Feasibility of large group cognitive behavioural therapy education classes for anxiety disorders

2018 ◽  
Vol 6 (2) ◽  
pp. 274 ◽  
Author(s):  
Joshua Palay ◽  
Jacquelyne Y Wong ◽  
Jason R Randall ◽  
Tanya Sala ◽  
James M Bolton ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Waiting Times ◽  
Behavioural Therapy ◽  
Stepped Care ◽  
Care Clinic ◽  
Large Group ◽  
Cognitive Behavioural ◽  
Group Cbt

Rationale, aims and objectives: Cognitive behavioural therapy (CBT) is effective in treating anxiety disorders. In publically funded systems, CBT is not easily accessible due to long wait times. In order to provide quicker access, a large group CBT intervention was implemented in a tertiary care clinic. This study describes the design, feasibility and acceptability of such an intervention as part of stepped care for anxiety disorders. Method: The intervention followed a 2-session curriculum, consisting of 90 minutes classes providing didactic instruction on key CBT topics and self-management strategies. Classes accommodated 30 patients and were led by staff psychiatrists formally trained in CBT. A retrospective analysis of patients referred to the clinic during the first year of class implementation was performed to determine class completion rate, patient satisfaction (using a usefulness Likert Scale and Session Rating Scale [SRS]) and symptom trajectory (using the GAD-7).Results: The implementation of large group CBT classes reduced waiting times from approximately one year to approximately 3 months. One hundred and thirty-one patients were screened by the clinic, 88 of whom (67%) completed the intervention. Sixty-eight percent of patients rated the classes as useful; however, SRS findings indicated that only 46% of patients were satisfied. GAD-7 scores decreased by 1.57 (95% CI 0.2 to 2.95; SMD=0.24).Conclusions: This analysis contributes preliminary evidence that large group CBT education classes may be an acceptable means to reduce waiting times for CBT for anxiety disorders. Further controlled research is required to elucidate the benefit and cost effectiveness of such classes.

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.

Is cognitive behavioural therapy an effective complement to antidepressants in adolescents? A meta-analysis

2011 ◽  
Vol 23 (6) ◽  
pp. 263-271 ◽  
Author(s):  
Raffaella Calati ◽  
Laura Pedrini ◽  
Sara Alighieri ◽  
Mariela Ivana Alvarez ◽  
Lorenzo Desideri ◽  
...  
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Meta Analysis ◽  
Combined Treatment ◽  
Behavioural Therapy ◽  
Global Functioning ◽  
Major Depressive ◽  
Cognitive Behavioural ◽  
Children’S Depression

Calati R, Pedrini L, Alighieri S, Alvarez MI, Desideri L, Durante D, Favero F, Iero L, Magnani G, Pericoli V, Polmonari A, Raggini R, Raimondi E, Riboni V, Scaduto MC, Serretti A, De Girolamo G. Is cognitive behavioural therapy an effective complement to antidepressants in adolescents? A meta-analysis.Objective: Evidence on effectiveness of combined treatments versus antidepressants alone in adolescents consists on a few studies in both major depressive and anxiety disorders. A meta-analysis of randomised 12-week follow-up studies in which antidepressant treatment was compared to combined treatment consisting of the same antidepressant with cognitive behavioural therapy has been performed.Methods: Data were entered into the Cochrane Collaboration Review Manager software and were analysed within a random effect framework. A quality assessment has been performed through Jadad Scale.Results: Higher global functioning at the Children's Global Assessment Scale was found in the combined treatment group (p < 0.0001) as well as higher improvement at the Clinical Global Impressions Improvement Scale (p = 0.04). No benefit of combined treatment was found on depressive symptomatology at the Children's Depression Rating Scale – Revised.Conclusion: Combined treatment seems to be more effective than antidepressant alone on global functioning and general improvement in adolescents with major depressive and anxiety disorders.

Pre-Existing Antidepressant Medication and the Outcome of Group Cognitive-Behavioural Therapy

1999 ◽  
Vol 33 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Tian P. S. Oei ◽  
Alice E. O. Yeoh
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Depression Scale ◽  
Antidepressant Medication ◽  
Behavioural Therapy ◽  
Automatic Thoughts ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
The Impact ◽  
Group Cbt

Objective: This study aimed to investigate the impact of pre-existing medication on the outcome of group cognitive-behavioural therapy (CBT) in the treatment of patients with depression. Method: Of the 71 patients diagnosed with major depression who participated in group CBT, 25 were on medication (CBT-M) and 46 were unmedicated (CBT). The patients received 12 sessions of group CBT over a 3-month period. The dependent measures used were the Beck Depression Inventory, Zung Self-Rating Depression Scale, Automatic Thoughts Questionnaire, Hopelessness Scale, Dysfunctional Attitude Scale, Daily Activity Rating Scale and Daily Mood Rating Scale. Results: Both the CBT and CBT-M groups showed statistically significant improvement in depression scores and cognitive process measures. However, the rate of improvement for both groups on these measures did not differ. Conclusion: The study indicated that pre-existing antidepressant medication did not enhance or detract from the positive treatment outcome of depressed patients receiving a group CBT treatment.

scholarly journals An investigation of general predictors for cognitive–behavioural therapy outcome for anxiety disorders in a routine clinical setting

BMJ Open ◽  
2016 ◽  
Vol 6 (3) ◽  
pp. e010898 ◽  
Author(s):  
Sara Kerstine Kaya Nielsen ◽  
Signe Vangkilde ◽  
Kate B Wolitzky-Taylor ◽  
Sarah Ingrid Franksdatter Daniel ◽  
Ida Hageman
Keyword(s):  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Clinical Setting ◽  
Behavioural Therapy ◽  
Therapy Outcome ◽  
Cognitive Behavioural ◽  
Routine Clinical Setting

scholarly journals Cognitive–behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication

2005 ◽  
Vol 186 (4) ◽  
pp. 324-330 ◽  
Author(s):  
Lucia R. Valmaggia ◽  
Mark van der Gaag ◽  
Nicholas Tarrier ◽  
Marieke Pijnenborg ◽  
Cees J. Slooff
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Controlled Study ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
Treatment Refractory

BackgroundThere is increasing evidence that cognitive–behavioural therapy can be an effective intervention for patients experiencing drug-refractory positive symptoms of schizophrenia.AimsTo investigate the effects of cognitive–behavioural therapy on in-patients with treatment-refractory psychotic symptoms.MethodManualised therapy was compared with supportive counselling in a randomised controlled study. Both interventions were delivered by experienced psychologists over 16 sessions of treatment. Therapy fidelity was assessed by two independent raters. Participants underwent masked assessment at baseline, after treatment and at 6 months' follow-up. Main outcome measures were the Positive and Negative Syndrome Scale and the Psychotic Symptoms Rating Scale. The analysis was by intention to treat.ResultsParticipants receiving cognitive–behavioural therapy had improved with regard to auditory hallucinations and illness insight at the post-treatment assessment, but these findings were not maintained at follow-up.ConclusionsCognitive–behavioural therapy showed modest short-term benefits over supportive counselling for treatment-refractory positive symptoms of schizophrenia.

Long-term Effects of Cognitive-Behavioural Therapy and Lithium Therapy on Depression in the Elderly

1995 ◽  
Vol 167 (5) ◽  
pp. 653-658 ◽  
Author(s):  
K. C. M. Wilson ◽  
M. Scott ◽  
M. Abou-Saleh ◽  
R. Burns ◽  
J. R. M. Copeland
Keyword(s):  
Maintenance Therapy ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Lithium Therapy ◽  
Controlled Study ◽  
Depression Severity ◽  
Cognitive Behavioural

BackgroundWe examine the effects of cognitive-behavioural therapy (CBT) as an adjuvant to acute physical treatment and lithium maintenance therapy in reducing depression severity over a follow-up year in elderly depressed patients.MethodThe study consists of three phases. During the acute treatment and continuation phase, 17 of 31 patients received CBT as an adjuvant to treatment as usual. During the maintenance phase of 1 year, subjects were entered into a double-blind, placebo-controlled study of low-dose lithium therapy.ResultsReceiving adjuvant CBT significantly reduced patients' scores on the Hamilton Rating Scale for Depression during the follow-up year (repeated measures analyses of variance; P = 0.007). No significant differences were found between lithium and placebo maintenance therapy.ConclusionsCBT can be adapted as an adjuvant therapy in the treatment of severely depressed elderly patients and reduces depression severity during follow-up. The prophylactic failure of long-term lithium therapy may be explained through poor compliance.

scholarly journals Stepped care and cognitive–behavioural therapy for bulimia nervosa: randomised trial

2011 ◽  
Vol 198 (5) ◽  
pp. 391-397 ◽  
Author(s):  
James E. Mitchell ◽  
Stewart Agras ◽  
Scott Crow ◽  
Katherine Halmi ◽  
Christopher G. Fairburn ◽  
...  
Keyword(s):  
Bulimia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Relative Effectiveness ◽  
Randomised Trial ◽  
Behavioural Therapy ◽  
Individual Therapy ◽  
Stepped Care ◽  
Self Help ◽  
Treatment Conditions ◽  
Cognitive Behavioural

BackgroundThis study compared the best available treatment for bulimia nervosa, cognitive–behavioural therapy (CBT) augmented by fluoxetine if indicated, with a stepped-care treatment approach in order to enhance treatment effectiveness.AimsTo establish the relative effectiveness of these two approaches.MethodThis was a randomised trial conducted at four clinical centres (Clinicaltrials.gov registration number: NCT00733525). A total of 293 participants with bulimia nervosa were randomised to one of two treatment conditions: manual-based CBT delivered in an individual therapy format involving 20 sessions over 18 weeks and participants who were predicted to be non-responders after 6 sessions of CBT had fluoxetine added to treatment; or a stepped-care approach that began with supervised self-help, with the addition of fluoxetine in participants who were predicted to be non-responders after six sessions, followed by CBT for those who failed to achieve abstinence with self-help and medication management.ResultsBoth in the intent-to-treat and completer samples, there were no differences between the two treatment conditions in inducing recovery (no binge eating or purging behaviours for 28 days) or remission (no longer meeting DSM–IV criteria). At the end of 1-year follow-up, the stepped-care condition was significantly superior to CBT.ConclusionsTherapist-assisted self-help was an effective first-level treatment in the stepped-care sequence, and the full sequence was more effective than CBT suggesting that treatment is enhanced with a more individualised approach.

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