A pragmatic randomized controlled trial of group transdiagnostic cognitive-behaviour therapy for anxiety disorders in primary care: study protocol

Roberge, Pasquale; Provencher, Martin D.; Patrick, Graham; Vasiliadis, Helen Maria; Gaboury, Isabelle; Benoît, Annie; Antony, Martin M.; Chaillet, Nils; Houle, Janie; Hudon, Catherine; Norton, Peter J.

doi:10.1186/s12888-018-1898-1

Cited by 16 publications

(17 citation statements)

References 94 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This was a multisite, single-blind, patient-level, two-arm pragmatic superiority randomized trial in community-based care settings within three regions in Québec, Canada. The protocol was published (Roberge et al, 2018 ).…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Group transdiagnostic cognitive-behavior therapy for anxiety disorders: a pragmatic randomized clinical trial

et al. 2020

Self Cite

View full text Add to dashboard Cite

Background Transdiagnostic group cognitive-behavioral therapy (tCBT) is a delivery model that could help overcome barriers to large-scale implementation of evidence-based psychotherapy for anxiety disorders. The aim of this study was to assess the effectiveness of combining group tCBT with treatment-as-usual (TAU), compared to TAU, for the treatment of anxiety disorders in community-based mental health care. Methods In a multicenter single-blind, two-arm pragmatic superiority randomized trial, we recruited participants aged 18–65 who met DSM-5 criteria for principal diagnoses of generalized anxiety disorder, social anxiety disorder, panic disorder, or agoraphobia. Group tCBT consisted of 12 weekly 2 h sessions. There were no restrictions for TAU. The primary outcome measures were the Beck Anxiety Inventory (BAI) and clinician severity rating from the Anxiety and Related Disorders Interview Schedule for DSM-5 (ADIS-5) for the principal anxiety disorder at post-treatment, with intention-to-treat analysis. Results A total of 231 participants were randomized to either tCBT + TAU (117) or TAU (114), with outcome data available for, respectively, 95 and 106. Results of the mixed-effects regression models showed superior improvement at post-treatment for participants in tCBT + TAU, compared to TAU, for BAI [p < 0.001; unadjusted post-treatment mean (s.d.): 13.20 (9.13) v. 20.85 (10.96), Cohen's d = 0.76] and ADIS-5 [p < 0.001; 3.27 (2.19) v. 4.93 (2.00), Cohen's d = 0.79]. Conclusions Our findings suggest that the addition of group tCBT into usual care can reduce symptom severity in patients with anxiety disorders, and support tCBT dissemination in routine community-based care.

show abstract

Section: Methodsmentioning

confidence: 99%

“…PHQ-9; Kroenke, Spitzer, & Williams, 2001 ), functioning measures (e.g. Sheehan Disability Scale; Sheehan, Harnett-Sheehan, & Raj, 1996 ), and therapy process measures (described in the protocol; Roberge et al, 2018 ). Participants received a $20 compensation for in-person assessments.…”

Section: Methodsmentioning

confidence: 99%

Group transdiagnostic cognitive-behavior therapy for anxiety disorders: a pragmatic randomized clinical trial

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…The design and the results of the pragmatic randomized controlled trial are detailed elsewhere (Roberge et al, 2018, 2020). In summary, participants were recruited from the general population and were volunteers.…”

Section: Methodsmentioning

confidence: 99%

Benzodiazepines and group transdiagnostic cognitive-behaviour therapy for anxiety disorders: A mixed methods study.

Durand¹,

Dubois²,

Provencher³

et al. 2024

Canadian Journal of Behavioural Science / Revue canadienne des

Self Cite

View full text Add to dashboard Cite

Cognitive behavioural therapy (CBT) is an evidence-based treatment for anxiety disorders. Patients engaging in CBT often have ongoing pharmacological treatment, generally antidepressants. Benzodiazepines are also commonly used, although they are recommended as short-term adjunctive treatment due to side effects. This mixed methods study, embedded in a randomized controlled trial of group transdiagnostic CBT (tCBT), explored the influence of benzodiazepine use prior to tCBT and the participants' experience of their use before, during, and after therapy. The experimental arm received tCBT and treatment-as-usual (TAU; n = 117) for 12 weeks while the control arm received TAU (n = 114). Anxiety symptoms were assessed with the Beck Anxiety Inventory (BAI). Multiple linear regression analysis examined BAI pre-post differences with benzodiazepine use in the past 12 months, tCBT and their interaction. Semistructured interviews were conducted with 13 participants reporting the use of benzodiazepines at baseline and analyzed using an interpretive descriptive method. Quantitative results suggested that tCBT had a significant effect on anxiety symptoms change, but this effect was nondifferential according to benzodiazepine use in the past 12 months. Qualitative results provided nuances about the perceived helpfulness of benzodiazepines. Participants reported that benzodiazepines facilitated the experience of sharing in group therapy and conducting exposure exercises. Despite some benefits, participants perceived that benzodiazepines may have interfered with the effectiveness of exposure exercises and the acquisition of concepts due to a sedative effect. This study highlight the importance of sensitizing therapists and patients to the potential effects of benzodiazepines on the experience of tCBT. Public Significance StatementParticipants expressed a need for guidance regarding their use of benzodiazepines, especially when they perceived that this medication could potentially interfere with some psychotherapeutic interventions. Therapists should be aware of the potential effects of the utilization of benzodiazepines on psychotherapy processes and address this issue in their intervention plan, considering that many people choose to engage in cognitive behavioural therapy (CBT) while undergoing pharmacological treatment.

show abstract

“…All participants provided written informed consent for their de-identified data to be used for the primary purposes of the original study, as well as other related analyses for future research. The study design and details are described in detail elsewhere (Roberge et al, 2018(Roberge et al, , 2020. All methods and procedures were reviewed and approved by local institutional ethical review boards.…”

Section: Methodsmentioning

confidence: 99%

Which, who and when? Therapeutic processes in group cognitive behaviour therapy for anxiety disorders

Luong

Roberge

Provencher

et al. 2022

Clin Psychology and Psychoth

View full text Add to dashboard Cite

The evidence for the effect of therapeutic alliance in group cognitive behaviour therapy (CBT) for anxiety disorders is unclear. Identifying whether the alliance–outcome relationship depends on (1) which components are assessed, (2) who is measuring the alliance and (3) when the alliance is measured will help to clarify the role of the client–therapist relationship in therapy. The present study explored the effects of alliance component (agreement vs. bond), rater perspective (client vs. therapist) and timing (early vs. late therapy) on the alliance–outcome relationship. Individuals with an anxiety disorder enrolled into transdiagnostic group CBT were studied, with n = 78 at early therapy and n = 57 at late therapy. Results showed that greater client‐rated agreement significantly predicted improved post‐treatment outcomes throughout the course of therapy, while stronger client‐rated bond in late therapy predicted reduced treatment gains. In contrast, therapist perceptions of agreement and bond were not associated with post‐treatment outcomes at any point in therapy. Client‐reported group cohesion also was not associated with additional variance in outcome after accounting for client‐rated alliance. Overall, the findings highlight the importance of prioritizing the client's perception of the client–therapist relationship in CBT for anxiety disorders, as well as distinguishing the effects of component, rater and timing in future process–outcome studies.

show abstract

A pragmatic randomized controlled trial of group transdiagnostic cognitive-behaviour therapy for anxiety disorders in primary care: study protocol

Cited by 16 publications

References 94 publications

Group transdiagnostic cognitive-behavior therapy for anxiety disorders: a pragmatic randomized clinical trial

Group transdiagnostic cognitive-behavior therapy for anxiety disorders: a pragmatic randomized clinical trial

Benzodiazepines and group transdiagnostic cognitive-behaviour therapy for anxiety disorders: A mixed methods study.

Which, who and when? Therapeutic processes in group cognitive behaviour therapy for anxiety disorders

Contact Info

Product

Resources

About