Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial

Background: Individual metacognitive therapy (MCT) for generalized anxiety disorder (GAD) is well established, but only one study has investigated the effectiveness of Group MCT (g-MCT) for GAD. The aim of the current study was therefore to evaluate the feasibility and effectiveness of g-MCT for GAD...

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Main Authors: Svein Haseth, Stian Solem, Grethe Baardsen Sørø, Eirin Bjørnstad, Torun Grøtte, Peter Fisher
Format: Article
Language:English
Published: Frontiers Media S.A. 2019-02-01
Series:Frontiers in Psychology
Subjects:
Online Access:https://www.frontiersin.org/article/10.3389/fpsyg.2019.00290/full
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author Svein Haseth
Stian Solem
Stian Solem
Grethe Baardsen Sørø
Eirin Bjørnstad
Torun Grøtte
Torun Grøtte
Peter Fisher
Peter Fisher
author_facet Svein Haseth
Stian Solem
Stian Solem
Grethe Baardsen Sørø
Eirin Bjørnstad
Torun Grøtte
Torun Grøtte
Peter Fisher
Peter Fisher
author_sort Svein Haseth
collection DOAJ
description Background: Individual metacognitive therapy (MCT) for generalized anxiety disorder (GAD) is well established, but only one study has investigated the effectiveness of Group MCT (g-MCT) for GAD. The aim of the current study was therefore to evaluate the feasibility and effectiveness of g-MCT for GAD within a community mental health setting whilst addressing limitations evident in the previous study.Methods: The study used an open trial design, and 23 consecutively referred adults with GAD completed 10 sessions (90 min) of g-MCT, delivered by two therapists trained in MCT. Diagnoses were assessed by trained raters using the Anxiety Disorder Interview Schedule-IV. All patients but one had previous psychosocial treatment, and 17 (73.9%) had at least one comorbid axis-I disorder. Self-reported symptoms were assessed using the Penn State Worry Questionnaire, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 at pre- and post-treatment as well as 3-month follow-up. Feasibility was assessed using rates of patients who declined group treatment in favor of individual treatment, patients not able to attend due to pre-scheduled dates for sessions, and drop-out rate.Results: Of 32 eligible participants, six patients (19%) declined g-MCT in favor of individual MCT, and three (9%) were unable to attend due to scheduling conflicts. No patients dropped out during treatment, but two patients did not complete the self-report questionnaires at 3-month follow-up. g-MCT was associated with significant reductions in worry, anxiety, depression, metacognitive beliefs, and maladaptive coping. According to the standardized Jacobson criteria for recovery, 65.3% were recovered at post-treatment, whereas 30.4% were improved and 4.3% showed no change. At 3-month follow-up, the recovery rate increased to 78.3%. Moreover, recovery rates were comparable for patients with- and without comorbidity. Number of therapist hours per patient was 6.5 and the treatment has now been implemented as a standard treatment option at the clinic.Conclusion: g-MCT for GAD is an acceptable treatment which may offer a cost-effective alternative approach to individual MCT. Recovery rates and effect sizes suggested that g-MCT could be just as efficient as individual MCT and cognitive behavioral therapy.
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spelling doaj.art-dbef39e44d3d409597c3553c5c8bcc172022-12-22T00:04:58ZengFrontiers Media S.A.Frontiers in Psychology1664-10782019-02-011010.3389/fpsyg.2019.00290418665Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility TrialSvein Haseth0Stian Solem1Stian Solem2Grethe Baardsen Sørø3Eirin Bjørnstad4Torun Grøtte5Torun Grøtte6Peter Fisher7Peter Fisher8Nidaros DPS, St. Olavs Hospital, Trondheim, NorwayDepartment of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayDepartment of Research and Development, St. Olavs Hospital, Trondheim, NorwayNidaros DPS, St. Olavs Hospital, Trondheim, NorwayDepartment of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayNidaros DPS, St. Olavs Hospital, Trondheim, NorwayDepartment of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayNidaros DPS, St. Olavs Hospital, Trondheim, NorwayInstitute of Psychology, Health and Society, University of Liverpool, Liverpool, United KingdomBackground: Individual metacognitive therapy (MCT) for generalized anxiety disorder (GAD) is well established, but only one study has investigated the effectiveness of Group MCT (g-MCT) for GAD. The aim of the current study was therefore to evaluate the feasibility and effectiveness of g-MCT for GAD within a community mental health setting whilst addressing limitations evident in the previous study.Methods: The study used an open trial design, and 23 consecutively referred adults with GAD completed 10 sessions (90 min) of g-MCT, delivered by two therapists trained in MCT. Diagnoses were assessed by trained raters using the Anxiety Disorder Interview Schedule-IV. All patients but one had previous psychosocial treatment, and 17 (73.9%) had at least one comorbid axis-I disorder. Self-reported symptoms were assessed using the Penn State Worry Questionnaire, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 at pre- and post-treatment as well as 3-month follow-up. Feasibility was assessed using rates of patients who declined group treatment in favor of individual treatment, patients not able to attend due to pre-scheduled dates for sessions, and drop-out rate.Results: Of 32 eligible participants, six patients (19%) declined g-MCT in favor of individual MCT, and three (9%) were unable to attend due to scheduling conflicts. No patients dropped out during treatment, but two patients did not complete the self-report questionnaires at 3-month follow-up. g-MCT was associated with significant reductions in worry, anxiety, depression, metacognitive beliefs, and maladaptive coping. According to the standardized Jacobson criteria for recovery, 65.3% were recovered at post-treatment, whereas 30.4% were improved and 4.3% showed no change. At 3-month follow-up, the recovery rate increased to 78.3%. Moreover, recovery rates were comparable for patients with- and without comorbidity. Number of therapist hours per patient was 6.5 and the treatment has now been implemented as a standard treatment option at the clinic.Conclusion: g-MCT for GAD is an acceptable treatment which may offer a cost-effective alternative approach to individual MCT. Recovery rates and effect sizes suggested that g-MCT could be just as efficient as individual MCT and cognitive behavioral therapy.https://www.frontiersin.org/article/10.3389/fpsyg.2019.00290/fullmetacognitive therapygeneralized anxiety disorderGADoutcomemetacognitiongroup therapy
spellingShingle Svein Haseth
Stian Solem
Stian Solem
Grethe Baardsen Sørø
Eirin Bjørnstad
Torun Grøtte
Torun Grøtte
Peter Fisher
Peter Fisher
Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial
Frontiers in Psychology
metacognitive therapy
generalized anxiety disorder
GAD
outcome
metacognition
group therapy
title Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial
title_full Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial
title_fullStr Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial
title_full_unstemmed Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial
title_short Group Metacognitive Therapy for Generalized Anxiety Disorder: A Pilot Feasibility Trial
title_sort group metacognitive therapy for generalized anxiety disorder a pilot feasibility trial
topic metacognitive therapy
generalized anxiety disorder
GAD
outcome
metacognition
group therapy
url https://www.frontiersin.org/article/10.3389/fpsyg.2019.00290/full
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