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Abstract: Although reminiscence therapy alleviates mental illness and improves quality of life in neurocognitive disorders patients, little study reports its clinical application in cancer patients. Thus, this study aimed to explore the effect of reminiscence therapy on anxiety, depression, quality of life, and survival profile in postoperative gastric cancer patients.One hundred sixty surgical gastric cancer patients were enrolled in this randomized, controlled study, then randomly assigned to Reminiscence therapy group (N = 80) and Control group (N = 80) as 1:1 ratio. The evaluation was carried at baseline (M0), month 3 (M3), month 6 (M6), month 9 (M9), and month 12 (M12) after intervention by Hospital Anxiety and Depression Scale and European Organization for Research and Treatment of Cancer quality of life Questionnaire-Core 30 (QLQ-C30). Furthermore, disease-free survival and overall survival were analyzed using follow-up data.Reminiscence therapy decreased HADS for anxiety score at M6, M9, and M12, decreased anxiety rate at M9 and M12 compared to control care; while it did not affect HADS for depression score or depression rate at any time-point. Also, reminiscence therapy raised QLQ-C30 global health status score at M12, reduced QLQ-C30 symptoms score at M6, while did not affect QLQ-C30 function score at any time-point compared to control care. Reminiscence therapy did not affect disease-free survival and overall survival, either. Further subgroup analyses (divided by age and gender) observed that the effect of reminiscence therapy seemed more obvious in patients with age ≤60 years and male patients.Reminiscence therapy exhibits alleviation of anxiety and improvement of quality of life in postoperative gastric cancer patients., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Evidence supports the use of group therapy for symptom reduction and improving functioning in people with psychosis. However, research guidelines highlight the importance of establishing the feasibility of interventions. Adherence is an important indicator of feasibility and an essential step in supporting the development of the evidence base for group interventions. This review aims to estimate adherence, and possible barriers and facilitators, to psychotherapeutic groups in people with psychosis., Methods: Embase, Ovid MEDLINE and PsycINFO databases were searched for cross-referencing terms related to group therapy and psychosis. Studies were assessed against inclusion criteria and methodological quality was evaluated. Data wasextracted from each paper including the average session attendance, demographic, clinical, study and therapy-related characteristics and the impact of these on adherence levels evaluated., Results: Fifty-nine original research papers were included, reporting on 52 independent studies which consisted of 66 therapy groups comprised of 2109 participants. Average adherence was 76.4% (s.d. = 17.4). Adherence was improved by receiving incentives and was higher in participants of older age. Study sample size was inversely associated with adherence levels. Study quality was variable with approximately 61.5% found to be at risk of bias. The results support the feasibility of group therapy and suggest that adherence in people with psychosis is not dissimilar to those for people experiencing common mental health difficulties. These findings, alongside efficacy evidence, support the use of group interventions in people with psychosis but also highlight the need for further high-quality research on the efficacy for these approaches.

Motivational interviewing (MI) is devised to change unhealthy behaviors by increasing motivation. We adapted MI to a group format for the treatment of relapse during the behavioral treatment of obesity and performed a clinical audit to evaluate its effectiveness in stopping weight regain. The program was structured in seven weekly sessions, plus a 6-month follow-up. Patients ( n = 86) completed a questionnaire on motivation to change in both healthy diet and physical activity, and a self-reported measurement of calorie intake and physical activity at baseline, at program end and at 6-month follow-up. The attendance to the program was high, with only 13 patients (15%) not completing the program and 24% not attending the 6-month follow-up. By the end of follow up, the prevalence of patients in either precontemplation or contemplation was reduced from over 60% at enrollment to approximately 20%, whereas the sum of patients in action or maintenance stages was increased from 9.5% in healthy diet and 14% in physical activity to 39.7% and 41.3%, respectively. These changes translated into significant behavioral changes (mean calorie intake, -13%; total physical activity, +125%; sedentary time, -8%) and finally into reduced body weight ( -3%). We conclude that MI programs adapted for groups may be used to stop relapse in individuals following a behavioral intervention for obesity.

Objectives: There exists a dearth of research focused explicitly on predictors of attrition, particularly in the area of group therapy, where both attrition and attendance becomes of primary concern. The present study examined both pretreatment and treatment-specific variables in the prospective prediction of attendance and attrition in group therapy., Method: Fifty-two participants were randomized to one of two 12-week group treatments. Participants completed baseline interviews and questionnaires, as well as weekly assessments of treatment-specific factors., Results: No pretreatment factors predicted attendance or drop out, although men attended a larger amount of sessions and were less likely to drop out. Cross-lagged panel analyses supported bidirectional, causal relationships both treatment-specific predictors (therapeutic alliance and number of therapeutic techniques) and attendance., Conclusions: Successful retention in group therapy may be less predictable from pretreatment factors and instead lie in increasing alliance and fostering the practice of therapeutic strategies., (© 2020 Wiley Periodicals LLC.)

Background: According to the World Health Organization (WHO), up to 25% of people worldwide will develop mental health disorders during their lifetime. Patients admitted to acute inpatient units for mood disorders experience emotional distress. Group therapy has the potential to foster the therapeutic change through specific therapeutic mechanisms. Psychiatric nurses working in inpatient units are in a unique position to offer group therapy., Objectives: Explore and describe stabilised acute psychiatric patients with mood disorders' lived experiences of group therapy facilitated by psychiatric nurses. Make specific recommendations for psychiatric nurses to facilitate constructive group therapy for stabilised acute psychiatric patients with mood disorders in an inpatient unit., Method: A qualitative, exploratory, descriptive and contextual design was used in the study. A purposive sample of all patients with mood disorders older than 18 years admitted to inpatient units who participated in group therapy was made. Data were collected through conducting phenomenological interviews, observation and field notes. Interviews focussed on the following open question: 'How did you experience group therapy facilitated by the psychiatric nurses?' An independent coder analysed the data by using thematic coding. Measures to ensure trustworthiness were applied. The following four ethical principles were adhered to: autonomy, non-maleficence, beneficence and justice., Results: Three themes emerged from this study. Theme 1 entailed the psychological experiences of patients attending group therapy. Theme 2 highlighted the interpersonal experiences of patients. Theme 3 evolved around patients' experiences outside group therapy. Patients initially experienced attending group therapy as anxiety provoking. However, negative psychological experiences soon transformed into positive psychological experiences., Conclusion: The findings of this study were used to make specific recommendations to facilitate constructive group therapy for patients with mood disorders.

There is high variability in efficacy for interventions for youth with disruptive behavior problems (DBP). Despite evidence of the unique correlates and critical consequences of girls' DBP, there is a dearth of research examining treatment efficacy for girls. This meta-analysis of 167 unique effect sizes from 29 studies (28,483 youth, 50% female; median age: 14) suggests that existing treatments have a medium positive effect on DBP (g = .33). For both boys and girls, the most effective interventions included (a) multimodal or group format, (b) cognitive skills or family systems interventions, and (c) length-intensive programs for (d) younger children. Boys demonstrated significantly greater treatment gains from group format interventions compared to girls, which is particularly important given that the group program format was the most prevalent format for boys and girls, with 14 studies involving 10,433 youth encompassing this category. This is the first meta-analysis to examine the effect of program characteristics in a sample of programs selected to be specifically inclusive of girls. Given that girls are underrepresented in intervention research on DBP, findings are discussed in terms of gender-responsive considerations and elucidating how key aspects of program structure can support more effective intervention outcomes for youth., (© 2019 Society for Community Research and Action.)

The aim of this study was to investigate the effects of positive group psychotherapy with auricular acupressure on tobacco withdrawal symptoms and smoking cessation. This study used a randomized controlled trial design. Participants were randomly assigned to 1 of 3 groups: group 1 (counseling and auricular acupressure), group 2 (counseling and placebo acupressure), and the control group (self-help for smoking cessation). Positive group psychotherapy and auricular acupressure were performed once a week for 6 weeks. The smoking cessation rates for 1 year in groups 1 and 2 were higher than that in the control group (9.5%, 15.6%, and 0%, respectively; odd ratio: 7.98, P = .019, n = 109). There was a significant difference of tobacco withdrawal symptoms among the 3 groups over 4 weeks (F = 2.9, P = .04). The mean differences between week 1 and week 4 among the 3 groups were statistically significant (4.7 ± 6.96, 5.18 ± 7.9, and 0.14 ± 7.15, F = 4.25, P = .018).

Background: Academic and clinical stressors are experienced by most nursing students enrolled in a nursing education program. The students who cannot effectively deal with these stressors experience stress, anxiety and depression., Objective: The aim of this study was to determine the effects of group mindfulness-based cognitive therapy on mindfulness, depression, anxiety, and stress levels in nursing students., Design: This quasi-experimental study was carried out using a nonrandomized control group pre-test, post-test, and follow up design., Setting: Department of Nursing, Faculty of Health Sciences, University of Aksaray, Turkey., Participants: Eighty-two second-year undergraduate university nursing students., Methods: The group mindfulness-based cognitive therapy program was conducted with the experimental group. The Mindful Attention Awareness Scale (MAAS) and The Depression, Anxiety and Stress Scale (DASS) were measured at pre- and post- intervention, and at a 4-months follow-up., Results: The post-test mean scores of MAAS of the experimental group were statistically higher than the control group (p = .006). When the mean scores obtained in the pre-test, post-test and follow-up measurements were compared, the mean scores of MAAS increased (p = .000) and stress scores decreased significantly in the experimental group (p = .004)., Conclusion: A group mindfulness-based cognitive therapy program conducted with nursing students had an effect on students' mindful attention awareness and stress levels. These study results indicate that this program can be used to reduce the levels of stress in nursing students., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: Long-term evaluations of childhood obesity treatments are needed. We examined changes in weight and cardiometabolic risk 1 year after children completed individual family or group-based weight management interventions., Methods: In 2009-2010, 6- to 12-year-old children with overweight or obesity from Finnmark and Troms (Norway) were recruited after media coverage and randomised to 24 months of individual family (n = 49) or group intervention (n = 48). Individual family intervention included counselling by a paediatric hospital team and a public health nurse in the local community. Group intervention included meetings with other families and a multidisciplinary hospital team, weekly physical activity sessions and a family camp. The primary outcome body mass index (BMI) and cardiometabolic risk factors were analysed 12 months after intervention., Results: From baseline to 36 months, children's BMI increased 3.0 kg/m 2 in individual family and 2.1 kg/m 2 in group intervention (between-group -0.9kg/m 2 , P = 0.096). Data were available from 62 children (64%). Between-group differences in C peptide (P = 0.01) were detected in favour of group intervention. Pooled data from both treatment groups showed continued decrease in BMI standard deviation score (P < 0.001)., Conclusion: No between-group difference in BMI was observed 12 months after intervention. Both groups combined showed sustained decrease in BMI standard deviation score., (©2019 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Posttraumatic stress disorder (PTSD) is a primary mental health concern of veterans. In clinical settings, efforts to improve broad facets beyond symptom amelioration and consideration of moderators of treatment effectiveness in this population are needed for continued improvement in care. General self-efficacy (GSE) has been indicated as a useful treatment target because of its association with positive outcomes such as increased positive health behaviors. Both race and educational attainment represent potential moderators of treatment response that are relevant for a veteran PTSD population. This study aimed to determine whether a PTSD Recovery Group Therapy Program resulted in improvement in GSE and whether racial and educational differences moderated GSE outcomes. Archival data were examined from male veterans (N = 450) receiving mental health services at a Veterans Affairs medical center using multilevel modeling to examine change in GSE over the course of treatment as well as moderation of change in GSE as a function of race and educational attainment. After completion of group therapy, results indicated there was significant improvement in GSE, with significantly different improvement based on education. Higher levels of education were associated with greater increases in GSE after treatment. Improvement in GSE did not differ by participant race. In clinical settings, efforts to increase GSE and attending to moderators such as educational attainment may be useful for improving PTSD treatment approaches. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Introduction: Family caregivers of people with dementia (PwD) have a high burden and therefore are themselves at a high risk for psychiatric and somatic morbidities. Although individual psychotherapy has been shown to be a potentially effective treatment, it is rarely used by family caregivers. Possible reasons are poor accessibility and time restrictions on the side of the caregiver., Aim: To test the efficacy of a short-term and low threshold psychotherapeutic group intervention for family caregivers of PwD with respect to mental stability of the caregivers., Material and Methods: Data from a 12-week psychotherapeutic group intervention (10 participants each in the intervention and control groups) were analyzed. Main topics of the intervention were: personal limits, dysfunctional thoughts, emotions and resource activation. Primary endpoints were an increase of perceived self-efficacy and reduction of depressive symptoms using SWE and ADS questionnaires before, directly and 3 months after the end of the intervention., Results: A gain in perceived self-efficacy did not reach statistical significance, whereas depressive symptoms showed a statistically significant increase in the intervention group over time compared to the control group., Discussion: The intervention did not reach its primary endpoints. Possible reasons are the fact that the group was highly heterogeneous with respect to dementia etiology and the low number of participants. The short duration of the intervention may have reduced the potential of the program to address all urgent needs of the participants.

Background: Some studies have previously found that certain elevated early maladaptive schemas (EMSs) are negative predictors for outcome for patients with obsessive-compulsive disorder (OCD) treated with Cognitive-Behavioral Therapy (CBT) or Exposure and Response Prevention (ERP). The current study explores whether EMS were related to reductions in OCD symptom severity at long-term follow-up (Mean = 8 years) after group ERP for patients with OCD. The central hypothesis was that patients with no response to treatment or patients who relapsed during the follow-up period were more likely to have elevated pre-treatment EMSs compared to those who responded to initial treatment and maintained gains over time. We also investigated whether there were any differences in change over time of overall EMS between patients who were recovered versus patients who were not recovered at extended follow-up., Methods: Young Schema Questionnaire -Short Form (YSQ-SF), Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Beck Depression Inventory (BDI) were measured in 40 OCD patients in a general outpatient clinic before and after group ERP, after 12-months and at extended follow-up. To analyze the predictors, a multiple regression analyses was conducted. Changes in overall EMS was analyzed by mixed models procedures., Results: The major finding is that patients with high pre-treatment YSQ-SF total scores were less likely to respond to initial treatment or were more likely to relapse between post-treatment and the extended follow-up. The YSQ-SF total score at pre-treatment explained 10.5% of the variance of extended long-term follow-up outcome. The entire sample experienced a significant reduction in overall EMS over time with largest reduction from pre- to post-test. There were no statistically significant differences in total EMS change trajectories between the patients who were recovered at the extended follow-up compared to those who were not., Conclusion: The results from the present study suggest that patients with higher pre-treatment EMSs score are less likely to recover in the long-term after receiving group ERP for OCD. A combined treatment that also targets early maladaptive schemas may be a more effective approach for OCD patients with elevated EMS who don't respond to standard ERP.

Background: There is an increasing demand of evidence-based treatment options for methamphetamine users, but research in this field is limited. This study therefore evaluates the efficacy of two residential treatment programs for methamphetamine users., Method: A total of 108 patients with a history of methamphetamine abuse from two inpatient rehabilitation centers were studied for psychiatric symptoms, craving, psychosocial resources, and cognitive functioning at the start and end of therapy. Patients from one center ("amphetamine type stimulant group") received conventional group therapy plus an additional 10 h of group therapy focusing on stimulant use. Patients from the other center ("treatment as usual") received conventional group therapy only. Predictors of drop-out were estimated., Results: A drop-out rate of 40.7% was observed without a significant difference between both centers. Patients remained significantly longer in treatment as usual compared to amphetamine type stimulant treatment. Irrespective of treatment program, craving and psychiatric symptoms significantly decreased while psychosocial resources, processing speed, and cognitive flexibility improved over time. Other cognitive measures yielded mixed results. History of injection drug use was a significant predictor for treatment drop-out., Conclusions: Existing treatments are effective in reducing craving and psychiatric symptoms. Additional stimulant specific groups do not appear to influence treatment completion and secondary outcome measures. Institutions should therefore offer treatment for methamphetamine users, even if they do not provide a therapy content focusing on methamphetamine. History of injection drug use should receive attention in treatment to prevent drop-out. Changes in cognitive functioning need to be further explored., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Each year, 40% to 60% of smokers try to quit, but smoking cessation success rate for 1 year was 1% to 9% without professional help and 7% to 40% with professional help. The purpose of this study was to examine the effects of group counseling with auricular acupressure on smoking cessation and tobacco withdrawal symptoms. This study is a randomized controlled trial. This study was performed at a university in South Korea. Fifty-five smokers were randomly assigned to 3 groups: group 1 (auricular acupressure + counseling), group 2 (placebo acupressure + counseling), and the control group (self-help smoking cessation). Group counseling and auricular acupressure were undertaken once a week for 6 weeks. The smoking cessation rate in group 1 for 1 year was significantly higher than that in group 2 and the control group (22.2%, 5.3%, and 5.6%, respectively). Tobacco withdrawal symptom scores were significantly decreased in group 1 compared with that in group 2 over 6 weeks (F = 3.2, P = .025). Auricular acupressure with group counseling was effective and group counseling alone was not effective for 1-year smoking cessation.

Objective: The present meta-analysis evaluates the efficacy of group psychotherapy for post-traumatic stress disorder (PTSD) in adults directly compared to no treatment or active treatments examined in randomized controlled trials (RCTs)., Method: Electronic databases were searched for eligible studies. Effects on PTSD symptoms, depression, and anxiety were extracted. Between- and within-group effect sizes (Hedges' g) were calculated using a random-effects model. Data were adjusted to account for dependencies among observations in groups., Results: Twenty RCTs were included comprising 2244 individuals. Results showed significant effects of group psychotherapy in reducing symptoms of PTSD compared to no-treatment control groups (k = 13; g = 0.70; 95% CI: 0.41; 0.99). No significant differences in efficacy were found between group psychotherapy and other active treatments (k = 8; g = 0.13; 95% CI: -0.16; 0.42). Moderator analyses confirmed gender and trauma type as important moderators of within-treatment effects for PTSD., Conclusions: Group treatments are associated with improvements in symptoms of PTSD. Particularly, the efficacy of exposure-based cognitive-behavioral group therapy (group CBT) is empirically well demonstrated. Still little is known about the effects of group treatment approaches other than CBT and the comparative efficacy to alternative treatments such as individual therapy or pharmacotherapy. Clinical or Methodological Significance of this Article: This review provides an empirical base for group therapy as a viable treatment alternative for future PTSD practice guidelines. Although less is known about its comparative efficacy to alternative PTSD treatments such as individual therapy or pharmacotherapy, sufficient evidence exists to recommend group therapy (particularly exposure-based group CBT) for those who might not be able to access alternative treatments. Trauma type and gender proved to be important moderators of group treatment outcome. The results further indicate that the evidence base of recommendations for group therapy in current international treatment guidelines needs to be updated.

Background: Non-attendance of treatment groups in the community has been a long-standing problem in mental health care. It has been found to have financial ramifications for services, worsen outcomes for those that do not attend and negatively impact on therapeutic group processes. There is a need to gain a better understanding of patients' reasons for attending or not attending. This study aimed to explore patient views on facilitators and barriers to the attendance of treatment groups in the community., Methods: The study used interview data collected as part of three studies that investigated treatment groups for psychiatric patients in the community. Sixty-seven interview transcripts were analysed using the framework method., Results: Five themes relating to facilitators of group attendance were identified: opportunity for autonomy; self-acknowledging need and therapist encouragement; optimal group format and safe environment; interest in content and enjoyment; actual and expected benefits of attendance. Four themes related to barriers: not being sufficiently informed; concerns about social interactions and the unknown; limited accessibility; and negative group dynamics., Conclusion: To facilitate attendance and reduce attrition to treatment groups in the community clinicians should address patient's wishes for information, capture their interest in the group modality, and potentially offer a 'trial' session. Furthermore, they should make the group location and time as accessible as possible and create a moderately sized group of six to eight patients. In these groups, mutual respect, feelings of safety and encouragement appear essential to make patients feel they can benefit from attendance., Competing Interests: The authors have declared that no competing interests exist.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is an evidence-based group treatment program for ambulatory patients with borderline personality disorder (BPD). The program was introduced to the Iowa correctional system in 2005, and groups have been ongoing ever since. In this analysis, we examine whether response to the STEPPS program differs based on sex, age (<40/≥40 years), or race/ethnicity (minority/non-minority) using data collected in Iowa prisons and in community corrections. Subjects were recruited and assessed by correctional staff. Offenders with BPD were offered the opportunity to participate in the STEPPS program. The presence of BPD was assessed using a module from the Structured Interview for DSM-IV Personality. Efficacy assessments included the Borderline Evaluation of Severity Over Time Scale, the Beck Depression Inventory, and the Positive and Negative Affectivity Scale. The Client Satisfaction Questionnaire-8 assessed program satisfaction. Data on 77 offenders were analyzed. All participated in the STEPPS program and 53% completed all 20 weeks. The analysis showed that there were no significant differences in response to STEPPS in terms of sex, age, or race/ethnicity on any of the three efficacy measures. Women expressed greater satisfaction than men, but there were no differences with regard to age or race/ethnicity. The implications of the findings are discussed., (Copyright © 2018 Elsevier Inc. All rights reserved.)

The implementation of a Cognitive-Behavioural Group Intervention (CBGI) in Italian general hospital psychiatric units started in the years 2000-2001 in two Italian regions. Over the years it has became more and more popular also in other psychiatric units located in the rest of the country. Based on the "stress-vulnerability-coping" theory, the CBGI is a replicable and innovative psychosocial intervention that promotes the active involvement of inpatients in decisions concerning their individual objectives and care. In the present article, the authors briefly describe this intervention and the main findings regarding its implementation in several psychiatric units in different Regions of Italy. The authors emphasize that such a psychosocial approach to inpatient care is needed because it can produce improved clinical outcomes, reduction in untoward events and increased staff and inpatient satisfaction. However, its introduction and use still represent a major cultural and managerial challenge in our country.

To derive a method of identifying use of evidence-based psychotherapy (EBP) for post-traumatic stress disorder (PTSD), we used clinical note text from national Veterans Health Administration (VHA) medical records. Using natural language processing, we developed machine-learning algorithms to classify note text on a large scale in an observational study of Iraq and Afghanistan veterans with PTSD and one post-deployment psychotherapy visit by 8/5/15 (N = 255,968). PTSD visits were linked to 8.1 million psychotherapy notes. Annotators labeled 3467 randomly-selected psychotherapy notes (kappa = 0.88) to indicate receipt of EBP. We met our performance targets of overall classification accuracy (0.92); 20.2% of veterans received ≥ one session of EBP over the study period. Our method can assist with identifying EBP use and studying EBP-associated outcomes in routine clinical practice.

Alcohol and other drug abuse are frequently treated in a group therapy setting. If participants are allowed to enroll in therapy on a rolling basis, irregular patterns of participant overlap can induce complex correlations of participant outcomes. Previous work has accounted for common session attendance by modeling random effects for each therapy session, which map to participant outcomes via a multiple membership construction when modeling normally distributed outcome measures. We build on this earlier work by extending the models to semicontinuous outcomes, or outcomes that are a mixture of continuous and discrete distributions. This results in multivariate session effects, for which we allow temporal dependencies of various orders. We illustrate our methods using data from a group-based intervention to treat substance abuse and depression, focusing on the outcome of average number of drinks per day. Alcohol and other drug abuse are frequently treated in a group therapy setting. If 2 clients attend the some of the same sessions, we might expect that-on average-their posttreatment outcomes would be more similar than if they had not attended any sessions together. Hence, if participants are allowed to enroll in therapy on a rolling basis, irregular patterns of session attendance can induce complex relationships between participant outcomes. Statistical methods have been developed previously to account for rolling admission group therapy when the outcomes are normally distributed. In the case of alcohol and other drug use interventions, however, a substantial fraction of participants often report zero use after treatment. We extend previous work to build models that accommodate semicontinuous outcomes, which are a mixture of continuous and discrete distributions, for such situations. We find that modern Bayesian statistical methods and software allow users to efficiently estimate nonstandard models such as these. We illustrate our methods using data from a group-based intervention to treat substance abuse and depression, focusing on the outcome of average number of drinks per day. We find that the intervention is associated with a drop in the probability of any drinking, but find no evidence of a change in the amount of drinking, conditional on some drinking. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)

Objective: There is evidence that Cognitive Stimulation Therapy and maintenance Cognitive Stimulation Therapy are effective in mild to moderate dementia. There is, however, little evidence available for its implementation in practice and the impact of outreach support on the sustainability of the programme., Methods: Two hundred and forty-one staff members were randomised from 63 dementia care settings between outreach support including an online forum, email, and telephone support, compared to usual Cognitive Stimulation Therapy control group. The primary outcome was average number of attendees to the Cognitive Stimulation Therapy and maintenance Cognitive Stimulation Therapy programmes., Results: There was no difference in average number of attendees between the intervention and usual Cognitive Stimulation Therapy control groups for the Cognitive Stimulation Therapy (p = 0.82) or the maintenance Cognitive Stimulation Therapy programme (p = 0.97)., Conclusions: Outreach support does not affect the average number of people with dementia attending the Cognitive Stimulation Therapy or maintenance Cognitive Stimulation Therapy programme. Irrespective of outreach support, the programmes remain widely implemented and yield perceived benefits for people with dementia. Copyright © 2017 John Wiley & Sons, Ltd., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Group prenatal care (GPC) models have been gaining popularity in recent years. Studies of high-risk groups have shown improved outcomes. Our objective was to review and summarize outcomes for women in GPC for women with specific high-risk conditions., Methods: A systematic literature review of Ovid, PubMed, and Google Scholar was performed to identify studies reporting the effects of group prenatal care in high-risk populations. Studies were included if they reported on pregnancy outcome results for women using GPC. We also contacted providers known to be utilizing GPC for specific high-risk women. Descriptive results were compiled and summarized by high-risk population., Results: We identified 37 reports for inclusion (8 randomized trials, 23 nonrandomized studies, 6 reports of group outcomes without controls). Preterm birth was found to be decreased among low-income and African American women. Attendance at prenatal visits was shown to increase among women in GPC in the following groups: Opioid Addiction, Adolescents, and Low-Income. Improved weight trajectories and compliance with the IOM's weight recommendations were found in adolescents. Increased rates of breastfeeding were found in adolescents and African Americans. Increased satisfaction with care was found in adolescents and African Americans. Pregnancy knowledge was increased among adolescents, as was uptake of LARC. Improved psychological outcomes were found among adolescents and low-income women. Studies in women with diabetes demonstrated that fewer women required treatment with medication when exposed to GPC, and for those requiring treatment with insulin, GPC individuals required less than half the dose. Among women with tobacco use, those who had continued to smoke after finding out they were pregnant were 5 times more likely to quit later in pregnancy if they were engaged in GPC., Conclusions: Several groups of high-risk pregnant women may have benefits from engaging in group prenatal care. Because there is a paucity of high-quality, well-controlled studies, more trials in high-risk women are needed to determine whether it improves outcomes and costs of pregnancy-related care.

Cognitive theories point to reduction in dysfunctional posttraumatic cognitions (PTCs) as one mechanism involved in recovery from posttraumatic stress symptoms (PTSS), yet research findings have shown individual differences in the recovery process. We tested the cognitive mediation hypothesis above in a previously published psychosocial group intervention among war-affected children. We also examined heterogeneity in children's PTCs during the intervention. We used a cluster randomized trial of Smith et al.'s (2002) teaching recovery techniques (TRT) intervention among 482 Palestinians 10-13 years of age (n = 242 for intervention group, n = 240 for control group). Children reported PTSS, PTCs, and depressive symptoms at baseline, midpoint, postintervention, and at 6-month follow-up. Path analysis results showed that TRT was not effective in reducing dysfunctional PTCs, and the reductions did not mediate intervention effects on PTSS. Using latent class growth analysis, we chose the model with 3 differing trajectories in the intervention group: high, decreasing, moderate, downward trending, and severe, stable levels of PTCs. Higher PTSS and depressive symptoms at baseline were associated with membership in the severe, stable trajectory. The intervention did not produce the kind of beneficial cognitive change needed in the cognitive mediation conceptualization. Nevertheless, cognitive changes differed substantially across children during the intervention, and were associated with their preintervention mental health status. These findings call for more detailed examination of the process of cognitive mediation., (Copyright © 2016 International Society for Traumatic Stress Studies.)

Accessibility of psychotherapy for individuals with posttraumatic stress disorder (PTSD) and retention in treatment are major concerns for the Veterans Health Administration (VA). Group therapy is a common method for improving access to psychotherapy; however, PTSD patients may prefer individual therapy. This study assessed whether initial treatment with individual versus group psychotherapy relates to subsequent psychotherapy adequacy among VA patients with PTSD. The sample consisted of all VA patients who received a new PTSD diagnosis during a subspecialty PTSD clinical team visit in fiscal year 2010. Logistic and negative binomial regression analyses examined the relationship between modality of the first psychotherapy encounter and subsequent number of psychotherapy encounters within 14 weeks. Among 35,144 VA patients who initiated treatment for PTSD, 38% initiated group therapy and 62% initiated individual therapy. Patients who initiated with group therapy received a greater mean number of psychotherapy visits than those who initiated with individual therapy (4.7 vs. 2.8), and were about twice as likely (29.5% vs. 14.2%) to receive a minimally effective dose of 8 or more psychotherapy encounters. Group therapy predicted a greater number of psychotherapy visits (β = 0.46, SE = .01, p < .001) and greater likelihood of 8 or more sessions of psychotherapy (OR = 2.31, 95% CI [2.19, 2.45], p < .001), after adjusting for differences in demographic characteristics, comorbid conditions, and other service use. Greater treatment adequacy among group therapy participants suggests that these patients have greater access to frequent psychotherapy sessions or are more likely to persist with psychotherapy for PTSD than those treated individually. (PsycINFO Database Record, ((c) 2016 APA, all rights reserved).)

Objective: While empirically-supported treatment (EST) choices are continually expanding, choices regarding formats for delivery (individual only, group only, or conjoint [simultaneous individual & group]) are often determined by agency resources or clinician preference. Studies comparing individual and group formats have produced mixed results, while recent meta-analytic reviews support format equivalence., Method: We employed a multilevel model to test for outcome differences using the OQ-45 on an outpatient archival data set of clients receiving individual-only (n = 11,764), group-only (n = 152) or conjoint (n = 1557)., Results: Individual and group outcomes were equivalent with some analyses showing conjoint trailing. Moderators of change included initial distress, treatment duration, intra-group dependency, and format., Conclusions: Results support meta-analytic findings of format equivalence in a naturalistic setting for group and individual. Referral practices and future results are discussed.

Group-based interventions have been developed for treating patients across a range of health conditions. Enrollment into such groups often occurs on an open (or rolling) basis. Conditional autoregression modeling of random session effects has been proposed to account for the expected correlation in session effects associated with the overlap in patient participation session to session. However, when the analytic objective is to examine the relationship between a fixed-effect session feature and a patient outcome using conditional autoregression, confounding might arise if the fixed session feature of interest and the random session effects vary across sessions in similar ways, resulting in bias and inflated standard errors of a fixed-effect session feature of interest. Motivated by the goal of examining the relationships between outcomes and the session features of leader and session module theme, we applied restricted spatial regression to the analysis of patient outcomes collected from 132 participants in an open-enrollment group for treating depression among patients of a residential alcohol and other drug treatment program, adapting the approach to the multilevel data structure of open-enrollment group data. As compared with standard conditional autoregression, the restricted regression approach resulted in more precise estimates of regression coefficients of the module theme and leader predictor variables. The restricted regression approach provides an important analytic tool for group therapy researchers who are investigating the relationship between key components of open-enrollment group therapy interventions and patient outcomes., (Copyright © 2015 John Wiley & Sons, Ltd.)

Background: Psychotherapy not only has positive but also negative effects, which is especially true for group psychotherapy due to psychodynamic and interactional processes., Methods: Using the UE-G questionnaire 71 patients who participated in cognitive behavioral group psychotherapy reported on negative experiences in the context of the group therapy. The answers were then validated in a qualitative interview., Results: Of the patients 98.6% reported about at least one negative experience and 43.7% about severe or extremely severe negative experiences. Most prominent was the induction of hopelessness and demoralization by what patients saw and heard from other patients in the group., Conclusion: Burdensome and therefore undesired treatment effects are regularly seen in group psychotherapy, because of treatment or patient related factors. In any case they must be taken into account during treatment, in the training of group psychotherapists and in quality control.

A controlled trial to improve perceived health in a sample of long-term unemployed persons was conducted. As primary endpoint the SF12-questionnaire was used. The intervention was tailored to the specific needs of the long-term unemployed combining individual sessions based on motivational interviewing and group sessions designed with the participation of the participants. 365 participants were enrolled in the study. 287 or, respectively, 148 unemployed persons participated at the 3-months/12-months follow-up assessments. A positive effect of the intervention in the setting of long-term unemployed persons has been shown for perceived health, mental health and changes towards more physical activity and healthier nutrition., (© Georg Thieme Verlag KG Stuttgart · New York.)

Loneliness, anxiety and depression are common problems for older adults in long-term care. Reminiscence therapy is a non-pharmacological intervention that may be of some benefit. In comparison to individual reminiscence therapy, group reminiscence therapy is a preferred option when dealing with the resource constraints of long-term care. The aim of this paper was to systematically review the literature in order to explore the effectiveness of group reminiscence therapy for older adults with loneliness, anxiety and depression in long-term care. Results indicated that group reminiscence therapy is an effective treatment for depression in older adults, however to date, there is limited research support for its effectiveness to treat loneliness and anxiety. Further research and an improvement in methodological quality, such as using qualitative and mixed methods approaches, is recommended to help establish an evidence base and provide better understanding of the effectiveness of group reminiscence therapy., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Recent findings show the importance of acceptance in the treatment of chronic tinnitus. So far, very limited research investigating the different levels of tinnitus acceptance has been conducted. The aim of this study was to investigate the quality of life (QoL) and psychological distress in patients with chronic tinnitus who reported different levels of tinnitus acceptance. The sample consisted of outpatients taking part in a tinnitus coping group (n = 97). Correlations between tinnitus acceptance, psychological distress, and QoL were calculated. Receiver operating characteristic (ROC) curves were used to calculate a cutoff score for the German "Tinnitus Acceptance Questionnaire" (CTAQ-G) and to evaluate the screening abilities of the CTAQ-G. Independent sample t-tests were conducted to compare QoL and psychological distress in patients with low tinnitus acceptance and high tinnitus acceptance. A cutoff point for CTAQ-G of 62.5 was defined, differentiating between patients with "low-to-mild tinnitus acceptance" and "moderate-to-high tinnitus acceptance." Patients with higher levels of tinnitus acceptance reported a significantly higher QoL and lower psychological distress. Tinnitus acceptance plays an important role for patients with chronic tinnitus. Increased levels of acceptance are related to better QoL and less psychological distress.

Background: Studies investigating effectiveness of group psychotherapy intervention in sub-threshold depression have shown varying results with differing effect sizes., Aims: A systematic review of randomised controlled trials of group psychotherapy in adults with sub-threshold depression has been conducted to present the best available evidence in relation to its effect on depressive symptomatology and prevention of incident major depression., Methods: Electronic search for RCTs and a meta-analysis using random effects models to obtain a pooled estimate., Results: Eight studies from six clinical trials met the inclusion criteria. Group psychotherapy is an effective intervention for reducing depressive symptoms in adults with sub-threshold depression in comparison to waiting list controls (MD=-3.48, 95% CI: -5.02, -1.93). The reported benefits for group intervention in reducing depressive symptoms in comparison to other active interventions did not reach statistical significance (MD=0.37 95% CI: -1.29, 2.04). The benefit of group psychotherapy at follow-up is not maintained. Group psychotherapies do not appear to reduce the risk of incident depressive disorder during the follow up (RR=1.15 95% CI: 0.85, 1.54). Dutch studies had bigger effect sizes than studies from other countries. The quality of reporting of all the studies was suboptimal., Conclusions: The results of this meta-analysis show that group CBT interventions for patients with sub-threshold depression have a significant effect on depressive symptomatology at post treatment in both working age and older adult population. However it does not appear to reduce the incidence of major depressive disorders and has minimal or no effect on depressive symptomatology during follow-up., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Background: Inpatient treatment of chronic complex tinnitus can be necessary for patients with a high symptomatic strain, mostly accompanied by a corresponding mental comorbidity, and/or for patients that can only perceive their psychogenic suffering through somatization into tinnitus., Methods: We report the results of 368 consecutively treated inpatients with chronic complex tinnitus. Patients' audiometric data were collected, and at the beginning and end of treatment, the Mini-Tinnitus Questionnaire (Mini-TQ12; Hiller und Goebel) was completed, as was the German version of the Hospitality Anxiety and Depression Score (HADS). Effect sizes were calculated for both questionnaires. Mean treatment duration was 38.8 days (standard deviation, SD: 13.6 days). The main therapeutic elements were intensive disorder-specific neurotologic counselling and psychoeducation; improvement of hearing by fitting of hearing aids, complemented by an individualized hearing therapy; and intensive individual and group-based psychotherapy., Results: In addition to tinnitus, 82.1% of the patients had reduced hearing requiring rehabilitation with hearing aids. After hospitalization, a highly significant improvement in tinnitus strain could be demonstrated by the Mini-TQ12. Furthermore, a significant reduction in the depression and anxiety components of HADS was also achieved, with high effect sizes of 1.6 to 2.2. No reduction of tinnitus symptoms to a medium- or low-range level was experienced by 8.9% of patients., Conclusion: With corresponding symptomatic suffering, disorder-specific inpatient tinnitus treatment comprising neurotologic and psychosomatic alignment can achieve medium- to high-range therapeutic effects.

Objectives: To describe the amount and content of group therapies provided during inpatient rehabilitation for traumatic brain injury (TBI), and to assess the relations of group therapy with patient, injury, and treatment factors and outcomes., Design: Prospective observational cohort., Setting: Inpatient rehabilitation., Participants: Consecutive admissions (N=2130) for initial TBI rehabilitation at 10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from October 2008 to September 2011., Interventions: Not applicable., Main Outcome Measures: Proportion of sessions that were group therapy (≥2 patients were treated simultaneously by ≥1 clinician); proportion of patients receiving group therapy; type of activity performed and amount of time spent in group therapy, by discipline; rehabilitation length of stay; discharge location; and FIM cognitive and motor scores at discharge., Results: Of the patients, 79% received at least 1 session of group therapy, with group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy hours. On average, patients spent 2.9h/wk in group therapy. The greatest proportion of treatment time in group format was in therapeutic recreation (25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%), psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of treatment activities varied among admission FIM cognitive subgroups and treatment sites. Several factors appear to be predictive of receiving group therapy, with the treatment site being a major influence. However, group therapy as a whole offered little explanation of differences in the outcomes studied., Conclusions: Group therapy is commonly used in TBI rehabilitation, to varying degrees among disciplines, sites, and cognitive impairment subgroups. Various therapeutic activities take place in group therapy, indicating its perceived value in addressing many domains of functioning. Variation in outcomes is not explained well by overall percentage of therapy time delivered in groups., (Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Health anxiety (HA) is prevalent and costly for health services. However, little is known about the full societal burden of HA. Based on complete register data, we (1) compared weeks on sickness-related benefits (SB) in untreated patients with severe HA (n=126) with a matched population sample (n=12,600); and (2) tested whether Acceptance & Commitment group Therapy (ACT-G) (n=63) reduced weeks on SB during the first year after randomisation compared to a waitlist (n=63). We found that (1) HA patients showed a six-monthly increment of 2 weeks on SB compared with the general population (p<0.0001), and (2) that ACT-G and the waitlist showed no difference in their ability to reduce SB during the first year (p=0.246). We conclude that HA is associated with a considerable societal burden. A possible beneficial effect of psychotherapy on SB needs further investigation., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The aim was to investigate predictors of treatment dropout among 182 children (aged 8-15 years) participating in an effectiveness trial of manual-based 10-session individual and group cognitive behavior therapy (CBT) for anxiety disorders in community clinics. The dropout rate was 14.4%, with no significant difference between the two treatment conditions. We examined predictors for overall dropout (n=26), early (≤session 4, n=15), and late dropout (≥session 5, n=11). Overall dropout was predicted by low child and parent rated treatment credibility, and high parent self-rated internalizing symptoms. Low child rated treatment credibility predicted both early and late dropout. High parent self-rated internalizing symptoms predicted early dropout, whereas low parent rated treatment credibility predicted late dropout. These results highlight the importance of addressing treatment credibility, and to offer support for parents with internalizing symptoms, to help children and families remain in treatment., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This study examined the acceptance, use and -adherence with regard to stop-smoking medication in addition to a smoking cessation programme. In a multi-centre field study with quasi-experimental control group design, the participants of a smoking cessation programme were asked about their smoking behaviour at the beginning and at the end of the course. A sample of 1 319 participants was contacted via telephone one year after the end of the course. Among the 1 052 participants, who could be interviewed, 312 subjects (29.7%) reported to have used stop-smoking medication while 85.2% of the medication users preferred nicotine replacement therapy. The objective medication adherence was 13.2%. 79.3% of the medication users believed that they had used the medication adherently. There were no significant differences between participants who started use of medication and non-users (long-term abstinence rate: no medication 34.6% vs. medication 31.7%; p=0.34). The outcome of a modern smoking cessation group programme could not be improved by providing additional stop-smoking medication. This finding and the lack of medication adherence raise doubts about the effectiveness of offering stop-smoking medication in addition to an intensive cognitive-behavioural-based smoking cessation programme that focusses on behavioural changes., (© Georg Thieme Verlag KG Stuttgart · New York.)

BACKGROUND. Drop-out from psychotherapy is common and represents a considerable problem in clinical practice and research. Aim. To explore pre-treatment predictors of early and late drop-out from psychodynamic group therapy in a public outpatient unit for non-psychotic disorders in Denmark. Methods. Naturalistic design including 329 patients, the majority with mood, neurotic and personality disorders referred to 39-session group therapy. Predictors were socio-demographic and clinical variables, self-reported symptoms (Symptom Check List-90-Revised) and personality style (Millon Clinical Multiaxial Inventory-II). Drop-out was classified into early and late premature termination excluding patients who dropped out for external reasons. Results. Drop-out comprised 20.6% (68 patients) of the sample. Logistic regression revealed social functioning, vocational training, alcohol problems and antisocial behavior to be related to drop-out. However, early drop-outs had prominent agoraphobic symptoms, lower interpersonal sensitivity and compulsive personality features, and late drop-outs cognitive and somatic anxiety symptoms and antisocial personality features. Clinical and psychological variables accounted for the major part of variance in predictions of drop-out, which ranged from 15.6% to 19.5% (Nagelkerke Pseudo R-Square). Conclusion. Social functioning was consistently associated with drop-out, but personality characteristics and anxiety symptoms differentiated between early and late drop-out. Failure to discriminate between stages of premature termination may explain some of the inconsistencies in the drop-out literature. Clinical implications. Before selection of patients to time-limited psychodynamic groups, self-reported symptoms should be thoroughly considered. Patients with agoraphobic symptoms should be offered alternative treatment. Awareness of and motivation to work with interpersonal issues may be essential for compliance with group therapy.

Objective: This secondary analysis investigated the impact of 12 sessions of Seeking Safety (SS) on reducing posttraumatic stress disorder (PTSD) symptoms in a sample of dually diagnosed women with physical disabilities versus nondisabled (ND) women. SS is an evidence-based and widely implemented manualized therapy for PTSD and/or substance use disorder. It is a present-focused model that promotes coping skills and psychoeducation., Design: As part of the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN), 353 participants with current PTSD and substance use disorder (SUD) were randomly assigned to partial-dose SS or Women's Health Education (WHE) group therapy conducted in community-based substance abuse treatment programs. The women were categorized as participants with disabilities (PWD; n = 20) or ND (n = 333) based on the question, "Do you receive a pension for a physical disability?" PTSD was assessed on the Clinician-Administered PTSD Scale (CAPS) at baseline and follow-ups after treatment (1 week, 3 months, 6 months, and 12 months)., Results: PWD experienced sustained reductions in PTSD symptoms when treated with SS but not WHE. Indeed, PTSD symptoms of PWD in WHE returned to baseline levels of severity by 12-month follow-up. This pattern of results was not observed among ND women, who sustained improvements on PTSD in both treatment conditions., Implications: These results suggest strong potential for using SS to treat PTSD among women with physical disabilities, and speak to the genuine need to address trauma and PTSD more directly with PWD. Our results are also consistent with other findings from the NIDA CTN trial, in which virtually all significant results evidenced SS outperforming WHE.

Aim: To map the availability and types of depression and anxiety groups, to examine men's experiences and perception of this support as well as the role of health professionals in accessing support., Background: The best ways to support men with depression and anxiety in primary care are not well understood. Group-based interventions are sometimes offered but it is unknown whether this type of support is acceptable to men., Methods: Interviews with 17 men experiencing depression or anxiety. A further 12 interviews were conducted with staff who worked with depressed men (half of whom also experienced depression or anxiety themselves). There were detailed observations of four mental health groups and a mapping exercise of groups in a single English city (Bristol)., Findings: Some men attend groups for support with depression and anxiety. There was a strong theme of isolated men, some reluctant to discuss problems with their close family and friends but attending groups. Peer support, reduced stigma and opportunities for leadership were some of the identified benefits of groups. The different types of groups may relate to different potential member audiences. For example, unemployed men with greater mental health and support needs attended a professionally led group whereas men with milder mental health problems attended peer-led groups. Barriers to help seeking were commonly reported, many of which related to cultural norms about how men should behave. General practitioners played a key role in helping men to acknowledge their experiences of depression and anxiety, listening and providing information on the range of support options, including groups. Men with depression and anxiety do go to groups and appear to be well supported by them. Groups may potentially be low cost and offer additional advantages for some men. Health professionals could do more to identify and promote local groups.

This study examined research attrition in clinical service settings by comparing psychotherapy research completers and dropouts in a private therapy practice. Seventy-seven children 7-12 years old enrolled in the Resilience Builder Program(®) (RBP), a manualized group therapy created and administered in a private practice. Children had social impairments, and most were diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and/or anxiety disorders. Results found that compared to completers, research dropouts had significantly greater social deficits, disruptive behavior problems, affective problems, medication use, and were more likely to be ethnic minorities. We discuss implications for research recruitment and retention in clinical service settings.

Group therapy is used extensively within public mental health services, but more detailed knowledge is needed. All 25 health authorities in Norway were invited to describe their groups: theory, primary tasks, interventions, structure, patients and therapists. Four hundred twenty-six groups, 296 in community mental health centres and 130 in hospitals, were categorized into nine types, based on theoretical background. Psychodynamic groups were most frequent, followed by cognitive-behavioural, psycho-educative, social skills/coping and art/expressive groups. Weekly sessions of 90 min and treatment duration <6 or >12 months was most frequent. Main diagnosis for 2391 patients: depression (517), personality disorder (396), schizophrenia/psychosis (313) and social phobia (249). Patients with depression or personality disorder were mostly in psychodynamic groups, psychosis/bipolar disorder in psycho-educative groups. Cognitive-behavioural groups were used across several diagnoses. Most therapists were nurses, only 50% had a formal training in group therapy. There is a plethora of groups, some based on one theoretical school, while others integrate theory from several 'camps'. Patients with similar diagnosis were offered different group approaches, although some trends existed. More research evidence from regular clinical groups is needed, and clinician-researcher networks should be developed. More group therapists with formal training are needed., (© 2013 John Wiley & Sons Ltd.)

Background: Patients with depression are treated for a relatively long period as inpatients in Germany. A new treatment model with symptom-orientated release management, post-hospitalization treatment and standardized referral to outpatient therapists could be suitable to specifically shorten the hospital stay of patients who have already profited sufficiently from treatment., Materials and Methods: The aim of the present study was to investigate the effects of a new treatment method (intervention group) with hospitalized depressive patients in comparison to a standard protocol (treatment-as-usual control group) on the length of stay as part of a pragmatic randomized, controlled multicentre study. The evaluation was made using covariance analysis., Results: Of the 202 randomized patients 184 could be included in the analysis. The estimated marginal mean of the length of stay (n = 83) was 57.3 days (range 1-305 days, SE = 3.8) in the intervention group and (n = 101) 57.6 days (range: 6-196 days, SE = 3.5) in the control group. There were no significant statistical differences between the groups (p = 0.966)., Conclusions: An effect of the new treatment model on the inpatient length of hospital stay in depressive patients could not be demonstrated.

Objective: High quality demands are being placed on concepts of educational group programmes in medical rehabilitation as well as the related trainer qualifications. A nationwide survey of German medical rehabilitation clinics in 2005 had revealed a need for improving educational practice according to these quality criteria. An updated investigation was performed in 2010 aiming at describing group programmes used in medical rehabilitation., Method: 1 473 inpatient and outpatient medical rehabilitation clinics were invited to participate. 908 clinics reported on their training programmes. Data from clinics caring for patients with somatic disorders could be compared to the 2005 survey. Data from clinics for both psychosomatic and substance abuse disorders was collected for the first time in 2010., Results: Overall, psychologists and physicians were reported to be the most frequent conductors of educative programmes. In somatic clinics, psychologists, dieticians and occupational therapists or physiotherapists were the most common conductors. Two-thirds of the institutions reported no training prerequisites for staff members to perform patient education. 80% of the education programmes were categorized post hoc into 3 classes: "generic health education", "disorder-specific patient education", and "psychoeducational group programmes". Almost two-thirds of all programmes were carried out with 8-15 participants, and many used several interactive didactic methods. Programmes conducted in small groups (<8 participants) used significantly more interactive methods than those conducted in larger groups did (>15 participants). Only half of the programmes were manualized. Significantly more interactive methods were used in completely manualized programmes. Only about half of the programmes were evaluated, and only very few evaluation studies were published. The institutions wished additional support by workshops especially concerning qualification of their staff and concerning educational concepts., Conclusions: A need for further improvement and support exists relative to the training of educators and the development of manuals as well as evaluation and publication of the programmes., (© Georg Thieme Verlag KG Stuttgart · New York.)

Intimate partner violence (IPV) is a widespread global health problem. Despite growing evidence indicating that men and women commit IPV, most traditional interventions focus on male-to-female violence and do not address mutual violence. This circumscribed focus represents one potential reason traditional treatments have had only a modest effect on recidivism. The current study investigated a pilot intervention for mutually violent couples with ethnically diverse, treatment-mandated men and women. Using a longitudinal design, 121 couples were assessed (semistructured clinical interview, Conflict Tactics Scale-Revised [CTS-2]) and mandated to either the pilot intervention or another community agency. Of the 92 couples referred for the 12-week, pilot group intervention (plus 1-2 preparatory, individual sessions), 89% of couples had one or both partners complete. Posttreatment assessments were conducted (CTS-2, satisfaction ratings), anticipating reductions in perpetrated and received IPV among treatment completers. Using 1-year conviction data to assess recidivism (IPV and general violence convictions), it was hypothesized that the lowest recidivism rates would be found when both partners completed, intermediate rates when one partner completed, and the highest rates when neither completed. Consistent with hypotheses, men who completed treatment reported reduced perpetration of physical assault and received less injury, and women who completed reported receiving less physical assault and injury. At 1-year follow-up, couples who completed had lower recidivism rates, with couples in which both partners completed evidencing the best outcomes. Results provide preliminary support for the proposed mutual violence intervention. Clinical implications, including the effect of a thorough assessment and tailored treatment recommendations, are discussed., (© 2013 American Psychological Association)

This article examines the findings of an ecological analysis of the factors influencing men's engagement in intimate partner violence (IPV) groups. Individual interviews and two focus groups were conducted with men who participated in group programs in two agencies in Canada. Our qualitative analysis of interviews and focus groups suggested that both individual and program-related factors were determinants in the men's engagement. These findings drew our attention to the influence of certain factors outside of the group therapy, in particular organizational practices. Implications for practice are explored, in particular the role of time in the intervention, and implications for research and limitations are discussed.

Little is known about the impact of hurricanes on people who are homeless at the time a disaster occurs. Although researchers have extensively studied the psychosocial consequences of disaster produced homelessness on the general population, efforts focused on understanding how homeless people fare have been limited to a few media reports and the gray literature. In the event of a hurricane, homeless veterans may be at increased risk for negative outcomes because of their cumulative vulnerabilities. Health care statistics consistently document that homeless veterans experience higher rates of medical, emotional, substance abuse, legal, and financial problems compared with the general population. This study used the 2004 to 2006 Veterans Health Administration (VHA) Outpatient Medical Dataset to examine the effects of hurricanes on use of outpatient mental health services by homeless veterans. Homeless veterans residing in hurricane-affected counties were significantly more likely to participate in group psychotherapy (32.4% vs. 13.4%, p < .002), but less likely to participate in individual 30-40-min sessions with medical evaluations (3.5% vs. 17.3%, p < .001). The study findings have implications for homeless programs and the provision of VHA mental health services to homeless veterans postdisaster., (PsycINFO Database Record (c) 2013 APA, all rights reserved.)

Compulsive buying (CB) is defined as extreme preoccupation with buying/shopping and frequent buying that causes substantial negative psychological, social, occupational and financial consequences. There exists preliminary evidence that group cognitive-behavioural therapy (CBT) is effective in the treatment of CB. The present pilot study made a first attempt to compare group CBT for CB with telephone-guided self-help (GSH). Fifty-six patients were allocated randomly to one of the three conditions: (1) group CBT (n = 22); (2) GSH (n = 20); and (3) a waiting list condition (n = 14). The results indicate that face-to-face group CBT is superior not only to the waiting list condition but also to GSH. Patients who received GSH tended to have more success in overcoming CB compared with the waiting list controls. Given the sample size, the results must be considered as preliminary and further research is needed to address the topic whether GSH also could be a helpful intervention in reducing CB., (Copyright © 2011 John Wiley & Sons, Ltd.)

Objectives: The purpose of this study was to understand the degree to which mental health services targeting anxiety and depression disorders are offered by adult day services (ADS) centers in the US. In addition, researchers wanted to determine whether staffing and organizational characteristics are associated with the provision of medication management, individual counseling, and group counseling for participants with anxiety or depression., Method: Data were drawn from the MetLife National Study of ADS. Hierarchical logistic regression analyses were conducted to determine which staffing and organizational factors were associated with the provision of services to treat anxiety and depression., Results: Approximately, three in four adult day programs provided medication management for the treatment of anxiety and depression while 38% provided individual counseling and almost 30% group counseling. Programs offering medication management were more likely to have more registered nurse (RN) service hours available per shift and higher costs. Programs that provided individual and group counseling for participants with anxiety or depression were more likely to have more hours of RN and social work services available and a lower percentage of participants who pay privately for services., Conclusion: The results suggest that ADS are well positioned to act as a platform for delivering mental health care to older persons with anxiety or depression.