A multidimensional investigation of anxiety sensitivity and depression outcomes in cognitive-behavioral group therapy.

We examined how anxiety sensitivity - the fear of symptoms of anxiety due to their perceived harmful effects - and gender are associated with treatment trajectory and outcomes in a large outpatient sample (N = 278) who received 14-weeks of cognitive-behavioral group therapy (CBGT) for depression. Three dimensions of anxiety sensitivity (cognitive, physical, and social concerns) and depression were assessed at pre-treatment, and the latter was assessed weekly during treatment. Latent growth curve models supported a link between cognitive concerns (fears of losing control over thoughts) and greater improvement in depression near the end of treatment (i.e., weeks 10-14); gender did not moderate trajectory. Gender (i.e., identifying as a woman) and greater physical concerns (fears of physical consequences of arousal symptoms) were associated with completion of < 8 sessions. Results suggest that those with more cognitive concerns might require greater time in treatment and/or benefit most from the focus on maladaptive assumptions and core beliefs in later CBGT sessions. Future research, including investigation of intervening variables, may elucidate the mechanisms through which greater physical concerns and gender are associated with treatment non-completion. Results supported differential associations of anxiety sensitivity dimensions with depression treatment outcomes, though further research attention is needed.

Long-term effects of mindfulness-based cognitive therapy in patients with obsessive-compulsive disorder and residual symptoms after cognitive behavioral therapy: Twelve-month follow-up of a randomized controlled trial.

We examined the long-term efficacy of mindfulness-based cognitive therapy (MBCT) compared to a psychoeducation group as an active control condition in patients with obsessive-compulsive disorder (OCD) with residual symptoms of OCD after cognitive behavioral therapy. A total of 125 patients were included in a bicentric, interviewer-blind, randomized, and actively controlled trial and were assigned to either an MBCT group (n = 61) or a psychoeducation group (n = 64). Patients' demographic characteristics and the results from our previous assessments have already been reported (Külz et al., 2019). At the 12-month follow-up the completion rate was 80%. OCD symptoms were reduced from baseline to follow-up assessment with a large effect, but no difference was found between groups. Exploratory analyses showed that a composite score of time occupied by obsessive thoughts, distress associated with obsessive thoughts, and interference due to obsessive thoughts differed between groups in the per-protocol analysis, with a stronger reduction in the MBCT group. At the 12-month follow-up, the two groups showed a similar reduction of symptoms. However, preliminary evidence indicates that MBCT has a superior effect on some aspects of OCD. This should be replicated in future studies.

Process of therapeutic changes in Meaning-Centered Group Psychotherapy adapted to the Portuguese language: A narrative analysis.

OBJECTIVE: The aim was to understand the processes of therapeutic changes in Meaning-Centered Group Psychotherapy (MCGP) in a Portuguese sample. METHOD: Adult cancer patients with distress motivated to participate in MCGP were identified; descriptive and narrative analyses were performed on the session content. RESULTS: The sample had 24 participants (mean age: 63.43 years); the majority were females (75%), with a median academic degree (54%). Breast cancer was most frequent (67%) at the localized stage (71%). The narrative analysis defined seven categories according to the MCGP themes. In "Moments with Meaning (MwM)," the most relevant dimensions were related to interpersonal relations, the moment of diagnosis, and personal achievements. This category established relations with almost all other categories, as did the category "historical sources of meaning (SoM)." The category "identity before and after cancer diagnosis" was only related to "attitudinal SoM" and "transitions." Historical SoM had two dimensions, "past" and "present and future" legacies, in which prominent topics related to family, childhood, achieved goals, and values to pass to others explored. Attitudinal SoM established relations only with the category "creative SoM," in which "courage" and "responsibility" were the main dimensions, which were also related to "MwM," "historical," and "attitudinal SoM." Experiential SoM, with the main dimension "love," was related to "MwM" and "historical SoM." Transitions only established relations with "historical SoM" and "identity before and after cancer." SIGNIFICANCE OF RESULTS: The findings that "MwM" and "historical SoM" were the categories which established a solid pattern of relations suggest that these are the main psychotherapy topics that can have more influence for the participants; one explanation is that these categories imply a concrete way of thinking, which is easier to understand. This process of therapeutic changes must be integrated in a cultural context, as it is well known to have an impact upon the "meaning" of life.

Examining the Relationship Between Parental Symptomatology and Treatment Outcomes in Children with Autism Spectrum Disorder.

This report examines the relationship between treatment response in children with ASD and parents' affective symptomatology. This study examined 29 children with ASD in a manualized group psychotherapy program, Resilience Builder Program® (RBP), where emotional and social functioning of parent and child were measured through pre- and post-treatment questionnaires. Greater parental symptomatology was associated with children's reduced response to RBP in resilience-based emotion regulation skills. Greater parental interpersonal sensitivity (ß = - .27, p = .024) predicted worse post-treatment scores in child communication skills, greater parental anxious symptoms (ß = - .45, p = .005) predicted worse post-treatment scores in child emotional control, and greater parental depressive (ß = .27, p = .041) and anxious symptoms (ß = .36, p = .004) predicted worse post-treatment scores in child internalizing problems.

Trajectories of Change in a Group Behavioral Activation Treatment for Severe, Recurrent Depression.

Depression is a common and costly problem. Behavioral Activation (BA) is an effective treatment for depression when delivered 1:1, but group treatments often do not perform as well as 1:1 treatments. One way to begin to understand how group treatments perform is to assess the process of change during treatment. This study examined trajectories of change across 10-session group BA for individuals with severe, chronic, or recurrent forms of depression. We also tested whether individuals who had associated sudden gains or depression spikes had better outcomes than those who did not have these change patterns. We examined psychological and sociodemographic predictors of the patterns of change. Participants were 104 individuals who met diagnostic criteria for major depressive disorder and participated in one of 10 BA groups, provided over a 2-year period. A linear, but not quadratic or cubic, rate of change fit the data and the effect size for the change in mood symptoms from baseline to posttreatment was large, Cohen's d = 1.25. Although 34% (26 of the 77 who provided outcome data) of individuals had a sudden gain and 10% (7/77) had a depression spike, neither sudden gains nor depression spikes predicted posttreatment outcomes. None of the demographic or psychological factors (rumination, behavioral activation) predicted the pattern of change. These results suggest that although group BA may help to reduce depressive symptoms in individuals with severe, recurrent, and/or chronic forms of depression, the overall linear pattern of change is different from quadratic patterns of change reported for 1:1 BA.

Evidence Base Update on the Treatment of Early Childhood Anxiety and Related Problems.

The controlled evaluation of treatments for early childhood anxiety and related problems has been a relatively recent area of investigation, and accordingly, trials examining early childhood anxiety treatment have not been well represented in existing systematic reviews of youth anxiety treatments. This Evidence Base Update provides the first systematic review of evidence supporting interventions specifically for the treatment of early childhood anxiety and related problems. Thirty articles testing 38 treatments in samples with mean age < 7.9 years (N = 2,228 children) met inclusion criteria. We applied Southam-Gerow and Prinstein's (2014) review criteria, which classifies families of treatments according to one of five levels of empirical support-Well-Established, Probably Efficacious, Possibly Efficacious, Experimental, and of Questionable Efficacy. We found family-based cognitive-behavioral therapy (CBT) to be a Well-Established treatment, and Group Parent CBT and Group Parent CBT + Group Child CBT to both be Probably Efficacious treatments. In contrast, play therapy and attachment-based therapy are still only Experimental treatments for early childhood anxiety, relaxation training has Questionable Efficacy, and there is no evidence to date to speak to the efficacy of individual child CBT and/or medication in younger anxious children. All 3 currently supported interventions for early childhood anxiety entail exposure-based CBT with significant parental involvement. This conclusion meaningfully differs from conclusions for treating anxiety in older childhood that highlight the well-established efficacy of individual child CBT and/or medication and that question whether parental involvement in treatment enhances outcomes.

Emotion Regulation Intensive Outpatient Programming: Development, Feasibility, and Acceptability.

Individuals with Autism Spectrum Disorder (ASD) and/or intellectual and developmental disabilities (DD) often struggle with behavior management and emotion-regulation (ER). In this manuscript, we describe the results of a chart review examining a group treatment program designed to address ER deficits in youth with ASD and/or DD. The intensive 5 week program utilizes cognitive behavior, applied behavior analysis, and mindfulness techniques and includes biweekly child and parent groups. Results indicate that this program is feasible and associated with high caregiver satisfaction. Pre-and-post outcome results indicate statistically significant improvement on behavioral measures, but did not demonstrate significant improvment on the Pediatric Quality of Life Family Impact Module. Based on overall positive outcomes, a randomized controlled trial of the program is indicated.

Changes in Decentering Across Cognitive Behavioral Group Therapy for Social Anxiety Disorder.

To further improve treatments, we need to better understand potential common treatment mechanisms, such as decentering, or the ability to observe thoughts and feelings as objective events in the mind rather than personally identifying with them (Safran & Segal, 1990). Therefore, this study examined whether 12 sessions of Cognitive Behavioral Group Therapy (CBGT) for 63 clients (57.6% female, 50.8% White) diagnosed with social anxiety disorder led to increases in decentering and whether increased decentering was associated with improved outcome. Furthermore, this study examined whether decentering was associated with outcome over and above a competing mechanism-cognitive reappraisal. Overall, results indicated that CBGT in this study led to similar outcomes compared to previous studies and decentering increased over CBGT (d's from 0.81 to 2.23). Change in decentering predicted improvement on most, but not all, measures of outcome and those who no longer met criteria for social anxiety disorder at posttreatment had significantly greater change in decentering across therapy and significantly higher decentering scores at post-treatment compared to those who retained a social anxiety disorder diagnosis at posttreatment. Finally, changes in decentering predicted outcome over and above changes in reappraisal on all outcome measures. These results largely support the role of decentering in CBGT for social anxiety; however, the implications of the inconsistencies in results based on which outcome measure was used are discussed.

Psychological aspects of meaning-centered group psychotherapy: Spanish experience.

ABSTRACTObjective:Our aim was to identify the themes that arise when applying adapted meaning-centered group psychotherapy (MCGP) in Spanish-speaking advanced cancer patients. METHOD: A mixed qualitative-quantitative analysis was performed on the transcripts of interviews with 22 advanced cancer patients who had been assigned to three MCGP subgroups. RESULTS: We found six new emergent themes in addition to the originally constructed themes of MCGP. Threat and uncertainty were the two most frequent emergent issues for our Spanish patients. SIGNIFICANCE OF RESULTS: The implementation of MCGP in Spanish patients validated the themes proposed by Breitbart and colleagues' foundational work on MCGP and also suggested new issues relevant to patient well-being (classified as "emergent themes"). Taking our findings into account, we propose that these new themes be considered in the Spanish adaptation of MCGP as well as in future adaptations of this form of psychotherapy in treating Latin American patients.

Transitioning Together: A Multi-family Group Psychoeducation Program for Adolescents with ASD and Their Parents.

Currently there are few evidence-based programs available for families of individuals with ASD during the transition to adulthood. The present study provided a preliminary evaluation of a multi-family group psychoeducation intervention using a randomized waitlist control design (n = 41). Families in the intervention condition participated in Transitioning Together, an 8-week program designed to reduce family distress and improve social functioning for adolescents. Findings indicated significant improvements in parental depressive symptoms and problem solving from pre- to post-intervention for parents in the intervention condition but not for parents in the control condition. Social interactions also improved for youth in the intervention condition relative to controls. Parents reported satisfaction with the program and particularly valued the opportunity to interact with other families.

Experiencias de danzaterapia de mujeres que han sufrido cáncer de mama. Un estudio fenomenológico / Danze therapy in women with breast cancer. A phenomenological study

Objetivo: Este estudio se dirige a identificar, describir y analizar los posibles cambios en la experiencia vivida del cuerpo propio y los cambios en las relaciones interpersonales de las mujeres con cáncer de mama derivados de su participación en encuentros grupales de danzaterapia. Método: Ésta es una investigación cualitativa de orientación fenomenológica con utilización del método de danzaterapia de María Fux para las vivencias grupales. Se describen aquí las experiencias de ocho encuentros y se aporta un análisis de las descripciones basándonos principalmente en Merleau-Ponty y María Fux. Resultados: Las participantes han podido expresar dolores y tristeza por las situaciones que les han ocasionado el cáncer de mama y sus entornos relacionales; ellas han podido experimentar momentos de creación y entrega a las sensaciones rítmicas del cuerpo y del entorno vivencial con distintas emociones vividas por separado y conjuntamente; ellas han experimentado recuerdos y sensaciones de su niñez y adolescencia; finalmente, ellas han redescubierto su cuerpo sensible, mediante resignificaciones del cuerpo marcado por la ausencia de la mama y mediante sentimientos de mayor aceptación e integración de lo vivido en nuevas gestalts. Conclusiones: Este proyecto todavía está en marcha, pero ya es posible concluir resultados: las vivencias aportadas en la danzaterapia han permitido a estas mujeres tener experiencias de integración y bienestar, al igual que cambios positivos de percepción de su corporeidad y en cuanto a la forma de ser y estar en el mundo y con los otros sujetos, experimentando, así, el cuerpo de una manera nueva y distinta

Objective: This essay aims at identifying, describing and analyzing possible changes both in the experience of the body and in interpersonal relations of women with breast cancer, which result from their participation in Dance Therapy group meetings. Method: This is a phenomenologically oriented qualitative research using Maria Fux´s dance therapy method for group experiences. Eight meetings are described here, and an analysis of descriptions based primarily on Merleau-Ponty and María Fux is provided. Results: The participants have been able to express pain and sorrow over the circumstances that breast cancer and its relational environments have brought to their lives. They have been able to go through moments of creation and surrender to the rhythmic body sensations and experiential environment with different emotions lived separately and jointly. They have revived memories and sensations of their childhood and adolescence, and finally, they have rediscovered their sensitive body through body resignifications marked by the absence of the breast, and by means of feelings of greater acceptance and integration of lived experiences in new gestalts. Conclusions: This project is still under way, but it is already possible to conclude that the life experiences provided in dance therapy have allowed these women to improve their integration and welfare. Likewise, they have felt positive changes in the perception of their corporality and in their way of being in the world and with other subjects, thus experiencing the body in a new and different way

Evolución de un paciente con diagnóstico de Tea en una terapia grupal / Evolution of a patient diagnosed of ASD in a therapy group

Presentamos la evolución de un niño con diagnóstico de Trastorno del Espectro Autista en el marco de una terapia grupal mantenida durante tres años en una institución pública de Salud Mental. La principal herramienta terapéutica era el juego. El grupo, al igual que los niños, pasa por distintas fases. A, a pesar de seguir presentando el núcleo de las dificultades de los niños con TEA, ha podido a través de su camino grupal vivir experiencias nuevas en un ambiente sostenedor. Los juegos de alianzas que los diferentes miembros del grupo le han permitido creemos han sido un elemento clave en su evolución (AU)

We report the clinical course of a child diagnosed with ASD as a part of a sustained group therapy during a three year period in a public Mental Health institution. Game was the main therapeutic tool. The group, as children, goes through different phases. In spite of the persistance of the main core of hándicaps in ASD children, he has been able to live new experiences throughout his group pathway in a supportive environment. We believe alliance games given by the different team members have been a key ítem in his clinical course (AU)

Prevención de enfermedad mental en adolescentes a través del grupo / Prevention of mental illness in adolescents through the group

Se presentan reflexiones y pensamientos entorno a un proyecto piloto que estamos realizando en un Hospital de Día Infanto-Juvenil con adolescentes relacionados sintomatológica o genéticamente con la psicosis. Debido a ser una etapa de la vida en la que se necesita una búsqueda de identidades, entre ellas la grupal y la vulnerabilidad que se produce en estas edades, se decidió realizar este proyecto de terapia grupal en fases iniciales con finalidad preventiva (AU)

We present thoughts and considerations about a pilot project that we are doing in a Child and Adolescent Psychiatry Day Hospital with adolescents which are related by symptoms or genetic with psychosis. Because of being a period in which it is needed the searching of identities, from them the group one, and the vulnerability that this period produces; we decided to do this group therapy project in the prodromal phase with preventive purpose (AU)

Cognitive behavioral group therapy for anxiety: recent developments.

Anxiety disorders occur frequently, and can have a negative impact on the quality of people's lives. They often begin at an early age and can have some serious consequences. This article is an overview of the recent studies concerning group cognitive-behavioral interventions for anxiety disorders. In the last few years, anxiety disorder prevention for children and adolescents has become an important focus of research work. Group prevention programs are based on standard cognitive behavioral therapy (CBT) strategies and are aimed at preventing anxiety disorders as early as possible. Numerous cognitive behavioral group therapies for children as well as adults have been well studied. There are many CBT protocols that have been developed for treating specific anxiety disorders. Now, specialized CBT programs are available for individuals who suffer from different anxiety disorders, enabling them to be treated together in groups.

Los trastornos de ansiedad son de ocurrencia frecuente y pueden provocar un impacto negativo en la calidad de vida de las personas. Estos trastornos a menudo comienzan a edades precoces y pueden determinar serias consecuencias. Este artículo entrega una panorámica de los estudios recientes relacionados con las intervenciones de grupo cognitivo conductuales para los trastornos de ansiedad. En los últimos años la prevención para el trastorno de ansiedad de niños y adolescentes ha sido un foco importante dentro de la investigación. Los programas grupales de prevención están basados en estrategias estándar de terapia cognitivo conductual (TCC) y tienen como objetivo la prevención de los trastornos ansiosos lo antes posible. Numerosas terapias grupales cognitivo conductuales para niños y también para adultos han sido bien estudiadas. Hay muchos protocolos de TCC que se han desarrollado para el tratamiento de trastornos de ansiedad específicos. Hoy se dispone de programas especializados de TCC para sujetos que sufren de diferentes trastornos de ansiedad, lo que les permite ser tratados en un mismo grupo.

Les troubles anxieux font partie des troubles les plus fréquents en santé mentale et entraînent des altérations fonctionnelles significatives dans la vie quotidienne des personnes. Ils se développent souvent tôt et peuvent avoir de sérieuses conséquences. Cet article est une revue des études récentes concernant les interventions cognitives et comportementales de groupe pour les troubles anxieux. Ces dernières années, la prévention des troubles anxieux chez les enfants a pris une place importante dans les travaux des chercheurs. Les programmes de prévention en groupe se basent le plus souvent sur les stratégies cognitivo-comportementales habituelles et ont pour but la prévention des troubles anxieux aussi tôt que possible. De plus, beaucoup d'études ont porté leur intérêt sur les thérapies cognitivo-comportementales de groupe tant pour les enfants que pour les adultes. Beaucoup de protocoles cognitivo-comportementaux ont été développés pour traiter spécifiquement chaque trouble anxieux. Mais, il existe aujourd'hui également des protocoles uniques visant à traiter différents troubles anxieux au sein d'un même groupe.

Group Psychotherapy in Germany.

This article gives an overview of the development of group psychotherapies in Germany originating from a psychodynamic tradition. The German health system provides access to inpatient and outpatient psychotherapy for all of its citizens. Whereas groups are common in inpatient settings, the provision of outpatient group treatment still could be improved, as it is the case for the general training of group psychotherapists. Group research in Germany largely reflects clinical practice, with more studies coming from the inpatient field. It is stated that the general image of group treatment seems to be largely positive, which could provide a basis for political initiatives to improve the dissemination of group therapy in this country.

Group Psychotherapy in Sweden.

The paper presents an overview of the national developments of group psychotherapy (GPS) in Sweden during the period from World War II until the present time. Methods and concepts, imported primarily from England and the United States, inspired trainings and widespread psychodynamic and group analytic applications in schools, health treatment, and social care. Education in psychotherapy and GPS at universities opened new therapeutic and vocational areas during the period 1970-2005. Increasing criticism of psychodynamics, as in other Western societies, but more radical in Sweden, has in the last decades made group analytic GPS diminish in favor of cognitive behavioral therapy models. Prospects for GPS further development may presently look bleak but, in a longer perspective, are promising.

Group Psychotherapy in Finland.

This article describes the development of group psychotherapy in Finland as a treatment in the 1950s, 1960s, and 1970s. Different theoretical preferences split the training programs into two; both are now trying to survive in a psychotherapeutically changing landscape. All training programs have been transferred to the universities, but a lack of interest in, and knowledge about, group psychotherapy has resulted in fewer students choosing this program. This may result, in the future, in even less knowledge of, and research in, group dynamics in Finland.

Group Psychotherapy in Iceland.

In this overview of group psychotherapy in Iceland, an attempt will be made to describe how it is practiced today, give some glimpses into its earlier history, and clarify seven issues: (1) the standing of group psychotherapy in Iceland, its previous history, and the theoretical orientation of dynamic group therapy in the country; (2) the role of group therapy in the health care system; (3) how training in group therapy is organized; (4) the relationship between group psychotherapy research and clinical practice; (5) which issues/processes can be identified as unique to therapy groups in Iceland; and (6) how important are group-related issues within the social background of the country; and (7) what group work holds for the future.

Group Psychotherapy in Egypt: Past, Present, and Future.

Egypt has a central position in Africa and the Middle East. Events in the last few years have brought Egypt to the forefront of the world's interest in politics, sociology, and group psychology. This paper explores the evolution, development, and current status of group psychotherapy and group processes in Egypt. Starting from times of old in Pharaonic, Islamic, and Christian cultures, the paper discusses the theoretical orientation of contemporary group psychotherapy in the country, its status in the health care system, its training and research opportunities, and its current and future challenges.