Effectiveness of group versus individual psychotherapy for depression in a community counselling setting using the "Mind over mood" cognitive therapy manual
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AbstractAlthough an extensive body of research supports the efficacy of cognitivebehavioral therapy (CBT) for depression, the preponderance of previous research has focused on individual (as opposed to group) treatment, and been conducted in controlled research settings such as universities and university hospitals. Controlled research, however, often excludes clients that most resemble those who typically receive treatment in community settings (e.g., clients with comorbid anxiety, personality, and other disorders). The present study sought to extend previous empirical research by demonstrating the effectiveness of CBT as it is typically delivered in a community setting, both in group and individual treatment formats. Thirty-four participants (10 men, 24 women) who met the DSM-IV criteria for Major Depressive Disorder completed either group (N = 21) or individual (N = 13) CBT that was delivered by the same researcher using the same treatment manual and client handbook. The majority of both group and individually treated participants made statistically significant and clinically meaningful positive change on the six outcome measures (Beck Depression Inventory, Second Edition; Mind Over Mood Depression Inventory; Hamilton Rating Scale for Depression; Rosenberg Self-esteem Scale; Attributional Style Questionnaire; Outcome Questionnaire - 45 Item). There were no statistically significant differences between the outcomes of group or individual treatment on any of the outcome measures, but individual treatment was slightly more effective (not statistically significant) for participants with more severe depressive symptoms. Group treatment appeared to be more effective (not statistically significant) for women than men, but because of the small number and unequal distribution of male participants, any putative gender differences should be regarded as tentative. Group treatment was more cost-effective than individual treatment, both for the participants involved and for the agency providing treatment. The cost-effectiveness of group CBT appears to make it an attractive adjunct (if not alternative) to individual treatment, in some cases. Group CBT is likely most helpful for those clients who are amenable to the notion of participating in a group and who meet at least minimal inclusion criteria (no current suicidal potential, limited co-morbid diagnoses, no current substance use problems, adequate cognitive abilities to understand the client guidebook and to apply the cognitive model). The apparent cost benefits of group treatment, which make it attractive for fiscal reasons, do not surpass the need and duty to provide treatment in a format that is acceptable to all clients. Advantages and limitations of both individual and group treatment are discussed. Recommendations for future research are made.
Bibliography: p. 208-232
CitationScott, R. H. (2004). Effectiveness of group versus individual psychotherapy for depression in a community counselling setting using the "Mind over mood" cognitive therapy manual (Unpublished doctoral thesis). University of Calgary, Calgary, AB. doi:10.11575/PRISM/22477
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