Efficacy of group psychotherapy for anxiety disorders: A systematic review and meta-analysis.

Objective: This meta-analysis evaluates the efficacy of group psychotherapy in the treatment of anxiety disorders. Method: A comprehensive literature search using PubMed, PsychInfo, Web of Science, CENTRAL, and manual searches was conducted to locate randomized controlled trials. We found 57 eligible studies (k = 76 comparisons) including 3656 participants receiving group psychotherapy or an alternative treatment for generalized anxiety disorder, social anxiety disorder, and panic disorder. Results: Effect size estimates show that group psychotherapy reduces specific symptoms of anxiety disorders more effectively than no-treatment control groups (g = 0.92, [0.81; 1.03], k = 43) and treatments providing common unspecific treatment factors (g = 0.29 [0.10; 0.48], k = 12). No significant differences were found compared to individual psychotherapy (g = 0.24 [-0.09; 0.57], k = 7) or pharmacotherapy (g = -0.05 [-0.33; 0.23], k = 6). The effects were unrelated to factors of the group treatment. Within head-to-head studies, a significant moderating effect emerged for researcher allegiance. Conclusions: Our results support the efficacy of group psychotherapy for anxiety disorders. They indicate that mixed-diagnoses groups are equally effective as diagnosis-specific groups, although further evidence is required. Future primary studies should address differential effectiveness, include a wider range of therapeutic approaches as well as active comparison groups.

Group psychotherapy for borderline personality disorder: A meta-analysis of randomized-controlled trials.

Treatment guidelines for borderline personality disorder (BPD) recommend psychotherapy as an important, if not essential, component of patient care. The current study is a meta-analysis of randomized controlled trials comparing group psychotherapy for BPD with treatment as usual (TAU). We included moderator analysis to examine how outcomes differ based on group and patient characteristics, risk of bias variables, and treatment elements of the TAU comparison condition (e.g., whether psychotherapy was included). Twenty-four studies with 1,595 participants met eligibility criteria for interpretative analysis. Group psychotherapy had a large effect on reduction of BPD symptoms (g = 0.72, 95% confidence interval [0.41, 1.04], p < .001) and a moderate effect on suicidality/parasuicidality symptoms (g = 0.46, 95% confidence interval [0.22, 0.71], p < .001). Heterogeneity was high for both outcomes (I2 = 76% and 70%, respectively), and the moderator analyses found an association between treatment structure and BPD symptoms and between theoretical orientation and suicidality/parasuicidality symptoms. There was also an association between group size and both BPD symptoms and suicidality/parasuicidality symptoms. There was a small to medium effect in favor of group treatments for secondary outcomes (i.e., anxiety, depression, and mental health). We concluded group treatments were associated with greater symptom reduction when compared with TAU and though some moderating variables were identified, additional heterogeneity needs to be explained. The discussion includes recommendations both for group psychotherapy practitioners and researchers. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Efficacy of group psychotherapy for social anxiety disorder: A meta-analysis of randomized-controlled trials.

Group psychotherapy for social anxiety disorder (SAD) is an established treatment supported by findings from primary studies and earlier meta-analyses. However, a comprehensive summary of the recent evidence is still pending. This meta-analysis investigates the efficacy of group psychotherapy for adult patients with SAD. A literature search identified 36 randomized-controlled trials examining 2171 patients. Available studies used mainly cognitive-behavioral group therapies (CBGT); therefore, quantitative analyses were done for CBGT. Medium to large positive effects emerged for wait list-controlled trials for specific symptomatology: g=0.84, 95% CI [0.72; 0.97] and general psychopathology: g=0.62, 95% CI [0.36; 0.89]. Group psychotherapy was also superior to common factor control conditions in alleviating symptoms of SAD, but not in improving general psychopathology. No differences appeared for direct comparisons of group psychotherapy and individual psychotherapy or pharmacotherapy. Hence, group psychotherapy for SAD is an efficacious treatment, equivalent to other treatment formats.

Outcome differences between individual and group formats when identical and nonidentical treatments, patients, and doses are compared: A 25-year meta-analytic perspective.

There are mixed findings regarding the differential efficacy of the group and individual format. One explanation of these mixed findings is that nearly all-recent meta-analyses use between-study effect sizes to test format equivalence introducing uncontrolled differences in patients, treatments, and outcome measures. Only 3 meta-analyses were located from the past 20 years that directly tested format differences in the same study using within-study effect sizes; mixed findings were reported with a primary limitation being the small number of studies. However, we located 67 studies that compared both formats in the same study. Format equivalence (g = -0.01) with low effect size heterogeneity (variability) was found in 46 studies that compared identical treatments, patients, and doses on primary outcome measures. Format equivalence (g = -0.06) with moderate effect size heterogeneity was found for 21 studies that compared nonidentical treatments; however, allegiance to a specific format moderated differences in effect sizes. There were no differences between formats for rates of treatment acceptance, dropout, remission, and improvement. Additionally, there were no differences in outcome between formats by patient diagnosis; however, differences in pre-to-post improvement were explained by diagnosis with depression, anxiety, and substance disorder posting the highest outcomes and medical and childhood disorders the lowest. Findings are discussed with reference to the practical challenges of implementing groups in clinical practice from an agency, clinician, and reimbursement perspective. (PsycINFO Database Record