In adults with anxiety, which group intervention is most effective in improving patient outcomes?
Plain language summary
Research suggests that group cognitive behavioural therapy and
group psychotherapy can be helpful in reducing symptoms of anxiety.
However, in order to determine the most effective group
intervention, more trials comparing different group therapies are
Clinical and research implications
Evidence from three high-quality systematic reviews (70 studies,
3585 participants) showed that group CBT significantly improved
social anxiety symptoms, and group psychotherapy significantly
improved social anxiety, general anxiety and depression compared to
a waiting list control in adults with social anxiety. Group CBT
also significantly reduced anxiety compared to a waiting list or
treatment as usual in adults with generalised anxiety disorder
however, no statistically significant differences were found
between group and individual CBT.
These conclusions are likely to be reliable. However, as there
were no studies comparing group CBT to a different form of group
therapy (comparators were waiting list control, treatment as usual
or individual therapy) the question about group versus group
therapy cannot be answered.
Further research is needed into non-CBT models such as cognitive
analytic or interpersonal therapy, and comparing CBT and non-CBT
models in generalised anxiety disorder. Large trials comparing
different active interventions in social anxiety disorder, with
controlled long-term follow-up, clear reporting of the therapy
components and measurement of economic outcomes are also
These results are consistent with the NICE guidelines, in fact
Mayo-Wilson et al. (2014) stated that the "NICE recommendations are
consistent with the results of the study which suggests that
increased access to treatment would reduce disability and improve
quality of life for people with social anxiety disorder". NICE
recommends offering individual CBT to people with social anxiety
disorder, but not group CBT as it is less clinically and
cost-effective. This is supported by the Mayo-Wilson results as
they compared a range of treatments, not just group CBT, and
concluded that individual CBT was the most effective.
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