Academic journal article Journal of Cognitive Psychotherapy

CBT Basics: A Group Approach to Teaching Fundamental Cognitive-Behavioral Skills

Academic journal article Journal of Cognitive Psychotherapy

CBT Basics: A Group Approach to Teaching Fundamental Cognitive-Behavioral Skills

Article excerpt

CBT Basics I is a psychoeducational group program originally developed as a pre-individual therapy introduction to cognitive-behavioral therapy (CBT) skills for clients presenting with depression and/or anxiety disorders. We describe the development and content of this sixsession introductory CBT group and provide data from a 3-year pilot program. The results support the potential for symptom improvement and CBT skill acquisition, and provide preliminary evidence for the group's potential to enhance accessibility to CBT. Future directions for the development of this group are discussed, including expanding to a 10-session group model incorporating mindfulness meditation.

Keywords: CBT; group; psychoeducation; depression; anxiety

Recent clinical practice guidelines (CPGs) for depression (National Institute for Clinical Excellence [NICE], 2007a; Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Depression, 2004) and anxiety (NICE, 2007b; Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Panic Disorder and Agoraphobia, 2003; Swinson et al., 2006) recommend cognitive behavioral therapy (CBT) as an equivalent, and in some cases (e.g., specific phobia, panic disorder), more effective treatment than medication. These guidelines recognize several years of randomized controlled trials consistently demonstrating the cost-effectiveness (e.g., Antonuccio, Thomas, & Danton, 1997) and efficacy (Chambless & Hollon, 1998; Chambless & Ollendick, 2001; Otto, Pollack, & Maki, 2000; Otto, Smits, & Reese, 2005; Vos, Corry, Haby, Carter, & Andrews, 2005) of CBT for depression and anxiety. Recent advances in CBT, such as the incorporation of mindfulness meditation techniques (Segal, Williams, & Teasdale, 2002), also demonstrate reduced relapse rates (Ree & Craigie, 2007).

A major limitation to CBT acknowledged in CPGs is accessibility (NICE, 2007a, 2007b). CBT is typically taught in specialized psychology graduate training programs, and it is difficult for other mental health care professionals to obtain adequate training (Hamilton & Dobson, 2001; Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for Panic Disorder and Agoraphobia, 2003). Recent initiatives have targeted the accessibility issue through the creative provision of CBT (e.g., computerized CBT; see Wright et al., 2002).

The current article describes a psychoeducational group program, CBT Basics I (Hamilton & Macrodimitris, 2005; Macrodimitris & Hamilton, 2005) developed for individuals with depression and/or anxiety and implemented to enhance accessibility to CBT. This article describes the rationale for developing this non-syndrome-specific psychoeducational CBT group program. In addition, we review preliminary outcome data over 3 years of piloting this group program. Finally, we describe other current and future initiatives, including the expansion to a 10-session group format that incorporates mindfulness meditation techniques, and potential future applications of the program beyond standard mental health clinics.

Rationale for Developing CBT Basics I

The group program described in this article was developed in order to address an increasingly long wait list for a CBT program. The CBT therapists in this program discussed the possibility of developing a psychoeducational group that (a) could provide more rapid access to service and (b) could enhance individual treatment by ensuring participants had the fundamental skills of CBT prior to entering more intensive individual treatment. Given that the primary presenting problems treated through the CBT program are depression and anxiety disorders, it was proposed that we develop a psychoeducational "pre-individual therapy" group program that would address the core components of therapy that are similar across these two diagnostic groups. …

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