The effect of cognitive behavioral group therapy for depression: a meta-analysis 2000-2010.

OBJECTIVE: The goals of the meta-analysis were to investigate the overall effectiveness of cognitive behavioral group therapy (CBGT) for depression and relapse prevention in depression from 2000 to 2010, and to investigate how the variables (episode, residual symptoms, group size, control group, group manual, therapist experience, therapy frequency, session length, and take-home assignment) of a CBGT study could affect the effect size. METHOD: This study collected actual study designs sought of CBGT for depression published from 2000 to 2010. These studies were then cross-referenced using Medical Subject Headings (MeSH) with the following keywords: group therapy, cognitive therapy, cognitive behavioral therapy, cognitive behavioral group therapy, psychotherapy, depression, relapse, and recurrence. The quality of the studies was evaluated using Cochrane Collaboration Guidelines. The effect size of CBGT on depression and relapse prevention in depression used the formula devised by Hedges and Olkin (1985). RESULTS: The study investigated the results of 32 studies on the effect of CBGT for depression. The CBGT had an immediate (g=-0.40) and continuous effect over 6 months (g=-0.38), but no continuous effect after 6 months (g=-0.06). The CBGT lowered the relapse rate of depression (RD = 0.16). Variables significantly different from each other in terms of immediate effect were: CBGT versus usual care, therapy sessions lasting longer than 1 hour, and take-home assignments. Preintervention severity of depression and patient turnover rate were found to be significantly related to the size of the immediate effect. The relapse rate after 6 months was significantly related only to "participants have no residual symptoms/participants did not mention residual symptoms." CONCLUSIONS: Researchers and clinicians should take note that CBGT had a moderate effect on the level of depression and a small effect on the relapse rate of depression. The results of this study suggest that the patient should receive a course of therapy at least every 6 months.

A moral life after a suicide death in Taiwan.

In this article we present the findings of a qualitative study exploring what suicide survivors in Taiwan experienced after a family member's suicide and how they adjusted to the perceived stigma. Fifteen suicide survivors participated in this study. We found that when a family member's suicide death occurred, survivors first kept a low profile when holding the funeral, and then tried to expel the dead person from their family. They also wished that their grief and painful, shameful feelings could be buried with the dead person. These findings suggest that health care professionals need to work more closely with suicide survivors through understanding the survivors' fear and pain from a sociocultural perspective, and to help them construct a new moral life.

Evaluation of assertiveness training for psychiatric patients.

AIM AND OBJECTIVES: To investigate the effectiveness of assertiveness training programmes on psychiatric patients' assertiveness, self-esteem and social anxiety. BACKGROUND: Assertiveness training programmes are designed to improve an individual's assertive beliefs and behaviours, which can help the individual change how they view themselves and establish self-confidence and social anxiety. It is useful for patients with depression, depressive phase of bipolar disorder, anxiety disorder or adjustment disorder. DESIGN: Experimental. METHOD: There were 68 subjects (28, experimental group; 40, diagnosis-matched comparison group). Subjects in experimental groups participated in experimenter-designed assertiveness training twice a week (two hours each) for four weeks. The comparison groups participated the usual activities. Data were collected in the two groups at the same time: before, after and one month after training programme. Efficacy was measured by assertiveness, self-esteem and social anxiety inventories. A generalised estimating equation was used for analysis. RESULTS: After training, subjects had a significant increase in assertiveness immediately after the assertiveness training programme and one-month follow-up. There was a significant decrease in social anxiety after training, but the improvement was not significant after one month. Self-esteem did not increase significantly after training. CONCLUSION: With our sample of patients with mixed diagnoses, assertiveness seemed to be improved after assertiveness training. RELEVANCE TO CLINICAL PRACTICE: Patients would benefit more from the assertiveness training programme for the change in how they view themselves, improve their assertiveness, properly express their individual moods and thoughts and further establish self-confidence. The assertiveness training protocol could be provided as a reference guide to clinical nurses.

[Applying cognitive-behavioral therapy to a patient with schizophrenia].

The purpose of this article was to describe a nursing experience with a patient who suffered from delusions and hallucinations due to schizophrenia. Through conversation and observation, the authors gathered both subjective and objective data and identified two major nursing problems, as follows: altered thought processes and sensor/ perceptual alteration (auditory). During the nursing process, the authors established a rapport with the patient and provided cognitive-behavioral therapy to help him to reduce his irrational beliefs and improve his coping methods. The behavioral therapy enabled the patient to face his negative beliefs, and he developed cognitive-behavioral skills to improve his self-management of delusions and hallucinations. From this perspective, cognitive-behavioral therapy was an effective intervention in the nursing process of caring for this patient with positive symptoms.

The evaluation of cognitive-behavioral group therapy on patient depression and self-esteem.

We evaluated the impact of cognitive-behavioral group therapy on the depression and self-esteem of clinically depressed patients. This longitudinal study involved 26 experimental group patients who received 12 weeks of cognitive-behavioral group therapy and 25 comparison subjects. Two weeks before the study, immediately upon therapy completion, and 1 month later, all the participants underwent pretest, posttest, and follow-up, respectively. The experimental group patients experienced greater cognitive improvements (i.e., depression relief, self-esteem increase) as compared with the comparison group subjects. One month after therapy completion, the depressive symptoms and self-esteem of the experimental group patients remained slightly but significantly better than those of the comparison group subjects.