Evaluation of a brief Cognitive Behavioral Group Therapy for Psychological Distress among Female Icelandic University Students

Bernharðsdóttir, Jóhanna; Vilhjálmsson, Rúnar; Champion, Jane Dimmitt

doi:10.3109/01612840.2013.773473

Cited by 15 publications

(17 citation statements)

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“…The quasi-experimental study showed that psychological distress decreased significantly in the intervention group (n = 19) compared to the control group (n = 11) post therapy. [8] This finding concurs with other more recent CBGT intervention studies which were also provided in four sessions for mildly depressed and/or anxious students. [43][44][45] The major finding of the qualitative study was that the participants evaluated the brief CBGT intervention favorably and felt their mood improved.…”

Section: Validation Of the Preliminary In-terventionsupporting

confidence: 81%

“…In the first step the effectiveness of the cognitive behavioral group therapy post intervention was evaluated with a quasi-experimental study (n = 30) and in the second step the acceptability of the intervention was evaluated with semi-structured interviews and a qualitative content analysis (n = 19). [8,10] Results of the validation of the preliminay intervention The validation of the intervention, based on two previous studies, showed positive results. The quasi-experimental study showed that psychological distress decreased significantly in the intervention group (n = 19) compared to the control group (n = 11) post therapy.…”

Section: Validation Of the Preliminary In-terventionmentioning

confidence: 99%

“…Consequently all participants and the facilitators worked with the same written material for the purpose of increasing intervention fidelity. [8] The group facilitators and participants were seen as co-workers who collaborated to provide the participants with information and skills to deal with stress and psychological distress. Active participation and engagement of students was encouraged.…”

Section: Intervention Deliverymentioning

confidence: 99%

“…The results of the quantitative and qualitative validation of the intervention have been reported elsewhere. [8,10] …”

Section: Introductionmentioning

confidence: 99%

“…[6] Based on this high prevalence of psychological distress and the lack of mental health care for Icelandic female university students it was decided to design, validate and revise an intervention for this group to be delivered by advanced practice psychiatric nurses (APPN's). [8] The framework by van Meijel, Gamel, van Swieten-Duijfjes and Grypdonck [9] was chosen as a reference to systematically guide and describe this process. The initial step of intervention design according to this framework is to define the target group and operationalize the problem to be addressed.…”

Section: Introductionmentioning

confidence: 99%

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Designing and revising a cognitive behavioral group intervention for psychological distress among female university students

Bernharðsdóttir

Thome²,

Skärsäter³

et al. 2017

JNEP

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Background: Psychological distress in the form of depression and/or anxiety has been found to be common among university students, especially in females. Roughly one in five of Icelandic female university students exhibit elevated psychological distress, yet less than 30% of them do receive professional mental health care. To ameliorate the psychological distress a cognitive behavioral group therapy was designed to target the distress. The purpose of this paper is to describe the main steps in designing the respective intervention and the revisions made by the expert panel based on the validation of the preliminary intervention and the experience of the advanced practice psychiatric nurses therapists. Methods: The intervention design took place in four phases. Initially psychological distress was defined, secondly a literature review was conducted to see if there were effective interventions available to solve the problem. Thirdly the drafting of the intervention took place based on theory and evidence and finally the intervention was validated with quantitative and qualitative methods. The intervention was provided by two advanced practice psychiatric nurses in 4 sessions in groups of 5 to 8 females. An expert panel of 6 psychiatric nurses was formed to guide the intervention design, the delivery of the intervention and intervention validation. Results: The quantitative and qualitative validation of the preliminary intervention showed that psychological distress decreased and was acceptable to participants. Conclusions: The validation of the preliminary intervention provided the expert group with rationale for modifying the content and structure of the intervention in nine categories.

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Section: Validation Of the Preliminary In-terventionsupporting

confidence: 81%

Section: Validation Of the Preliminary In-terventionmentioning

confidence: 99%

Section: Intervention Deliverymentioning

confidence: 99%

“…The results of the quantitative and qualitative validation of the intervention have been reported elsewhere. [8,10] …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Designing and revising a cognitive behavioral group intervention for psychological distress among female university students

Bernharðsdóttir

Thome²,

Skärsäter³

et al. 2017

JNEP

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A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

Bjornstad,

Sonthalia,

Rouse

et al. 2024

Campbell Systematic Reviews

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BackgroundDepression is a public health problem and common amongst adolescents. Cognitive behavioural therapy (CBT) is widely used to treat adolescent depression but existing research does not provide clear conclusions regarding the relative effectiveness of different delivery modalities.ObjectivesThe primary aim is to estimate the relative efficacy of different modes of CBT delivery compared with each other and control conditions for reducing depressive symptoms in adolescents. The secondary aim is to compare the different modes of delivery with regard to intervention completion/attrition (a proxy for intervention acceptability).Search MethodsThe Cochrane Depression, Anxiety and Neurosis Clinical Trials Register was searched in April 2020. MEDLINE, PsycInfo, EMBASE, four other electronic databases, the CENTRAL trial registry, Google Scholar and Google were searched in November 2020, together with reference checking, citation searching and hand‐searching of two databases.Selection CriteriaRandomised controlled trials (RCTs) of CBT interventions (irrespective of delivery mode) to reduce symptoms of depression in young people aged 10–19 years with clinically relevant symptoms or diagnosis of depression were included.Data Collection and AnalysisScreening and data extraction were completed by two authors independently, with discrepancies addressed by a third author. CBT interventions were categorised as follows: group CBT, individual CBT, remote CBT, guided self‐help, and unguided self‐help. Effect on depressive symptom score was estimated across validated self‐report measures using Hedges' g standardised mean difference. Acceptability was estimated based on loss to follow‐up as an odds ratio. Treatment rankings were developed using the surface under the cumulative ranking curve (SUCRA). Pairwise meta‐analyses were conducted using random effects models where there were two or more head‐to‐head trials. Network analyses were conducted using random effects models.Main ResultsSixty‐eight studies were included in the review. The mean age of participants ranged from 10 to 19.5 years, and on average 60% of participants were female. The majority of studies were conducted in schools (28) or universities (6); other settings included primary care, clinical settings and the home. The number of CBT sessions ranged from 1 to 16, the frequency of delivery from once every 2 weeks to twice a week and the duration of each session from 20 min to 2 h. The risk of bias was low across all domains for 23 studies, 24 studies had some concerns and the remaining 21 were assessed to be at high risk of bias. Sixty‐two RCTs (representing 6435 participants) were included in the pairwise and network meta‐analyses for post‐intervention depressive symptom score at post‐intervention. All pre‐specified treatment and control categories were represented by at least one RCT. Although most CBT approaches, except remote CBT, demonstrated superiority over no intervention, no approaches performed clearly better than or equivalent to another. The highest and lowest ranking interventions were guided self‐help (SUCRA 83%) and unguided self‐help (SUCRA 51%), respectively (very low certainty in treatment ranking). Nineteen RCTs (3260 participants) were included in the pairwise and network meta‐analyses for 6 to 12 month follow‐up depressive symptom score. Neither guided self‐help nor remote CBT were evaluated in the RCTs for this time point. Effects were generally attenuated for 6‐ to 12‐month outcomes compared to posttest. No interventions demonstrated superiority to no intervention, although unguided self‐help and group CBT both demonstrated superiority compared to TAU. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking approaches were unguided self‐help and individual CBT, respectively. Sixty‐two RCTs (7347 participants) were included in the pairwise and network meta‐analyses for intervention acceptability. All pre‐specified treatment and control categories were represented by at least one RCT. Although point estimates tended to favour no intervention, no active treatments were clearly inferior. No CBT approach demonstrated clear superiority over another. The highest and lowest ranking active interventions were individual CBT and group CBT respectively. Pairwise meta‐analytic findings were similar to those of the network meta‐analysis for all analyses. There may be age‐based subgroup effects on post‐intervention depressive symptoms. Using the no intervention control group as the reference, the magnitudes of effects appear to be larger for the oldest age categories compared to the other subgroups for each given comparison. However, they were generally less precise and formal testing only indicated a significant difference for group CBT. Findings were robust to pre‐specified sensitivity analyses separating out the type of placebo and excluding cluster‐RCTs, as well as an additional analysis excluding studies where we had imputed standard deviations.Authors' ConclusionsAt posttreatment, all active treatments (group CBT, individual CBT, guided self‐help, and unguided self‐help) except for remote CBT were more effective than no treatment. Guided self‐help was the most highly ranked intervention but only evaluated in trials with the oldest adolescents (16–19 years). Moreover, the studies of guided self‐help vary in the type and amount of therapist support provided and longer‐term results are needed to determine whether effects persist. The magnitude of effects was generally attenuated for 6‐ to 12‐month outcomes. Although unguided self‐help was the lowest‐ranked active intervention at post‐intervention, it was the highest ranked at follow‐up. This suggests the need for further research into whether interventions with self‐directed elements enable young people to maintain effects by continuing or revisiting the intervention independently, and whether therapist support would improve long‐term outcomes. There was no clear evidence that any active treatments were more acceptable to participants than any others. The relative effectiveness of intervention delivery modes must be taken into account in the context of the needs and preferences of individual young people, particularly as the differences between effect sizes were relatively small. Further research into the type and amount of therapist support that is most acceptable to young people and most cost‐effective would be particularly useful.

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Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial

Corpas

Moriana

Martínez

et al. 2021

International Journal of Clinical and Health Psychology

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Background/Objective Brief transdiagnostic psychotherapies are a possible treatment for emotional disorders. We aimed to determine their efficacy on mild/moderate emotional disorders compared with treatment as usual (TAU) based on pharmacological interventions. Method: This study was a single-blinded randomized controlled trial with parallel design of three groups. Patients ( N = 102) were assigned to brief individual psychotherapy ( n = 34), brief group psychotherapy ( n = 34) or TAU ( n = 34). Participants were assessed before and after the interventions with the following measures: PHQ-15, PHQ-9, PHQ-PD, GAD-7, STAI, BDI-II, BSI-18, and SCID. We conducted per protocol and intention-to-treat analyses. Results: Brief psychotherapies were more effective than TAU for the reduction of emotional disorders symptoms and diagnoses with moderate/high effect sizes. TAU was only effective in reducing depressive symptoms. Conclusions: Brief transdiagnostic psychotherapies might be the treatment of choice for mild/moderate emotional disorders and they seem suitable to be implemented within health care systems.

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Evaluation of a brief Cognitive Behavioral Group Therapy for Psychological Distress among Female Icelandic University Students

Cited by 15 publications

References 36 publications

Designing and revising a cognitive behavioral group intervention for psychological distress among female university students

Designing and revising a cognitive behavioral group intervention for psychological distress among female university students

A comparison of the effectiveness of cognitive behavioural interventions based on delivery features for elevated symptoms of depression in adolescents: A systematic review

Brief psychological treatments for emotional disorders in Primary and Specialized Care: A randomized controlled trial

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