDC group, women more frequently discussed the theme of self-perception (e.g., feelings of comfort, safety, shame) compared with men. Men overwhelmingly expressed the benefits of having women in the group, whereas women expressed advantages and disadvantages of mixed-gender groups and preference for single-gender groups. Guilt and shame were discussed by women and men; however, only women discussed stigma and its important role in their addiction and recovery.
DISCUSSION AND CONCLUSION
Men more frequently endorsed the helpfulness of mixed-gender groups than did women while women appreciated the enhanced support in single-gender SUD groups. Issues of stigma are especially salient for women.
SCIENTIFIC SIGNIFICANCE
Men and women express differences in their experiences of SUD group therapy. Only women endorse stigma as an obstacle to their treatment and recovery. Tailoring treatment to meet women's and men's needs may enhance engagement, retention, and clinical outcomes.
Topics: Counseling; Female; Humans; Male; Psychotherapy, Group; Substance-Related Disorders; Women
PubMed: 34730866
DOI: 10.1111/ajad.13242