RESUMEN
BACKGROUND: Group psychotherapy for older adults with generalised anxiety disorder is an under-researched area. AIM: This report describes a mixed method evaluation of the acceptability and feasibility of an Overcoming Worry Group. METHOD: The Overcoming Worry Group was a novel adaptation of a cognitive behavioural therapy protocol targeting intolerance-of-uncertainty for generalised anxiety disorder, tailored for delivery to older adults in a group setting (n = 13). RESULTS: The adapted protocol was found to be acceptable and feasible, and treatment outcomes observed were encouraging. CONCLUSIONS: This proof-of-concept study provides evidence for an Overcoming Worry Group as an acceptable and feasible group treatment for older adults with generalised anxiety disorder.
Asunto(s)
Terapia Cognitivo-Conductual , Psicoterapia de Grupo , Anciano , Ansiedad , Trastornos de Ansiedad/terapia , Estudios de Factibilidad , HumanosRESUMEN
BACKGROUND: This was a multi-service evaluation of the clinical and organisational effectiveness of large group psychoeducational CBT delivered within a stepped care model. METHOD: Clinical outcomes for 4451 participants in 163 psychoeducational groups delivered across 5 services were analysed by calculating pre-post treatment anxiety (GAD-7) effect sizes (Cohen's d). Overall and between-service effects were compared to published efficacy benchmarks. Multilevel modelling was used to examine if variability in clinical outcomes was explained by differences in service, group and patient-level (case-mix) variables. RESULTS: The pooled GAD-7 (pre-post) effect size for all services was d = 0.70, which was consistent with efficacy benchmarks for guided self-help interventions (d = 0.69). One service had significantly smaller effects (d = 0.48), which was explained by differences in group treatment length and case-mix. Variability between groups (i.e., group effects) explained up to 3.6% of variance in treatment outcomes. CONCLUSIONS: Large group psychoeducational CBT is clinically effective, organisationally efficient and consistent with a stepped care approach to service design. Clinical outcome differences between services were explained by group and patient variables.