Group Dynamics: Theory, Research, and Practice

The complexity of becoming an evidence-based group clinician: Introducing an evidence-based group treatment website.
Objective: A 5-year journey is described with three organizations that jointly sponsored international teams to produce the first phase of an evidence based group treatment (EBGT) website. The confluence of advances in both the training and research-supported group treatment protocols for common psychiatric and medical indications created the impetus for this resource. As expected, considerable time was invested in creating a consensual agreement on sponsorship responsibilities, goals, structure, development process, and maintenance of the website. Method: Senior authors of disorder-specific meta-analyses testing the differential effectiveness of group treatment protocols published over the past 10 years were invited as content experts for twelve common psychiatric and medical indications. A common codebook was used for these meta-analyses ensuring some degree of comparability although differences in comparators and treatments emerged by disorder. Results: Seven senior authors agreed to summarize and, in some cases, update their meta-analytic findings to illustrate the process for producing content for the EBGT website along with a clinical example and considerations regarding diversity, strengths, and future directions. Two commentaries are provided by group treatment experts. Conclusions: The results illustrate the variability of treatment offerings and the rigor of extant research across common psychiatric disorders. Some disorders and treatments are more mature in producing evidence-based recommendations while others are still emerging. Future directions for the website and concluding thoughts are shared. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Evidence-based group therapy for mood disorders: Treatment for depression and bipolar disorders.
Objective: Mood disorders, which include major depressive and bipolar disorders, are prevalent around the globe. Depression and bipolar disorders are traditionally treated with a combination of individual therapy and pharmacotherapy, but cost can be an access barrier for both treatments. There is evidence that group therapy for both depression and bipolar disorders provides effective outcomes in terms of alleviation of symptoms and fidelity to medication instructions. We begin with a brief history of group treatment for depression and bipolar disorders, review current practice guidelines, outline effectiveness findings from a recent meta-analysis, and provide key clinical resources. Method: Findings from a recent meta-analysis along with clinician resources for evidence-based group treatments are summarized. Results and Conclusions: There is sufficient evidence to support group therapy as an efficacious treatment for depression and bipolar disorder. Resources for clinicians for evidence-based group treatment for both depression and bipolar disorder include cognitive–behavioral group therapy and group cognitive therapy; resources for depression include group behavioral activation, group interpersonal therapy, and group mindfulness-based cognitive therapy; and resources for bipolar disorder include group functional remediation, integrated group therapy, and group psychoeducation. We include a clinical example of a group session for each disorder; thoughts on equity, diversity, and identity; and recommendations for further research. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Evidence-based group treatments for anxiety disorders, obsessive–compulsive disorder, and posttraumatic stress disorder.
Objective: Anxiety-related disorders such as panic, social anxiety disorders, obsessive–compulsive disorder, and posttraumatic stress disorder are prevalent mental disorders in the general population worldwide. This article summarizes the empirical evidence for the efficacy of group treatments for patients suffering from these disorders. The evidence is contrasted with the consideration of this evidence in the current U.K. and U.S. practice guidelines. Method: A review of the evidence is provided, which is mainly based upon several recent meta-analyses related to the single disorders. Following an overview of the representation of group therapy within guidelines, we also summarize resources for clinicians that were compiled within an international project aiming to provide online information about evidence-based group therapy. Results: The review reveals very solid evidence for the efficacy of group treatments for social anxiety disorders, panic and generalized anxiety disorder, obsessive–compulsive disorder, and posttraumatic stress disorder with a dominance of different approaches based on cognitive behavioral therapy. Meta-analytic results demonstrated that cognitive behavioral therapy groups are superior to no-treatment control conditions (large effects, g > 0.8) and were mainly equivalent to active control conditions. It is shown that the good evidence is almost unreflected in the existing guidelines. Conclusions: There is still a discrepancy between the positive results of group therapy as an effective, equivalent, and economic (“triple E”) treatment and its presence in clinical practice. This discrepancy might be explained by some barriers in the health system, insufficient training, missing research related to differential indications, and a clinician-friendly dissemination of research results. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Evidence-based group therapy for eating disorders.
Objective: The goal was to identify evidence-based group psychotherapy for adults with anorexia nervosa (AN), bulimia nervosa (BN), and binge-eating disorder (BED). Method: We reviewed randomized controlled trials of group psychotherapy for clinical samples of adults diagnosed with AN, BN, and BED published between January 1980 and July 2023. Studies that indicated evidence-based treatments were those that compared a bona fide group therapy to a no-treatment control condition and that had a minimum sample size of 30 participants per condition. Results: Four randomized controlled trials examining the efficacy of group psychotherapy for adults with BED met our inclusion criteria. Those studies supported cognitive behavioral group therapy and group psychodynamic-interpersonal psychotherapy as evidence-based group treatments of BED. No studies on the efficacy of group psychotherapy for adults with AN or BN met our criteria. Few studies adequately reported sample characteristics related to diversity, and those that did sample predominantly White participants. Most group treatment studies had methodological issues, such as small sample sizes that increased the risk of bias and reduced replicability. Conclusions: High-quality evidence supports the efficacy of cognitive behavioral group therapy and group psychodynamic-interpersonal psychotherapy for the treatment of BED, and treatment guidelines for BED should reflect these findings. Researchers should pay particular attention to equity, diversity, and inclusion when conducting and reporting future studies. Overall, there are few high-quality studies on the efficacy of group psychotherapy for eating disorders, particularly AN and BN. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Evidence-based group therapy for severe mental illness (SMI): Treatment for schizophrenia and borderline personality disorder.
Objective: Despite significant need, those with severe mental illness (SMI) often remain underserved and understudied. Schizophrenia and borderline personality disorder (BPD) stand out as recurring SMI conditions that historically have been difficult to treat. Empirical evidence for therapeutic treatment for each disorder continues to grow and evolve. Group intervention should be incorporated into care due to the format’s empirical effectiveness and resourcefulness. Method: The current article aims to provide clinically relevant information on group modalities with the most substantial empirical support for first schizophrenia (Burlingame et al., 2020) and then BPD (McLaughlin et al., 2019), using recent meta-analytic findings. This is accomplished by first providing a brief history of group treatment for each disorder. Next, current American Psychiatric Association guidelines and current empirical evidence for group treatment of first schizophrenia and then BPD are reviewed. Results: Based on findings, special focus is given to social skills and cognitive remediation for the treatment of schizophrenia and dialectical behavioral therapy for the treatment of BPD. Empirical evidence, treatment content, vignettes, and resources for each of these modalities are provided. Other promising group treatment options are reviewed for the reader to consider. Given the vast diversity within the SMI population and the multicultural significance recognized today, diversity, equity, and inclusion considerations are provided on the highlighted group treatment options. Conclusions: It is the hope of the authors that the reader will have sufficient information and resources to begin an evidence-based group treatment. By doing so, practice and care for the SMI population will expand and improve. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Implementing group therapy for adults with substance use disorders: What research-based evidence?
Objective: Group therapy is the most common form of treatment for substance use disorders (SUDs). However, a research-practice gap has limited the implementation of group evidence-based treatments. This article aims to synthesize the best available evidence of the effectiveness of group psychotherapy for SUDs. Method: Building upon previous reviews and meta-analyses, we conducted a brief overview of the main outcome results of group models in SUD treatment, including cognitive behavioral therapy and psychoeducational groups, relapse prevention groups, group drug counseling, contingency management, and interpersonal process groups. Results: Results showed that there is substantial research evidence showing the efficacy of group therapy for SUD. Barriers limiting research on group therapy for SUD are highlighted. Moreover, some clinical resources are outlined that could possibly help clinicians provide group therapy for SUD. Conclusions: Group therapy is an effective therapy modality for treating adults with SUD. More research is needed on group effectiveness in relation to racial/ethnic underrepresented groups and gender and sexual minorities. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Group therapy for pain: The current literature and clinician resources.
Objective: Pain-related concerns are common among adults, and they tend to reduce quality of life and interfere with regular functioning. Conventional pharmacological approaches are used most frequently to treat pain but carry adverse side effects and risk of addiction. The purpose of this article is to highlight the history of group therapy for pain, discuss current practice guidelines, outline available clinician resources, and review meta-analytical findings regarding group therapy’s general efficacy for pain. Method: A literature review was conducted, which included a recent meta-analysis on groups for pain along with an in-depth search for clinician resources for well-established approaches and those that are deemed promising. Results and Conclusions: Based on the state of the current literature, there is evidence to support group psychotherapy as a viable and effective treatment option for pain. Clinician resources are provided for approaches such as group cognitive-behavioral therapy, group acceptance and commitment therapy, self-management groups, and mindfulness-based stress reduction. Information on two promising treatments, group hypnotherapy and group music therapy, is also included. Additionally, a clinical illustration is provided, along with considerations for equity, diversity, and inclusion, accompanied by suggestions to improve generalizability. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Group therapy for youth behavioral concerns: A meta-analysis.
Objective: Externalizing behavior concerns (EBCs) are a common concern among youth and can be associated with significant problems, indicating the need for effective treatment. While research on psychosocial interventions is promising, the specific efficacy of youth group therapy has not been assessed in a meta-analysis. The aim of this study was to assess group therapy’s efficacy for EBCs and evaluate treatment moderators. Method: Major databases were used to identify articles using inclusion criteria. Included studies (a) were randomized controlled trials published in 1990 or later, (b) involved the treatment of behavioral concerns, (c) assessed the efficacy of child group treatment, (d) included at least one comparison condition, and (e) were in English. Included studies were analyzed in a random effects meta-analysis. Results: We analyzed 30 studies representing 2,818 youth (Mage = 10.9 years; 27.4% female). Group therapy showed a significant, medium effect on EBCs compared to passive controls (g = .50). There were also significant effects on aggressive cognitions, anger, internalizing symptoms, and social problems. Furthermore, effects on EBCs among studies using active comparators generally produced outcomes in favor of group. Conclusions: These findings indicate that group therapy is associated with significant improvements in EBCs and various secondary outcomes, with outcomes being comparable to what has been reported in past research on psychosocial treatments. Future research is needed to clarify discrepancies and replicate the present findings. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
This is not just a commentary on evidence-based group therapy research: It is important to the future of psychotherapy practice.
Objective: Group therapists are in the trenches helping patients suffering from many different issues, including people diagnosed with depression, anxiety, substance use, eating disorders, and pain. Group therapists know the value of groups, and they understand that group therapy is a valid treatment intervention. Unfortunately, not everyone is aware of the benefits of group therapy. Method: This special issue is an important contribution to the field that is designed to bring researchers and clinicians together by highlighting (a) the empirical evidence supporting group therapy interventions, (b) the different aspects of group therapy that foster change, (c) the types of group models and manuals that offer guidance for group practitioners, and (d) clinical examples of how group therapists intervene in group treatment to address specific issues. Conclusion: The articles demonstrate that group therapy is an evidence-based treatment and shed light on future goals that include (a) increasing the training and practice of group therapy, (b) studying the factors that influence group treatment process and outcome, and (c) providing equitable and just treatment interventions to patients who represent diverse and marginalized identities. The authors all argue that we need more research to move the field forward. Despite the need for more research, the evidence in this special edition demonstrates how group therapy interventions are equal to individual treatment across diverse disorders. Group therapy is a natural solution to the increasing mental health care needs that we are seeing today. Recommendations for training and future research are discussed. Results: The research studies reviewed in the special issue support the use of group therapy to treat diverse disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The evidence-based group therapy website: A commentary on opportunities, challenges, and next steps.
Objective: The Evidence-based Group Psychotherapy Website is a collaboration between the American Psychological Association Division 49, the American Group Psychotherapy Association, and the German Ministry of Health. Its purpose is to improve quality of mental health care and patient access to effective group therapy through the compilation of the evidentiary base supporting the efficacy and effectiveness of group psychotherapy. Method: The author’s overview built upon a review of the website as it stands currently; the plans for additional expansion and development; and the discussion emerging from a scientific meeting of key contributors and stakeholders in October 2023. Seven articles compose the original entries to the website, reviewing the meta-analyses of group therapy outcomes for patients with depression and bipolar disorder; schizophrenia and borderline personality disorder; substance use disorders; pain; externalizing behaviors; eating disorders; and, anxiety disorders. Results: The website is meeting its early promise. The articles that populate the website reflect the state-of-the-art of group therapy for these important clinical populations, including a comprehensive bibliography and access to resources, as well as manuals. Future developments of the website include the elements that define effective group therapy relationships. A third area to be developed will help practitioners engage in routine outcome monitoring of their work, gathering practice- based evidence to complement their evidence -based practice. Conclusions: The Evidence-Based Group Therapy website will serve as an important resource for practitioners, patients, group therapy trainees, referral sources, educators, and supervisors, policy makers and funders, and clinical practice guidelines developers. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Group Dynamics: Theory, Research, and Practice - Vol 28, Iss 3