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

Abstract

Group cognitive behavioural therapy (gCBT) is commonly used in Increasing Access to Psychological Therapies (IAPT) services. However, there is limited knowledge of the efficacy of gCBT as a delivery format for generalised anxiety disorder (GAD). To address gaps in literature, this study aims to explore the efficacy and attrition of individual and group CBT interventions, respectively, at Step 3 for GAD using data from a routine IAPT service over a 24-month period. Data were retrospectively derived from a routine serviceʼs IAPTus database, separating those eligible for comparison into group (n = 44) and individual (n = 55) CBT for GAD. Outcomes were differences in pre–post self-reported anxiety (GAD-7) and depression (PHQ-9) scores, clinical recovery and attrition for gCBT and individual CBT. Both gCBT and individual CBT yielded significant reductions in self-reported anxiety and depression scores over time. Results indicate that 53% of patients attending individual CBT achieved clinical recovery, with similar but less competitive rates of 41% in gCBT. Attrition rates were similar between gCBT (29.5%) and individual CBT (27.3%), respectively. Preliminary results suggest that both individual and gCBT are effective interventions for GAD patients in IAPT, offering symptom alleviation and comparable recovery and attrition rates post-intervention. This observational design offers credibility and insight into a pragmatic evaluative and explorative comparison. gCBT may offer an acceptable and potentially economical alternative. Key learning aims (1) To explore whether gCBT and individual CBT yield significant symptom reduction in self-reported anxiety and depression in GAD patients from a routine IAPT service. (2) To explore gCBT and individual CBT clinical recovery rates in non-optimum routine conditions. (3) To explore whether gCBT for GAD produces unacceptable attrition rates and if this differs from attrition rates in individual CBT for GAD in a routine IAPT service.

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“…As a result, close examination of complex patterns and relationships between various factors can be explored. Considering attrition rates of around 30% for group interventions (based on CBT principles) (Fanous and Daniels, 2020), the study aimed to collect data from at least 15-20 participants during each phase.…”

“…The increased need for cost-effective and efficient programmes has made way for the considerations of group interventions as part of the IAPT service. As a result, it has been proposed that group CBT has the potential to be more cost-effective than individual CBT while equality efficacious (Fanous and Daniels, 2020). The current overall retention rate (88%) reported across both phases adds to the current literature suggesting faith-based interventions have the capacity to improve acceptability and increase treatment retention (Adewoye, 2016;Anderson et al, 2015;Ramos et al, 2014).…”

“…Recruiting and retaining participants as part of a psychological intervention has often been a challenge for researchers and practitioners (Coatsworth et al, 2015). Studies have shown that drop-out rates for group CBT intervention can vary from 15% to 50% (Friedlander, 2014) with more recent findings recording a rate of 30% (Fanous and Daniels, 2020). Inevitably, drop-out rates negatively impact recovery rates for individuals, as those who start but disengage from treatment have less opportunities to achieve change and recover.…”

Generative AI-Enabled Therapy Support Tool Improves Clinical Outcomes and Patient Engagement in NHS Talking Therapies

“…Thus, enhancing high-quality support between therapy sessions is a key objective for improving CBT treatment outcomes (Lebeau et al, 2013). This is particularly critical in group therapy settings, where dropouts are higher and recovery rates are lower than in individual therapy settings (Fanous & Daniels, 2020;Fernandez et al, 2015;Hans & Hiller, 2013). Traditionally, therapeutic materials and exercises in CBT have been distributed as worksheets in pen and paper format or downloadable PDF format, requiring the patient to engage with these materials without any supervision.…”

A randomized clinical trial in a public health context: inclusion of emotional techniques in group therapy for anxiety disorders

“…Although in many cases professionals choose to treat these patients via individual interventions, especially when mood disorders are also involved, group therapy offers a number of potential benefits, especially in the context of primary care.A number of studies have found that group interventions can be just as effective as individual treatment (i.e. Fanous & Daniels, 2020) and that both approaches can be valid ways to treat anxiety disorders (Fawcett et al, 2020). Additionally, group CBT offers some advantages in terms of treatment efficiency which is always an important concern for public health services.…”