Outcomes for Depressed and Anxious Inpatients Discharged Before or After Group Cognitive Behavior Therapy

Abstract

Treatment outcomes for psychiatric inpatients with a primary diagnosis of a depressive or anxiety disorder who completed a cognitive behavior therapy (CBT) program while inpatients or when discharged were examined. Of 340 inpatients, 197 had been discharged to day patient status before the end of the CBT program, and 143 remained as inpatients. Data were collected before and after the CBT program and at 3-month follow-up. There was a significant improvement by posttreatment in self-esteem, locus of control, anxiety, depression, and stress, and these gains were maintained at 3-month follow-up. In addition, anxious, but not depressed, patients who completed CBT as day patients demonstrated greater improvements from after the CBT program to follow-up than those treated as inpatients. Possible reasons for the beneficial effects of completing the CBT as a day patient rather than an inpatient are discussed, and threats to the validity of this naturalistic study are considered.

Cognitive and Behavioral Changes Related to Symptom Improvement Among Patients with a Mood Disorder Receiving Intensive Cognitive-behavioral Therapy

“…Elucidating the most effective components of CBT in randomized controlled trials continues to be a critical area of inquiry; however, it is also important to investigate these factors among patients with complex clinical profiles in real-world settings, 17 such as intensive partial hospital (PH). Several studies have found that CBT-oriented PH programs provide a cost-effective treatment option for various forms of psychopathology, including personality disorders, 18,19 anxiety disorders, 20 substance use disorders, 21 eating disorders, 22 and patient populations with mixed diagnoses. 23--25 PH programs first emerged in the 1970s as an alternative method to deliver long-term comprehensive psychosocial treatment with greater flexibility and reduced cost compared with previously favored inpatient treatment methods.…”

A Cognitive Behavioural Illness Management Program for Severe Depression: Predictors of Treatment Response

“…Patients who rapidly changed to the outpatient setting -on average even at the same psychopathological level of impairment as the remaining patientsshowed higher gains in well-being and problem solving compared to their counterparts remaining in the clinic. Other studies Page and Hooke [59], showed no differences in completing CBT as a patient in the inpatient setting or in the day clinic.…”

“…Even though cognitive behavioural therapy is an effective treatment for depression studies provide little guidance about whether it is best provided to inpatients while they are receiving inpatient services or after discharge [39]. Reasons for the inpatient setting are to use the time to provide empirically validated psychological treatments and to address difficulties with treatment adherence (e.g., homework assignment) more easily.…”

A waiting list group in anxiety ambulatory

“…A TCC possui uma sólida base empírica e um apoio indireto oferecido por várias décadas de pesquisas (Butler, Chapman, Forman & Beck, 2006). Estudos indicam resultados positivos quando a TCC de grupo é empregada para o manejo de transtornos da ansiedade Norton & Hope, 2005;Page & Hooke, 2003;Wessler, 1996). As indicações para este tratamento, entretanto, devem ser feitas individualmente, permitindo assim que o terapeuta avalie as características do paciente.…”