Effectiveness of transdiagnostic group cognitive-behavioural therapy for anxiety disorders in a naturalistic clinical setting

ABSTRACT

Objective: The present study evaluated the effectiveness of a transdiagnostic group-based cognitive-behavioural therapy (CBT) programme for treating anxiety, comorbid depression, and functional impairments in a hospital outpatient specialist anxiety disorders clinic.

Method: 107 adult outpatients with a primary anxiety disorder completed an eight-session transdiagnostic group CBT program. Participants also completed self-report measures assessing general anxiety, anxiety disorder-specific symptoms, comorbid depression symptoms, and functional impairments. Data were collected at pre - and post-treatment, and at follow-up.

Results: Significant pre- to post-treatment reductions were found on measures of state and trait anxiety, impairment in work and social functioning, comorbid depression, social anxiety, and worry severity. These treatment gains were maintained at follow-up.

Limitations: There was no comparison control group in the present study given that it was conducted in a hospital setting. Some diagnostic groups were also underrepresented in the sample, which limits the conclusions that can be drawn about the effectiveness of the group treatment across anxiety disorders.

Conclusions: The present findings provided preliminary support for the effectiveness and generalisability of an eight-session transdiagnostic group-based CBT delivered at a public health service, indicating its potential as a cost-effective and clinically efficient alternative to individual therapy or diagnosis-specific treatments for anxiety disorders.

KEY POINTS

What is already known about this topic:

• (1) Transdiagnostic group CBT is efficacious for treating anxiety disorders.

• (2) Very few studies to date have examined the effectiveness of transdiagnostic group CBT in naturalistic settings.

• (3) Few of the existing effectiveness studies have included disorder-specific and daily functioning measures, or conducted follow-up assessment.

What this topic adds:

• (1) An eight-session transdiagnostic group CBT for anxiety disorders appears sufficient in leading to improvements in general and specific anxiety symptoms, work and social functioning, and comorbid depression for patients from a hospital outpatient clinic.

• (2) Treatment gains were maintained at follow-up.

• (3) Transdiagnostic group CBT is an effective, potentially cost- and resource-efficient, and easily accessible alternative to individual therapy or diagnosis-specific treatments in a naturalistic setting.

KEYWORDS:

• Anxiety disorders
• depression
• transdiagnostic
• cognitive-behavioural therapy
• effectiveness study
• group therapy

Acknowledgments

J. Chen assisted to design the study, supervised data collection, conducted the data analysis, and drafted the manuscript, as principal investigator. We would like to thank Dr Danielle Einstein and Brian O’Grady for their assistance with the study planning and data collection process. We would also like to thank all past and present staff of the unit, intern psychologists, and research assistants who assisted with data collection and collation.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

^1. 71.1% of participants were followed up at six-month to one-year post-treatment. 15.6% were followed up two- to three-year post-treatment, 8.9% were followed up four- to five-year post-treatment, and 4.4% were followed up more than 6 years post-treatment.

^2. Excluding the participants who received post-group individual sessions (n = 37) from the analyses did not change the pattern of pre vs post and pre vs follow-up results found. Moreover, participants who received post-group individual sessions did not differ from those who only completed the group in terms of demographic variables (age, gender, years of education, and medication use), the number of diagnoses they met criteria for at baseline, as well as their baseline scores on outcome measures. Thus, participants who received post-group individual sessions were included in the results analyses to maximise statistical power.