Effectiveness of cognitive behavior therapy for diagnostically heterogeneous groups: A benchmarking study.

Abstract

Researchers have recently suggested that the commonalities across the emotional disorders outweigh the differences, and thus similar treatment principles could be applied in unified interventions. In this study, the authors used a benchmarking strategy to investigate the transportability of cognitive-behavioral therapy (CBT) for anxiety and depression to mixed-diagnosis groups. Patients (N = 143) attended 10 2-hour sessions of group CBT plus a 1-month follow-up. Changes in anxiety and depression were indexed by effect sizes, reliable change, and clinically significant change and then benchmarked to previous efficacy and effectiveness studies. Symptoms of depression and anxiety significantly improved, and mixed-diagnosis groups compared favorably with diagnosis-specific CBT, suggesting that unified treatments are an effective, efficient, and practical method of treatment delivery.

Quality of life in depression: An important outcome measure in an outpatient cognitive–behavioural therapy group programme?

“…Treatment integrity was maintained by using a structured therapist manual that detailed session structure and handouts, and through weekly supervision. This treatment programme has been benchmarked against published effi cacy and effectiveness studies and is associated with large effect sizes (McEvoy & Nathan, 2007). Written consent to information being placed on a clinic database and used in subsequent research was obtained from clients.…”

Effectiveness of routine psychotherapy: Method matters

“…As pointed out by McEvoy and Nathan (2007), studies of clinical benchmarking do not address end-state functioning, which is an important consideration in evaluating routine practice. If routine treatments are producing equivalent change to RCT trials but inadequate end-state results, it is possible to conclude that benchmarking methods are not an adequate measure of clinical effectiveness.…”

“…These limitations were partially addressed by McEvoy and Nathan (2007), who compared 143 outpatients in a mixed-diagnosis group CBT in routine care to efficacy trial groups of depression and anxiety patients. One important novel method in this paper was to contrast results based on pre-post change effect size benchmark analyses with results based on reliable change and clinically significant change, the latter incorporating an end-state functioning comparison.…”

Transdiagnostic treatment using a unified protocol: application for patients with a range of comorbid mood and anxiety disorders

“…13,14 The conceptual clinical process requires the setting of goals and their inclusion in the treatment. [1][2][3][4][5][6]12 The unified protocol can be applied individually or in groups and consists of therapeutic procedures that enable patients with severe multiple disorders to participate in the same group. Emotions are recognized, regulated and restructured through scientific techniques that reinforce new knowledge and behavior before the patient's problems surface.…”

“…Fear, worry, or decision-making are characteristics of thought that seem to be common in these patients. [5][6][7][8] However, in group psychotherapy, a primary treatment focus has to be elected, so that therapists can focus on connecting symptoms and follow the patient's experience during the process, promoting open communication in terms of both social skills and cognitive restructuring. [7][8][9][10][11] In recognition to the empirical origin of CBT, the treatment protocol usually provides measures for patients to focus on during their treatment and assist them in determining their progress.…”