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Cognitive behavioural therapy (CBT) is recommended as the frontline treatment for depression and anxiety disorders and has been implemented in a wide range of mental health care contexts. In Danish mental health services, group CBT is the most common psychotherapeutic treatment format. Recently, a standardized, time-restricted treatment format has been implemented. No studies have investigated the patients' experiences of group CBT in such a format. Furthermore, few studies have investigated patients' experiences of group CBT for anxiety and depression. The current study set out to explore patients' experiences of group CBT for anxiety and depression and the role of a standardized, time-restricted treatment format, using a qualitative framework.We explored the experiences of 23 patients with a primary diagnosis of social anxiety, panic disorder/agoraphobia, or depression. Data were collected through semi-structured interviews. Data were analyzed using phenomenological narrative analysis. The results revealed a common narrative across the 23 interviews. The narrative was made up of six distinct themes, namely: How did I get here?; Being seen, heard and recognized; Shared responsibility of problems and solutions; Education and tools; Limitations of this group format; and Launchpad. The results indicated that the patients found group CBT helpful due to a range of factors, both common factors and treatment-specific factors. Patients expressed skepticism towards group CBT prior to beginning, because of a lack of information and previous failed treatment attempts. The patients highlighted the importance of the context of the mental health system by explaining how systemic factors impacted negatively on their psychotherapy experience. Many described feeling abandoned due to the sudden ending of a treatment course that was generally considered insufficient.

Objective: Individual patient characteristics are important in trying to understand why people respond differently to group CBT. Only a few studies have explored therapists’ perceptions of within-patient attributes that may be hindering in group CBT in a mental health setting. Method: We explored the perception of individual patient characteristics and related obstacles in 12 psychotherapists in Danish Mental Health Services through semi-structured interviews. The interviews were analyzed using a descriptive qualitative framework. Results: The results revealed four distinct themes that the therapists pointed to as important for the outcome of a 14-week group CBT intervention for social phobia, panic disorder, agoraphobia and major depressive disorder. The four themes were Complexity & severity, External circumstances, Attitudes & coping and Cognitive ability & reflection level. The therapists explained how they perceived higher complexity and severity in the patients as an obstacle, they highlighted that a calm and stable outside environment aided therapeutic change, whilst stressors were hindering. They perceived active coping mechanisms, positive attitudes and high readiness to change as positive factors, whilst dependent and hostile coping mechanisms and negative attitudes were seen as obstacles. Finally, the therapists pointed to cognitive abilities and reflection level, explaining how it could be difficult to obtain good outcomes for patients who’s cognitive abilities were debilitated due to psychopathological factors or for patients with a generally low reflection level. Conclusions: The results indicated that the therapists experience group CBT as an intervention that requires certain prerequisites of the patients, and that the four themes should be considered when deciding on treatment options for any given patient. The clinical utility and theoretical implications of the results are discussed.

Cognitive behavioural therapy (CBT) is an evidence-based psychotherapy and one of the most widely used treatments for mental health problems. It is generally acknowledged that supervision improves the quality of treatment although systematic descriptions and empirical evaluation of supervision have been sparse. Moreover, there are relatively few valid and reliable instruments to evaluate supervision. Based on a comprehensive review of the supervision literature, six competency domains were identified to cover the scope of CBT supervision: Theory, Focus, Learning strategy, Techniques, Structure, and Interpersonal style. The Moeller, Moerch, Rosenberg Supervision Scale (MMRSS) was developed to evaluate supervisor performance within each of these domains after observation of supervision. The present study examined the psychometric properties of the MMRSS (inter-rater reliability and construct validity), the clinical utility, and satisfaction when using MMRSS to evaluate CBT supervision. CBT supervisors (n = 8) were recruited for the study and provided videos of group supervision. A total of 21 videos were rated using the MMRSS and the Supervisory Competency Scale (SCS) by two independent raters. Supervisees and supervisors completed a satisfaction questionnaire to capture their experience of using the MMRSS during supervision of supervision. The MMRSS showed acceptable internal consistency and validity. Several domains in MMRSS (Structure, Learning strategy, and Interpersonal style) correlated significantly with the corresponding domains in the SCS for cognitive supervision. Preliminary results indicate that the MMRSS may be a valid and clinically useful tool to evaluate CBT supervision, although further systematic evaluation is needed. Key learning aims (1) To understand that empirically founded evaluation of cognitive behavioural supervision is essential for good training.(2) To argue that a modern view of supervision places an emphasis on learning principles.(3)