The purpose of this week’s discussion is to explain how the use of CBT in groups compares to the use of CBT in family or individual settings. Some challenges that may be experienced will also be discussed.
Cognitive behavioral therapy (CBT) is useful in psychotherapy for a wide range of mental disorders. In fact, CBT is one of the most widely researched psychotherapeutic models (Wheeler, 2020). Studies have shown that CBT is useful in many different settings and populations. These setting include individual, family, and group settings. CBT is focused on helping patients recognize high stress/negative situations, thoughts, and feelings and subsequently avoid these.
Usually within a group setting, patients have similar issues. This can sometimes make it easier to provide therapy to similar populations/issues. One of the main focuses of CBT is to change irrational/negative thinking into more rational ways thinking. One goal is to recognize this thinking pattern in order to change it before it escalates. In the group setting, a therapist works with patients individually in a way, to come together as a whole. Group members support each other when they are going through similar issues/situations, and can offer different perspectives.
CBT within a family can help explore and improve roles and behaviors within a family to foster better communication and a better family environment. CBT within a family setting is more focused on the interactions within a family unit versus individuals in a group setting. CBT within a family allows exploration of the roles within a family and how thoughts and feelings affect everyone in the family unit (Nichols,2020). CBT in this setting helps families to adapt to more positive thinking and enhancing communication within the family to foster a better family environment. CBT has the strongest empirical basis in the treatment of anxiety and related disorders and can be used to enhance outcomes in family therapy (Reuman et al., 2021).
CBT within individual psychotherapy can differ from CBT in group therapy. It can be a more intense setting since it is one one-on-one between the patient and the therapist. It is a collaboration between the patient and the therapist. In this setting there isn’t much of a “filler”. According to studies, individual and group psychotherapy are equally effective, but depending on the person and the situation, individual therapy might be a better fit. A Norwegian study showed that in a group receiving CBT versus a group that received usual care, there was a significant effect in favor of the group receiving CBT in regard to decreasing negative thoughts (Keles & Idsoe, 2021).
There are many challenges that can arise when using CBT, especially in a group setting. Some of the challenges are group cohesion, boundaries, and willingness to participate. Studies have shown the use of CBT with a well cohesive group is better for clinical outcomes (Bryde et al., 2021). From my clinical experience, it is very common for adolescents to step outside of set boundaries in the group. Following these boundaries in a professional manner with the patient that is appropriate can set the tone for the group. Willingness of patients to participate can depend on how the patient perceives the group dynamic. The patient could be afraid that they may be judged and this could affect their willingness to share/participate.
Bryde Christensen, A., Wahrén, S., Reinholt, N., Poulsen, S., Hvenegaard, M., Simonsen, E., & Arnfred, S. (2021). “Despite the Differences, We Were All the Same”. Group Cohesion in Diagnosis-Specific and Transdiagnostic CBT Groups for Anxiety and Depression: A Qualitative Study. International Journal of Environmental Research and Public Health, 18(10). https://doi.org/10.3390/ijerph18105324
Keles, S., & Idsoe, T. (2021). Six- and Twelve-Month Follow-up Results of a Cluster Randomized Controlled Trial of a CBT-Based Group Course. Prevention Science, 22(4), 409–418. https://doi.org/10.1007/s11121-020-01160-0
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