Delivering group psychoeducational CBT in Primary Care: Comparing outcomes with individual CBT and individual psychodynamic‐interpersonal psychotherapy

Abstract

Within psychological services in Primary Care, service providers are expected and required to deliver clinical services that are prompt, safe and effective. However, long wait-times for treatment are common, with attendant clinical chronicity and risk issues. Evaluations of group-based treatments in Primary Care, which are clinically more efficient than individual treatments, are extremely scarce. The current evaluation attempted to appraise the effectiveness of a service innovation of introducing group-based psychoeducational cognitive-behaviour therapy (CBT; N=43), by comparing outcomes with clients treated in individual CBT (N=68) and individual psychodynamic-interpersonal psychotherapy (N=65). Group psychoeducational participants completed validated scales of psychological functioning (Beck Depression Inventory - 2, BDI-2; Brief Symptom Inventory, BSI; Inventory of Interpersonal Problems, IIP-32; and General Health Questionnaire, GHQ-12) at assessment, start of group, termination of group and 3-month follow-up, whereas participants in the individual therapies completed measures only at initiation and termination of treatment. The results indicate broad similarities between the outcomes achieved by the three services, with rates of clinically significant improvements and deteriorations comparable in the main across services. The results are discussed in terms of identified methodological limitations, service implications and models of service delivery for the psychological therapies in Primary Care.

Worksite stress management training: Moderated effects and clinical significance.

“…It can be argued that such criteria provide a more meaningful change index than relying solely on statistical significance and standardized effect sizes. The rates of clinically significant improvement compare very favorably to those reported in a number of group CBT studies (e.g., Kellett et al, 2007;Scott & Stradling, 1990;White, 1998), and support those who advocate the use of SMT for imparting cognitive-behavioral principles and skills in non-clinical contexts (Biglan et al, 2008;Brown, Cochrane, & Hancox, 2000;Schiraldi & Brown, 2001;White, 2000).…”

Group cognitive–behavioural therapy for anxiety and depression

“…Sessions are delivered in a more traditional didactic teaching style (Cuijpers 2005). Examples include the stress control programme developed to treat large numbers of people with anxiety in primary care (White 2004;Kellett 2007a) and all-day workshops for stress and self-confidence (Main 2005;Brown 2008). The large-scale stress workshops of Brown and colleagues contained 20-25 participants.…”

Predicting return to work from health related welfare following low intensity cognitive behaviour therapy

“…All of the mixed-condition group-based psychoeducational sessions were delivered in local community settings (e.g. leisure centres and voluntary organisations), with the aim of reducing any disabling effects of stigma and for ease of local access (Kellett, Clarke, & Matthews, 2007). The South Yorkshire region was covered by four CMP teams; Sheffield, Barnsely, Rotherham and Doncaster.…”