The effects of a feedback intervention on group process and outcome.

The effects of a feedback intervention directed at both members and leaders was examined in psychotherapy groups held in a university counseling center. Feedback consisted of group climate information using scores from the Group Climate Questionnaire, completed by members after each group session. The direct effects of the feedback intervention were assessed using scores on the Curative Climate Instrument as well as Group Climate Questionnaire subscales. These instruments were administered after each group session. Distal effects of the feedback intervention were examined using member symptom improvement (Outcome Questionnaire) and group attendance. Members and leaders in the experimental condition were given weekly written and graphical feedback and contrasted against comparable groups receiving no feedback. Results indicate the feedback intervention had little impact on the therapeutic factors and outcome. However, for members who reported that the group was high in conflict, the feedback intervention had a significant negative effect on outcome. Implications and directions for future research are examined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Identification of therapist differences in a group treatment for depression.

Examined therapist variables presumed to be related to outcome in a structured, cognitive-behavioral group treatment for depression. Each of 8 leaders conducted 2 consecutive psychoeducational treatment groups consisting of 5–8 Ss. Of the 106 Ss (aged 17–67 yrs) who participated in the study, 79 were clinically depressed; measures of depression included the Beck Depression Inventory, Hamilton Rating Scale for Depression, and a measure of social adjustment. A broad multivariate assessment was conducted of pretreatment leader characteristics, leader behavior and style during treatment, group behavior and process, and depression outcome. Results indicate that leaders differed significantly on behavioral and group-process measures, but differences in depression outcome between leaders did not attain statistical significance. (5 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment delay, outcome, and satisfaction in time-limited group and individual psychotherapy.

As part of a randomized clinical trial in which we compared outcome in time-limited individual and time-limited group psychotherapy, patients were interviewed and completed a battery of assessment measures. All participants in the study were then randomly assigned to one or the other treatment modality. There were inevitable delays before patients began their assigned therapies. Group treatment patients waited an appreciably longer period of time, on average, than did individual treatment patients (48 days vs. 31 days). Nonetheless, it was only for individual therapy patients that we found a highly significant relationship between this delay and treatment satisfaction at the completion of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An evaluation of a brief group therapy for depression.

Evaluated a brief group therapy for treating 20 depressed outpatients. As an adjunct to group therapy, clients used written self-instructional materials to guide them in monitoring and increasing their frequency of pleasurable activities. Ss were randomly assigned to an immediate (IT) or delayed treatment (DT) group. Results did not support the effectiveness of IT. However, after receiving treatment, DT clients successfully increased activities and decreased depression relative to IT. (2 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative outcomes for individual cognitive-behavior therapy, supportive-expressive group psychotherapy, and sertraline for the treatment of depression in multiple sclerosis.

This study compared the efficacy of 3 16-week treatments for depression in 63 patients with multiple sclerosis (MS) and major depressive disorder (MDD): individual cognitive- behavioral therapy (CBT), supportive expressive group therapy (SEG), and the antidepressant sertraline. Significant reductions were seen from pre- to posttreatment in all measures of depression. Intent-to-treat and completers analyses using the Beck Depression Inventory (BDI; A. T. Beck, C. H. Ward, M. Medelson, J. Mock, & J. Erbaugh, 1961) and MDD diagnosis found that CBT and sertraline were more effective than SEG at reducing depression. These results were largely supported by the BDI-18, which eliminates BDI items confounded with MS. However, the Hamilton Rating Scale for Depression (M. Hamilton, 1960) did not show consistent differences between treatments. Reasons for this inconsistency are discussed. These findings suggest that CBT or sertraline is more likely to be effective in treating MDD in MS compared with supportive group treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Randomized controlled trial of a preventive intervention for perinatal depression in high-risk Latinas.

Objective: A randomized controlled trial was conducted to evaluate the efficacy of a cognitive–behavioral (CBT) intervention to prevent perinatal depression in high-risk Latinas. Method: A sample of 217 participants, predominantly low-income Central American immigrants who met demographic and depression risk criteria, were randomized into usual care (UC; n = 105) or an 8-week CBT group intervention during pregnancy and 3 individual booster sessions during postpartum (n = 112). Participants completed measures assessing depressive symptoms (Center for Epidemiological Studies Depression Scale at baseline; Beck Depression Inventory, Second Edition [BDI–II]) and major depressive episodes (Mood Screener) at 5 time points throughout the perinatal period. Results: Intent-to-treat analyses indicated that intervention participants had significantly lower depressive symptoms and fewer cases of moderate depression (BDI–II ≥ 20) at Time 2 than UC participants. These effects were stronger for women who fully participated in the intervention (≥4 classes). The cumulative incidence of major depressive episodes was not significantly different between the intervention (7.8%) and UC (9.6%) groups. Conclusions: A CBT intervention for low-income, high-risk Latinas reduced depressive symptoms during pregnancy but not during the postpartum period. Low levels of depressive symptoms and lower than expected rates of clinical depression in both groups may partially be due to methodological issues. As perinatal depression is a significant public health problem, more work is needed to prevent perinatal depression in low-income, ethnically diverse women. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The dose effect of a group intervention for bereaved HIV-positive individuals.

Group interventions for health-related issues such as cancer and HIV infection have demonstrated effectiveness and are widely used, yet the question of dosage for group interventions has received little attention. This study examined the longitudinal effect of varying doses of a group intervention for coping with AIDS-related loss in 158 HIV-positive women and men. Grief and psychiatric distress were assessed at baseline, postintervention, and at 4-, 8-, and 12-month follow-ups. Longitudinal data analyses using mixed models were conducted to examine differences in outcome by dosage. Results show that both grief and psychiatric distress were inversely related to dosage across time, indicating that the higher the intervention exposure, the greater the reduction in distress and grief. The clinical significance of change by dosage was also considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Separating individual and group effects.

Presents a new multivariate statistical technique that includes both individual and group effects and allows for nonindependence between group members in hierarchically nested designs in small-group research. In the present statistical technique, the estimated correlation matrices for the individual and for the group can be used as input into multivariate procedures (e.g., multiple regression, factor analysis). The application of the technique is illustrated for data on crowding in university residential environments. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moderators of outcome in a brief family-centered intervention for preventing early problem behavior.

This study investigated moderators of change in an empirically supported family-centered intervention (the Family Check-Up) for problem behavior in early childhood. Participants were 731 2- to 3-year-olds (49% girls; 28% African American, 50% European American, 13% biracial) from low-income families and had been screened for risk of family stress and early-onset problem behavior. They were randomized to the Family Check-Up intervention or to a no-intervention control group. Latent growth models examined sociodemographic and parent psychological risk factors as potential moderators of change in problem behavior between ages 2, 3, and 4. Results revealed 2 moderators of intervention effectiveness. Caregivers with the lowest educational levels were more responsive to the family-centered intervention, and 2-parent families were more responsive to the intervention. Other risk factors showed no predictive effects. Overall, findings suggest that this brief family-centered intervention can be equally effective in reaching the most distressed and most disadvantaged families, compared to those who are more advantaged. However, results suggest that more attention may be needed to address the intervention needs of single parent families in reducing problem behavior in early childhood. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term small group intervention for college freshmen.

99 freshmen were randomly assigned to 1 of 2 treatment conditions or to a control condition. Ss were given questionnaires designed to assess social life satisfaction, social anxiety, and self-esteem. One treatment condition focused on the universality of social adjustment stress among freshmen, whereas no such emphasis was made in the "regular" condition. Half the sample was designated as particularly vulnerable to transition stress on the basis of Ss' concern about their social adjustment. The effect of group participation differed as a function of Ss' vulnerability. The social adjustment of vulnerable Ss was significantly enhanced by group participation, whereas nonvulnerable Ss were unaffected. No differences were found between universality-focused and regular groups. Results demonstrate the value of a small group experience in facilitating the transition to college of vulnerable freshmen. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Marital adjustment and outcome following treatments for depression.

Marital adjustment and treatment outcome were evaluated in the Treatment of Depression Collaborative Research Program, a multicenter clinical trial evaluating interpersonal psychotherapy, cognitive therapy, imipramine, and placebo. Marital adjustment and depression were assessed pre- and posttreatment, and depression was assessed at 6, 12, and 18 months after treatment. Results indicate that (1) there was a significant improvement in marital adjustment after treatment, (2) this effect was not moderated by treatment type, and (3) this effect was mediated by change in depression. Poor pretreatment marital adjustment was modestly associated with negative outcome, whereas poor posttreatment marital adjustment was strongly associated with negative outcome during follow-up. The findings suggest that poor marital adjustment at the end of active treatment is a risk factor for increases in depression severity during follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Follow-up outcome in short-term group therapy for complicated grief.

This study investigated 4 types of outcome over a 6-month follow-up period for 84 psychiatric outpatients who had been treated for complicated grief using short-term group therapy. The 4 types differed in regard to whether and when patients achieved clinically significant change on a primary grief outcome variable. Approximately half of the patients achieved clinically significant change by the end of treatment and maintained it over follow-up (maintenance). Another quarter of the patients reported clinically significant change, but only at follow-up (delayed recovery). A few patients achieved clinically significant change at the end of treatment, but not at follow-up (relapse). Finally, nearly a quarter of the patients failed to achieve clinically significant change (nonrecovery). The findings suggest that investigators look beyond the end of treatment when assessing improvement in patients treated with short-term group therapy for complicated grief. Inclusion of delayed recovery patients can substantially modify conclusions about the usefulness of short-term therapies for complicated grief. Delayed recovery patients differed from the other types of patients on greater perceived social support and greater change during the follow-up period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Helping child flood victims using group EMDR intervention in Argentina: Treatment outcome and gender differences.

A comprehensive group intervention with 124 children who experienced disaster-related trauma during a massive flood in Santa Fe, Argentina, in 2003 is illustrated, utilizing a one-session group eye movement desensitization and reprocessing (EMDR) protocol. A posttreatment session was done 3 months after the treatment intervention to evaluate results. Results of this one-session treatment procedure, utilizing the EMDR-Integrative Group Treatment Protocol, showed statistically significant reduction of symptoms immediately after the intervention. These statistically significant differences were sustained at posttreatment evaluation 3 months later, as measured by psychometric scales, and by clinical and behavioral observation. Data analysis also revealed significant gender differences. Despite methodological limitations, this study supports the efficacy of EMDR group treatment in the amelioration and prevention of posttraumatic stress disorder symptoms, providing an efficient, simple, and economic (in terms of time and resources) tool for disaster-related trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient suitability and outcome in short-term individual psychotherapy.

The effects of short-term (time-limited), dynamically oriented individual therapy and the patient characteristic quality of object relations (QOR) were studied in a controlled clinical trial involving 8 experienced therapists and 144 psychiatric outpatients. A comprehensive set of outcome scores was monitored at 5-month intervals including a follow-up assessment. A strong treatment effect that was maintained at follow-up was found. The effect was evident in terms of statistical significance, effect size, and clinical significance. Evidence for an additive effect of the combination of treatment and QOR was also found. The best results were attained by high QOR therapy patients, and the worst results were attained by low QOR control patients. The results were suggestive of an optimal match between type of patient and type of therapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pattern of alliance and outcome in short-term individual psychotherapy.

Pattern of change in the therapeutic alliance across time-limited, 20-session individual psychotherapy was investigated with the procedure of hierarchical linear modeling (HLM) in 2 samples of 32 psychiatric outpatients each (aged 21–53 yrs), those with low and those with high quality of object relations (QOR). Significant variation in the pattern of change in the therapeutic alliance was found within each sample. For low-QOR patients, a direct relationship was found between increasing therapist-rated alliance and favorable outcome. Pattern of change was more important than average level. For high-QOR patients, there was no evidence of a direct relationship between pattern of change and outcome. However, there was considerable evidence of a direct relationship between average level and favorable outcome. The use of HLM provided a new perspective to understanding alliance–outcome relationships. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized clinical trial of a brief, mailed intervention for symptoms of depression.

This research evaluated the efficacy of a brief, mailed personalized feedback intervention designed to alleviate depressed mood and antecedents (ineffective coping and hopelessness). College students (N = 177) were randomly assigned to intervention or control group following a baseline assessment. A week after completing the baseline assessment, participants in the intervention condition were mailed feedback and information detailing their mood, coping strategies, as well as suggestions for enhancing mood. Results indicated that feedback was effective in reducing depressive symptoms, hopelessness, and among men, increasing willingness to use coping strategies at the 1-month follow-up. Hopelessness mediated reductions in depressive symptoms. Results support the use of personalized feedback as a low-cost, initial intervention for college students suffering from symptoms of depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Need for cognition as a predictor and a moderator of outcome in a tailored letters smoking cessation intervention.

Objective: To analyze whether baseline need for cognition (NFC) was a predictor or a moderator of treatment outcome in a tailored letters intervention for smoking cessation. Design: A total of 1,499 daily smokers were recruited from general medical practices in Germany within a quasi-randomized trial testing the efficacies of two brief interventions for smoking cessation: (a) computer-generated tailored letters and (b) physician-delivered brief counseling versus assessment-only. For this study, we used data from 1,097 daily smokers who were assigned to the tailored letters or the assessment-only condition. Main Outcome Measures: self-reported 6-month prolonged abstinence from tobacco smoking assessed at 12-, 18-, and 24-month follow-ups, and smoking cessation self-efficacy assessed at 6- and 24-month follow-ups. Results: Baseline NFC predicted 6-month prolonged smoking abstinence (p = .01) and smoking cessation self-efficacy (p .05) but on smoking cessation self-efficacy (p = .05). Tailored letters resulted in higher smoking cessation self-efficacy only for persons with higher NFC. Conclusion: Higher levels of NFC are required to increase smoking cessation self-efficacy in computer-tailored interventions for smoking cessation. Considering an individual's NFC might improve the efficacy of written interventions for smoking cessation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peer group identification and smoking: Implications for intervention.

The present investigation had the goal of examining the relation between cigarette smoking and peer group affiliations in junior high school students. The data were obtained by administering a structured interview to 353 seventh and eighth graders. The results showed that two high-risk groups who made up 14.7% of the sample accounted for 55.6% of the smokers. In addition, a discriminant analysis revealed that cigarette smoking was the best discriminator of social group affiliations. The results suggest that smoking intervention programs will have a greater chance of being a success if they address specific social and emotional needs of individuals who are at greater risk for becoming smokers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy for depression in adults: A meta-analysis of comparative outcome studies.

Although the subject has been debated and examined for more than 3 decades, it is still not clear whether all psychotherapies are equally efficacious. The authors conducted 7 meta-analyses (with a total of 53 studies) in which 7 major types of psychological treatment for mild to moderate adult depression (cognitive-behavior therapy, nondirective supportive treatment, behavioral activation treatment, psychodynamic treatment, problem-solving therapy, interpersonal psychotherapy, and social skills training) were directly compared with other psychological treatments. Each major type of treatment had been examined in at least 5 randomized comparative trials. There was no indication that 1 of the treatments was more or less efficacious, with the exception of interpersonal psychotherapy (which was somewhat more efficacious; d = 0.20) and nondirective supportive treatment (which was somewhat less efficacious than the other treatments; d = -0.13). The drop-out rate was significantly higher in cognitive-behavior therapy than in the other therapies, whereas it was significantly lower in problem-solving therapy. This study suggests that there are no large differences in efficacy between the major psychotherapies for mild to moderate depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Biofeedback treatment for pediatric migraine: Prediction of treatment outcome.

Despite a growing number of studies showing good effectiveness of nonpharmacological treatments such as thermal biofeedback (TBF) for pediatric migraine, little is known about psychosocial variables that might be predictive of treatment outcome. The identification of predictors appears especially important when children are treated in a home-based treatment format that tends to be somewhat less effective than a therapist-administered treatment. A total of 32 children between the ages 8 and 16 years completed a home-based TBF treatment program with treatment outcome being of similar magnitude as previously reported in the literature. Multiple regression analysis revealed externalizing behavior tendencies, initial level of psychosomatic complaints, and the child's age to be highly predictive of outcome, whereas dimensions of family functioning failed to exert a direct influence. The implications of these findings for the development and evaluation of future treatment programs are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)