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Background: The improving access to psychological therapy (IAPT) initiative aims to provide widespread evidence-based psychological treatments for common mental health problems in the UK. Individual services have implemented National Institute for Clinical Excellence guidelines in various ways; some provide group-based therapy, whilst others do not., Aims: The study investigates how patients and staff experience group-based therapy, what they find helpful and where improvements can be made., Method: Forty-five semi-structured interviews were undertaken with staff and patients in three IAPT services. Framework analysis was used to analyse comments relating to patient experience in group-based treatment., Results: The study found that patients can feel isolated with their symptoms and group-based interventions can normalise the illness, reducing stress. Individuals experience benefits and, in some cases, difficulties, in different ways. Some patients hear of the strategies that others have found useful, and observe others' progress, which may bring hope for their own recovery., Conclusions: IAPT group-based interventions appear to aid recovery in different ways to one-to-one therapy, by normalising mental illness and increasing social contact. Greater understanding of the factors operating in group-based interventions might increase attendance and recovery facilitated by IAPT group interventions.

One of the fastest growing approaches to treating cocaine addiction is intensive outpatient treatment (INT). Nevertheless, there have been no previously reported controlled clinical trials comparing this approach to the more traditional (IND) or individual plus group (IND-GRP). This early report of the results of a clinical trial comparing these three approaches indicated that patients who remained in treatment and completed a twelve-week course of care demonstrated significant improvements in drug use and psychological functioning. However, INT, IND, and IND-GRP did not differ on any of the assessments made during treatment or at treatment completion. The results underscored the importance of remaining in a course of care in order to effect behavioral change. A next step would involve a systematic comparison of those persons who do best in each modality in an effort to define the variables which could help match a patient to a treatment in which he/she is most likely to remain.

There is a scarcity of information available with respect to postbereavement outcomes for survivors of the suicide of a loved one. Few studies have focused on postvention therapies for the bereaved, particularly the bereaved survivors of suicide. The major aim of this study as to compare the effects of two theoretically derived nursing postventions, Bereavement Group Postvention (BGP) and Social Group Postvention (SGP), among the widowed whose spouses died of suicide. The findings suggest that both groups experienced an overall reduction in depression and distress. Although participants in the SGP generally showed significant improvement in social adjustment, they tended to be less well adjusted with respect to their parental roles at the end of the 8-week postvention sessions. Comparison of the psychoemotional correlates of grief varied such that there were no significant differences between the postvention groups for social isolation, loss of control, somatization, or death anxiety. The BGP participants experienced significantly reduced levels of anger/hostility and guilt; however, feelings of anger/hostility actually increased for those receiving the SGP. There was a significant reduction in feelings of despair, rumination, and depersonalization for both groups. Although social isolation was not significantly reduced for participants in either group, those receiving the BGP tended to experience a reduction in social isolation and those receiving the SGP showed no changes.

Group psychotherapy is becoming a more prevalent treatment option for people with borderline personality disorder. Various types of group approaches have been discussed; however, data about specific interventions and their relationship to outcomes for subgroups of people with borderline personality disorder are lacking. The purpose of this study was to explicate the interventions used in a successful group therapy program developed for community mental health center clients with borderline personality disorder. Two independent raters used the Hill Counselor Verbal Response Category System-Revised to describe and categorize the therapists' verbal responses. Coding of eight videotaped sessions indicated that the therapists' level and type of verbal activity did not change over time. The most frequently utilized interventions across sessions were providing information and seeking information. These responses are indicative of a moderate and high degree of structure. The results suggest that clinicians must consider the unique needs of serious and persistently ill people with borderline personality disorder and plan group interventions accordingly.

Literature reports that cognitive understanding and social support can mitigate stress in both adults and adolescents. As a subcomponent of the Carolina Adolescent Health Project (CAHP), this research evaluated the efficacy of a Cognitive Social Support (CSS) group protocol designed to mitigate the disaster stress of adolescents who had been exposed seriously to Hurricane Hugo. A purposive sample of 259 students participated in and evaluated the CSS. This article reports the specific structure, content, process, rationale, and cost of the CSS. Evaluations indicated that 82% of the students evaluated the small-group component of the CSS as "very good" or "excellent," while 70% rated the large-group component as "very good" or "excellent."

Psychiatric mental health nurses are increasingly recognizing the traumatic effects of childhood incest on adult survivors. This article discusses a long-term group therapy that specifically deals with unresolved familial issues as a treatment for adult women who are survivors of incest. An interactional family model is described, as well as its use by nurse specialists who act as facilitators and surrogate parents in a long-term group process. Specific focus is on the use of the model in working through dysfunctional communication patterns and boundary and survival issues.

The purpose of this study was to ascertain the effect of nurse high prizing and nurse low prizing during group therapy in changing the self-concept of institutionalized aged persons. The hypothesis tested was that institutionalized aged clients participating in group therapy who receive nurse high prizing will show an increase in self-concept as measured by the Tennessee Self-Concept Scale (TSCS) when compared with those aged clients in the same settings participating in group therapy who receive nurse low prizing or those aged clients constituting the matched control groups. The study used an existing data source generated from the research of Williams and Lindell to conduct a secondary analysis of a variable not previously investigated. Mean difference scores from the posttest total self-concept score and subscales of the TSCS were analyzed in conjunction with the levels of prizing within the experimental and control groups. Using the Scale for Rating Prizing, two nurse raters judged the degree of prizing on 40 randomly extracted video segments. The findings indicated that 47.1% of those subjects who received low prizing decreased in self-concept; 68.4% of those who received high prizing increased in self-concept. No change in self-concept was noted in the control group. Findings were significant at the .0001 level. Investigating the effect of nurse high and low levels of prizing on client self-concept completes the Rogerian trilogy of therapist-offered conditions with this same sample of subjects. Extension of previous studies adds to the ever-growing body of nursing knowledge and increases the certitude, casualty, and generalizability of such investigations.

Hospitalized psychiatric patients frequently have deficits in their problem-solving abilities. An inpatient problem-solving group provides a therapeutic experience in which patients learn and apply the problem-solving process to practical and interpersonal difficulties they are presently experiencing. Two problem-solving group models, derived from cognitive-behavior theory, are suggested to accommodate diverse levels of inpatient functioning. Implications for nursing practice and recommendations are addressed.

This article describes the reorganization of one part of an individual, home visiting service for mentally dysfunctional women into a group intervention. Deinstitutionalization has been followed by escalating health care costs, cost containment, and restructuring of services, affecting the already constrained resources for community psychiatric services. Faced with these challenges, a nursing staff, under the administration of a clinical specialist psychiatric nurse, began reorganization of a home visiting service with one trial group. The model group used the prior success reports of groups that were adapted prospectively with a focus on immediate needs and led by nurses for women. The aims were to enhance social supports of the clients while reducing their relapse rates and to reduce the personnel time and cost. Evaluation found that these objectives were met. Thus, the involvement of nurses in the assessment, planning, implementation, and evaluation of its services demonstrates success in the redesign and reorganization of community psychiatric services.