What are the recovery and attrition outcomes for group CBT and individual CBT for generalised anxiety disorder in an IAPT service? An exploratory study

2020 ◽  
Vol 13 ◽  
Author(s):  
Marianne Fanous ◽  
Jo Daniels
Keyword(s):  
Anxiety Disorder ◽  
Behavioural Therapy ◽  
Anxiety And Depression ◽  
List Type ◽  
Generalised Anxiety Disorder ◽  
Post Intervention ◽  
Attrition Rates ◽  
Clinical Recovery ◽  
Psychological Therapies ◽  
Group Cbt

Abstract Group cognitive behavioural therapy (gCBT) is commonly used in Increasing Access to Psychological Therapies (IAPT) services. However, there is limited knowledge of the efficacy of gCBT as a delivery format for generalised anxiety disorder (GAD). To address gaps in literature, this study aims to explore the efficacy and attrition of individual and group CBT interventions, respectively, at Step 3 for GAD using data from a routine IAPT service over a 24-month period. Data were retrospectively derived from a routine serviceʼs IAPTus database, separating those eligible for comparison into group (n = 44) and individual (n = 55) CBT for GAD. Outcomes were differences in pre–post self-reported anxiety (GAD-7) and depression (PHQ-9) scores, clinical recovery and attrition for gCBT and individual CBT. Both gCBT and individual CBT yielded significant reductions in self-reported anxiety and depression scores over time. Results indicate that 53% of patients attending individual CBT achieved clinical recovery, with similar but less competitive rates of 41% in gCBT. Attrition rates were similar between gCBT (29.5%) and individual CBT (27.3%), respectively. Preliminary results suggest that both individual and gCBT are effective interventions for GAD patients in IAPT, offering symptom alleviation and comparable recovery and attrition rates post-intervention. This observational design offers credibility and insight into a pragmatic evaluative and explorative comparison. gCBT may offer an acceptable and potentially economical alternative. Key learning aims (1) To explore whether gCBT and individual CBT yield significant symptom reduction in self-reported anxiety and depression in GAD patients from a routine IAPT service. (2) To explore gCBT and individual CBT clinical recovery rates in non-optimum routine conditions. (3) To explore whether gCBT for GAD produces unacceptable attrition rates and if this differs from attrition rates in individual CBT for GAD in a routine IAPT service.

scholarly journals Group cognitive–behavioural therapy for anxiety and depression

2010 ◽  
Vol 16 (3) ◽  
pp. 219-227 ◽  
Author(s):  
Graeme Whitfield
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Anxiety And Depression ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Current Evidence Base ◽  
Group Cbt

SummaryCognitive–behavioural therapy (CBT) is a psychological treatment approach that can be delivered not only on a one-to-one basis but also to groups and in self-help formats. However, the evidence base supporting individual CBT is more extensive than the research regarding group CBT. This is likely to influence the choice of services that develop in the Improving Access to Psychological Therapies (IAPT) programme for the treatment of depression and anxiety disorders in primary care in England. This article outlines the different forms that group CBT takes, the way in which it may benefit people and the current evidence base supporting its use for anxiety and depression. It also outlines the advantages of group or individual CBT and describes those patients who appear to be best suited to a specific delivery.

Face-to-face versus Video Teleconference Group Cognitive Behavioural Therapy for Anxiety and Related Disorders: A Preliminary Comparison: Thérapie cognitivo-comportementale de groupe en personne contre par vidéo téléconférence pour l’anxiété et les troubles connexes: une comparaison préliminaire

2021 ◽  
pp. 070674372110273
Author(s):  
Irena Milosevic ◽  
Duncan H. Cameron ◽  
Melissa Milanovic ◽  
Randi E. McCabe ◽  
Karen Rowa
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Symptom Improvement ◽  
Face To Face ◽  
Compulsive Disorder ◽  
Cognitive Behavioural ◽  
Group Cbt ◽  
Delivery Formats

Objective: Telehealth is being increasingly incorporated into the delivery of mental health care and has received widespread attention during the COVID-19 pandemic for its ability to facilitate care during physical distancing restrictions. Videoconferencing is a common telehealth modality for delivering psychotherapy and has demonstrated similar outcomes to those of face-to-face therapy. Cognitive behavioural therapy (CBT) is the most common psychotherapy evaluated across various telehealth modalities; however, studies on CBT delivered via videoconference, particularly in a group therapy format, are lacking. Further, little research exists on videoconference group CBT for anxiety disorders. Accordingly, the present study compared the outcomes of group CBT for anxiety and related disorders delivered via videoconference versus face-to-face. Method: Using a non-randomized design, data on attendance, dropout, clinical outcomes, and functional impairment were collected from 413 adult outpatients of a tertiary care anxiety disorders clinic who attended a CBT group for panic disorder/agoraphobia, social anxiety disorder, generalized anxiety disorder (GAD), or obsessive-compulsive disorder delivered either face-to-face (pre-COVID-19 pandemic) or via videoconference (since the onset of COVID-19 pandemic). Outcomes were assessed using well-validated self-report measures. Data were collected pre-treatment, across 12 weekly sessions, and post-treatment. Intent-to-treat analyses were applied to symptom outcome measures. Results: Face-to-face CBT conferred only a slight benefit over videoconference CBT for symptom outcomes across all groups, but when assessed individually, only the GAD group showed greater symptom improvement in the face-to-face format. Effect sizes for significant differences between the delivery formats were small. Participants in videoconference groups tended to have slightly higher attendance rates in some instances, whereas functional improvement and treatment dropout were comparable across the delivery formats. Conclusions: Results provide preliminary evidence that videoconference group CBT for anxiety and related disorders may be a promising and effective alternative to face-to-face CBT. Additional research is needed to establish equivalence between these delivery formats.

scholarly journals The effectiveness of telemedicine interventions to address maternal depression: A systematic review and meta-analysis

2018 ◽  
Vol 24 (10) ◽  
pp. 639-650 ◽  
Author(s):  
Uthara Nair ◽  
Nigel R Armfield ◽  
Mark D Chatfield ◽  
Sisira Edirippulige
Keyword(s):  
Systematic Review ◽  
Maternal Depression ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Health Concern ◽  
Cochrane Library ◽  
Post Intervention ◽  
Attrition Rates ◽  
Cognitive Behavioural ◽  
Randomised Controlled

Introduction Maternal depression (MD), is an overarching term for depression affecting pregnant women and mothers for up to 12 months postpartum. Because MD may have chronic and long-lasting effects, it is an important public health concern. The extent to which telemedicine may be an effective way to provide services to sufferers of MD is unknown, therefore, this review aimed to assess the available evidence. Methods We conducted a search of The Cochrane Library, PubMed/MEDLINE, PsycINFO, and EMBASE for relevant randomised controlled trials published between 2000 and 2018; we then conducted a systematic review and meta-analysis. Results We identified 10 studies for inclusion. Therapeutic strategies involved cognitive behavioural therapy (CBT), behavioural activation and other psychoeducation. Eight trials reported significant improvement in depression scores post-intervention; four studies that conducted post-intervention follow-up found that these improvements continued. However, high attrition rates and lack of blinding were common problems. Discussion This review found limited evidence supporting the delivery of CBT for the treatment of MD and anxiety using telemedicine. However, most of the evidence only studied improvements in postpartum depression, indicating that use of telemedicine to provide MD intervention is still small and an under-researched area.

The acceptability and feasibility of group cognitive behavioural therapy for older adults with generalised anxiety disorder

2020 ◽  
Vol 48 (5) ◽  
pp. 621-625
Author(s):  
Jo Hall ◽  
Stephen Kellett ◽  
Manreesh Kaur Bains ◽  
Heather Stonebank ◽  
Shonagh Scott
Keyword(s):  
Older Adults ◽  
Anxiety Disorder ◽  
Cognitive Behavioural Therapy ◽  
Group Treatment ◽  
Behavioural Therapy ◽  
Generalised Anxiety Disorder ◽  
Group Setting ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Therapy Protocol

AbstractBackground:Group psychotherapy for older adults with generalised anxiety disorder is an under-researched area.Aim:This report describes a mixed method evaluation of the acceptability and feasibility of an Overcoming Worry Group.Method:The Overcoming Worry Group was a novel adaptation of a cognitive behavioural therapy protocol targeting intolerance-of-uncertainty for generalised anxiety disorder, tailored for delivery to older adults in a group setting (n = 13).Results:The adapted protocol was found to be acceptable and feasible, and treatment outcomes observed were encouraging.Conclusions:This proof-of-concept study provides evidence for an Overcoming Worry Group as an acceptable and feasible group treatment for older adults with generalised anxiety disorder.

scholarly journals Psychological therapies for generalised anxiety disorder

2007 ◽  
Author(s):  
Vivien Hunot ◽  
Rachel Churchill ◽  
Vanessa Teixeira ◽  
Mauricio Silva de Lima
Keyword(s):  
Anxiety Disorder ◽  
Generalised Anxiety Disorder ◽  
Psychological Therapies

Client-led culturally responsive CBT – integrating familism in the treatment of chronic depression: a case study

2020 ◽  
Vol 13 ◽  
Author(s):  
Lilian Skilbeck ◽  
Christopher Spanton ◽  
Ian Roylance
Keyword(s):  
Cultural Adaptation ◽  
Treatment Plan ◽  
Behavioural Therapy ◽  
Cultural Responsiveness ◽  
Chronic Depression ◽  
List Type ◽  
Her Family ◽  
Psychological Therapies ◽  
Cognitive Behavioural

Abstract Britain has increasingly become a multi-cultural society. In order to improve access to primary care psychological therapy including cognitive behavioural therapy (CBT), there has been an increase in focus on cultural adaptation and cultural responsiveness. To date, these adaptations have focused on domains such as language, beliefs and values. In this case, familism was the focus for adaptation. The client was a 22-year-old female from a black African-British background. She presented with severe symptoms of chronic depression as measured on routine standard questionnaires and the interview. She had minimal success from previous interventions and was struggling to make progress. Therapy was guided by the client’s views on what issues had a bearing on her difficulties. The client hypothesised that familism factors with themes around ‘my parents’ culture’ and ‘family comes first’ were interacting with her cognitive behavioural factors to maintain her problem. She requested the involvement of her family in her treatment plan. In line with the Improving Access to Psychological Therapies–Black, Asian and Minority Ethnic service user Positive Practice Guide, this was integrated as part of her formulation. Upon involvement of her father in a single session, the client attained reliable improvement. She attributed her improvement to this involvement. By the end of therapy, she reached recovery, which was maintained at 3-month follow-up. This study was responsive to the client’s own perceived cultural needs through the integration of familism into her CBT formulation. It illustrates a client-led cultural adaptation of CBT to treat chronic depression. Key learning aims It is hoped that the reader will increase their understanding of the following from reading this case study: (1) Creating an environment where clients can freely discuss their perceived cultural factors from the outset. (2) Client-led cultural responsiveness to their expressed cultural needs. (3) Familism as a domain for adapting CBT.

scholarly journals Mindfulness-based cognitive therapy v. group psychoeducation for people with generalised anxiety disorder: Randomised controlled trial

2016 ◽  
Vol 209 (1) ◽  
pp. 68-75 ◽  
Author(s):  
Samuel Yeung Shan Wong ◽  
Benjamin Hon Kei Yip ◽  
Winnie Wing Sze Mak ◽  
Stewart Mercer ◽  
Eliza Yee Lai Cheung ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Usual Care ◽  
Cognitive Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Generalised Anxiety Disorder ◽  
Significant Group ◽  
Time Interaction ◽  
Group Time ◽  
Randomised Controlled

BackgroundResearch suggests that an 8-week mindfulness-based cognitive therapy (MBCT) course may be effective for generalised anxiety disorder (GAD).AimsTo compare changes in anxiety levels among participants with GAD randomly assigned to MBCT, cognitive–behavioural therapy-based psychoeducation and usual care.MethodIn total, 182 participants with GAD were recruited (trial registration number: CUHK_CCT00267) and assigned to the three groups and followed for 5 months after baseline assessment with the two intervention groups followed for an additional 6 months. Primary outcomes were anxiety and worry levels.ResultsLinear mixed models demonstrated significant group × time interaction (F(4,148) = 5.10, P = 0.001) effects for decreased anxiety for both the intervention groups relative to usual care. Significant group × time interaction effects were observed for worry and depressive symptoms and mental health-related quality of life for the psychoeducation group only.ConclusionsThese results suggest that both of the interventions appear to be superior to usual care for the reduction of anxiety symptoms.

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