The influence of socio-demographic similarity and difference on adequate attendance of group psychoeducational cognitive behavioural therapy

Abstract

The influence of socio-demographic similarity and difference on adequate attendance of group psychoeducational cognitive behavioural therapy. Psychotherapy Research. AbstractAim: The study aimed to investigate the impact of socio-demographic similarity on the probability of attending an adequate dose of a psychoeducational group intervention (≥4 of 6 sessions). Method:The sample comprised 2071 patients (63% female, 93% White, 15% unemployed, mean age 43) who received the Stress Control intervention in the UK's national Improving Access to Psychological Therapies (IAPT) programme. Similarity indices were constructed to measure each patient's similarity to the rest of their group on four characteristics: age, gender, ethnicity, and neighbourhood deprivation (Index of Multiple Deprivation; IMD).Results: Multilevel analysis found that patients with greater IMD similarity to their group had significantly higher probabilities of attending an adequate dose of intervention (p=.026, controlling for absolute IMD). A cumulative effect of age similarity, ethnic similarity, and group size was also found, such that patients who were similar in age and ethnicity to their group had higher probabilities of adequate attendance in larger groups (p=.006). Conclusions: These results suggest that socio-demographic comparison (a.k.a. relational demography) may consciously or unconsciously impact on patients' attendance at group psychoeducational interventions, particularly regarding indicators of socio-economic similarity. Clinical implications include structuring group composition and/or intervention content to maximise attendance and therefore clinical effectiveness. Clinical and Methodological Significance of this Article This article highlights novel effects on the attendance of patients in group interventions. It is the first to our knowledge in the context of psychological interventions to investigate the impact on an individual basis of socio-demographic similarity to the group, and it dovetails with occupational psychology research on relational demography. Clinical considerations around group composition and intervention content follow from the results, and these results demand new lines of research enquiry. Word count: 6,115

Social anxiety and agoraphobia symptoms effectively treated by Prompt Mental Health Care versus TAU at 6‐ and 12‐month follow‐up: Secondary analysis from a randomized controlled trial

“…As the rate of missing outcome data was both substantial and not equal across treatment groups, this may have introduced bias that could not be fully mitigated by the state‐of‐the‐art missing data procedures used. Notably, modeling of IAPT data showed that clients suffering with agoraphobia were less likely to attend their appointments than those with other anxiety disorders (Firth et al, 2020). In the current trial, such noncompliance could provide bias if differential across the treatment arms.…”

Effectiveness of stress control large group psychoeducation for anxiety and depression: Systematic review and meta‐analysis

“…In terms of acceptability, the average dropout rate across SC studies (34%) appears comparable to other group psychological interventions, as approximately 25–50% dropout from groups in routine practice settings (Batch, 2018; Simon et al , 2012). Prior research indicates that high socio‐economic deprivation predicts dropout from SC groups (Burns et al , 2016; Firth, Delgadillo, Kellett, & Lucock, 2020). The average size of a SC group was N = 38 in the current review, suggesting the routine delivery of relatively large groups.…”

An investigation of the competencies involved in the facilitation of CBT-based group psychoeducational interventions

“…workshop-based) interventions, practitioners understanding and appropriately managing intragroup and intrapersonal exchanges comes to the fore (Burlingame et al, 2002). Moreover, if group facilitators can enable a sense of relatedness between patients then this can also reduce dropout from psychoeducation (Firth, Delgadillo, Kellett & Lucock, 2019), despite previous research suggesting normalisation is easily achieved during large group psychoeducational interventions by merely attending the intervention (Kellett et al, 2007). Competencies related to risk management (item 13) and maintaining a professional demeanour (items 22-24) were also identified.…”