Treatment Modality Preferences and Adherence to Group Treatment for Panic Disorder with Agoraphobia

Abstract

To examine the relationship between preference for group psychotherapy and adherence to group cognitive-behavioral therapy (CBT) for clients with panic disorder with agoraphobia (PDA), 109 participants experiencing PDA completed a questionnaire measuring preference for group treatment (PGTQ) before beginning CBT groups. A t test was used to compare preference scores for group treatment to investigate whether participants who completed treatment differed from those who abandoned treatment. Participants who completed group therapy expressed higher preference for group treatment than participants who dropped out of treatment (t[107] = 1.99; p < 0.05). The PGTQ-4 presented adequate psychometric properties. Reliability analyses of the items retained after factorization demonstrated an acceptable level of internal consistency (Cronbach's alpha of 0.76). Preference for individual or group therapy appears to impact treatment retention for patients with PDA. Matching patients' preferences to the type of treatment modality used appears to be pertinent, especially for the treatment of anxiety disorders. In terms of practical implications, the rationale and benefits of group therapy should be explained to participants reluctant to engage in group therapy. Individual intervention or a combination of group and individual treatment could be considered for clients who are likely to drop out of group therapy.

Preferences for panic control treatment and panic focused psychodynamic psychotherapy for panic disorder – who chooses which and why?

“…Overall, these studies find inconsistent and limited evidence for an association between treatment preferences and gender, age, education level, baseline clinical severity (mainly depression), previous treatment experience (mainly medication versus psychotherapy), social functioning and relational problems, and posttraumatic stress disorder (Dwight-Johnson et al, 2000;Houle et al, 2013;Markowitz et al, 2016;Sandell et al, 2011). To date, one study (Perreault et al, 2014) has examined factors associated with patient preferences for treatment of panic disorder (PD). The authors assessed patient preferences for individual versus group therapy prior to their enrolment in group-based cognitive behaviour therapy (CBT) for PD.…”

What are the recovery and attrition outcomes for group CBT and individual CBT for generalised anxiety disorder in an IAPT service? An exploratory study

“…Non-completers show a worse prognosis than completers (Manassis et al, 2002;Swift and Greenburg, 2014) and missed/incomplete treatment sessions cost in terms of finance, targets and time in IAPT (Radhakrishnan et al, 2013). Non-completers commonly terminate therapy prior to session 5 and may return for further treatment, utilising more resources than completers (Heatherington et al, 2014;Perreault et al, 2014). Retention is therefore important for both service users and service providers.…”

Predictors of Dropout From Cognitive-Behavioral Group Treatment for Panic Disorder With Agoraphobia

“…To better understand and address this problem, it is essential to differentiate the profile of people who complete treatment from those who unilaterally discontinue the intervention. In this regard, studies suggest different variables of interest, such as the severity of the disorder and comorbidities (Brown & Barlow, 2002; Issakidis & Andrews, 2004; Keijsers et al, 2001; Taylor, 2000; White et al, 2010); sociodemographic variables, such as income, education, and age (Grilo et al, 1998; Santana & Fontenelle, 2011; Swift & Greenberg, 2012); client’s expectations (Katerelos, Bélanger, et al, 2011; Katerelos, Perreault, Bélanger, Marchand, & Pecknold, 2011; Perreault et al, 2014); and dyadic variables (Bélanger, Leduc, Fredman, El-Baalbaki, & Baucom, 2008; El-Baalbaki, Bélanger, Perreault, Fredman, & Baucom, 2010; Marcaurelle, Bélanger, Marchand, Katerelos, & Mainguy, 2005).…”

“…Some variables specific to the therapeutic process may also affect treatment discontinuation. In this regard, some studies examined the impact of four variables known to affect the development, maintenance, and treatment of panic disorder with agoraphobia: anxiety, process, role, and prognosis expectations (Katerelos, Bélanger, et al, 2011; Katerelos, Perreault, et al, 2011; Perreault et al, 2014). Anxiety expectations are defined as the degree to which a person expects to experience anxiety during treatment (Katerelos, Perreault, et al, 2011).…”

“…Also associated with therapy dropout, process and role expectations include expectations regarding the course of treatment (e.g., procedures, techniques, format, and duration of treatment), as well as expectations of the respective roles of the therapist and the client (e.g., characteristics, attitudes, and behaviors; Constantino, 2012; Constantino, Arnkoff, Glass, Ametrano, & Smith, 2011). The results of a study conducted by Perreault et al (2014) showed that the way the therapeutic process is anticipated (e.g., individual or group therapy), as well as the behaviors of the therapist and the client (e.g., “the therapist tells me what to do” or “the therapist doesn’t talk”), are related to treatment satisfaction when these process expectations are met and to dropout when they are not. A study by Swift and Callahan (2011) also showed that expectations regarding the duration of treatment could influence treatment attrition.…”