Feasibility of large group cognitive behavioural therapy education classes for anxiety disorders

Palay, Joshua; Wong, Jacquelyne Y.; Randall, Jason R.; Sala, Tanya; Bolton, James M.; Furer, Patricia; Bolton, Shay-Lee; Whitney, Debbie; Thakur, Vishal; Parikh, Sagar V.; Sareen, Jitender

doi:10.5750/ejpch.v6i2.1454

Cited by 4 publications

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“…To our knowledge, this is the first study to investigate a brief, low intensity, large group CBT intervention which incorporates mindfulness. Our findings expand upon previous work from our group which found large group CBT classes were useful, led to modest improvements in anxiety symptoms, and reduced wait times for conventional CBT group therapy [20].…”

Section: Discussionsupporting

confidence: 84%

“…Large-group CBT was introduced at a tertiary care clinic in Winnipeg, Canada in 2014 to manage the problem of persistently long wait times. These transdiagnostic 2-session CBT classes were rated useful by clients, led to modest improvements in anxiety symptoms, and reduced wait-times from approximately one year to three months [20]. Given these promising findings and client feedback, the CBT classes were expanded to 4 sessions and introduced mindfulness within the core content.…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of large group cognitive behaviour therapy with mindfulness (CBTm) classes

et al. 2019

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Background Ensuring equitable and timely access to Cognitive Behaviour Therapy (CBT) is challenging within Canada’s service delivery model. The current study aims to determine acceptability and effectiveness of 4-session, large, Cognitive Behaviour Therapy with Mindfulness (CBTm) classes. Methods A retrospective chart review of adult outpatients ( n = 523) who attended CBTm classes from 2015 to 2016. Classes were administered in a tertiary mental health clinic in Winnipeg, Canada and averaged 24 clients per session. Primary outcomes were (a) acceptability of the classes and retention rates and (b) changes in anxiety and depressive symptoms using Generalized Anxiety Disorder 7-item (GAD-7) and Patient Health Questionnaire 9-item (PHQ-9) scales. Results Clients found classes useful and > 90% expressed a desire to attend future sessions. The dropout rate was 37.5%. A mixed-effects linear regression demonstrated classes improved anxiety symptoms (GAD-7 score change per class = − 0.52 [95%CI, − 0.74 to − 0.30], P < 0.001) and depressive symptoms (PHQ-9 score change per class = − 0.65 [95%CI, − 0.89 to − 0.40], P < 0.001). Secondary analysis found reduction in scores between baseline and follow-up to be 2.40 and 1.98 for the GAD-7 and PHQ-9, respectively. Effect sizes were small for all analyses. Conclusions This study offers preliminary evidence suggesting CBTm classes are an acceptable strategy to facilitate access and to engage and maintain clients’ interest in pursuing CBT. Clients attending CBTm classes experienced improvements in anxiety and depressive symptoms. Symptom improvement was not clinically significant. Study limitations, such as a lack of control group, should be addressed in future research.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

An evaluation of large group cognitive behaviour therapy with mindfulness (CBTm) classes

et al. 2019

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“…As such, therapists are required to be proficient in a range of therapies and to make complex decisions around which problems to deal with first in multiple morbidities or face conceptual difficulties when a specific diagnosis is uncertain. A transdiagnostic intervention, delivered in a group format, could simplify treatment, increase access, improve costs, and decrease waiting times [ 46 – 50 ]. Group-MCT can offer such an approach and has been found to be effective in adult mental health.…”

Section: Discussionmentioning

confidence: 99%

Youth Metacognitive Therapy (YoMeta): protocol for a single-blind randomised feasibility trial of a transdiagnostic intervention versus treatment as usual in 11–16-year-olds with common mental health problems

Wells

Carter

Hann

et al. 2022

Pilot Feasibility Stud

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Background Mental health disorders in children and young people (CYP) are increasing but the provision of current evidence-based treatment for common mental health problems is limited. Treatment effects vary widely with no clear superiority of a single treatment approach. Further evaluation of contemporary and effective treatments in CYP is needed. Metacognitive therapy (MCT) has shown enhanced efficacy over ‘gold standard’ approaches in adult mental health, but so far has not been evaluated in a randomised trial of CYP. As such, we aim to assess the acceptability and feasibility of group-MCT for CYP with common mental health problems in comparison to usual treatment within Child and Adolescent Mental Health Services (CAMHS). Method YoMeta is a multicentre, two-arm, single-blind randomised feasibility trial comparing group-MCT to usual care in CYP with common mental health problems in CAMHS. CYP (target sample n = 100) with a common mental health problem will be recruited across at least three CAMHS services in the UK. Participants in the intervention arm will receive up to eight sessions of group-MCT delivered by a CAMHS mental health practitioner. The control arm will receive usual care in CAMHS which includes individual or group-based therapy. Feasibility will be assessed by the success of recruitment, retention, and data quality. Acceptability of the intervention will be assessed by the number of sessions attended and through qualitative interviews aimed at exploring CYP acceptability and understanding of the intervention. Symptoms of psychological distress will be assessed using the Revised Children Anxiety and Depression Scale (RCADS) at 20 weeks. We will also assess psychological well-being, symptoms of depression, metacognitive beliefs, quality of life, and measures to support economic evaluation (health status and health and social care use). Qualitative interviews will be conducted to understand practitioner’s views on training and delivery of group-MCT. Discussion The trial is designed to evaluate the acceptability and feasibility of group-MCT for CYP with common mental health problems. Group-MCT may aid in improving access to treatment, reduce waiting times, and improve outcomes for CYP with common mental health disorders. The study will provide important information and data to evaluate future research potential and confirm sample size estimation for a definitive large-scale RCT to test the effectiveness and cost-effectiveness of group-MCT in CYP. Trial registration NCT05260060; ISCTRN18335255

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“…There is a growing body of evidence to support the use of LI-HV approaches for increasing access and decreasing symptoms for individuals with anxiety (Houghton & Saxon, 2007; Muntingh et al, 2014; Palay et al, 2018; Priemer & Talbot, 2013; Van Straten et al, 2006), mood (Bennett-Levy et al, 2010; Naeem et al, 2017), and sleep disorders (Ho et al, 2015; Seyffert et al, 2016; Ström et al, 2004; Zachariae et al, 2016). Outside of outpatient settings, there is also support for the use of LI-HV in primary care for problems such as chronic pain (Eisner & Johnson, 2008; Lamb et al, 2012; Moore et al, 2000; Pollio et al, 2006) and anxiety (Seekles et al, 2013).…”

mentioning

confidence: 99%

Canadian psychological practice: Development of low intensity/high volume initiatives in public healthcare.

Vincent¹,

Alcolado²,

Dirkse³

et al. 2021

Canadian Psychology / Psychologie canadienne

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Low intensity-high volume (LI-HV) interventions are increasingly being recognized as a means to communicate psychological principles and provide services to those with unmet mental health care needs. This article describes several different applications of LI-HV interventions in a central Canadian province, where underfunding of psychologists is well documented. The settings reviewed included tertiary hospital anxiety, depression, and sleep clinics, primary care, and a provincial mental health crisis setting. Descriptions of the LI-HV innovations and the impact of these innovations on referrals, providers, patients, and the healthcare system are reviewed. Some of the conclusions from these findings are that it is feasible to develop LI-HV interventions for psychological care, especially with limited psychologist resources. Patients find such interventions to be acceptable and satisfactory. Improvement in symptoms is often noted with LI-HV interventions, although the magnitude of improvement may be less than what is obtained with higher intensity services. Further, the provision of LI-HV services often results in changes to the higher intensity service. Anecdotally, psychologist providers report that the interventions are worth the investment. More work on investigating the efficacy of stepped care in this area is warranted. Public Significance StatementMental healthcare within the public health system in Canada is severely stretched in both human resource and economic capacities. Use of large group classes and internet-based programs represent a method to partially meet this need. Results suggest that these approaches are viewed favorably by patients and providers, and that implementation may change the nature of more intensive services.

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Feasibility of large group cognitive behavioural therapy education classes for anxiety disorders

Cited by 4 publications

References 0 publications

An evaluation of large group cognitive behaviour therapy with mindfulness (CBTm) classes

An evaluation of large group cognitive behaviour therapy with mindfulness (CBTm) classes

Youth Metacognitive Therapy (YoMeta): protocol for a single-blind randomised feasibility trial of a transdiagnostic intervention versus treatment as usual in 11–16-year-olds with common mental health problems

Canadian psychological practice: Development of low intensity/high volume initiatives in public healthcare.

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