Introduction
This manual is dedicated to a psychotherapeutic group that is intended for patients with mild-to-moderate depression. It will be a short-term psychoeducation group that will use cognitive-behavioral therapy (CBT). The aim of this manual is to provide direction and employ high-quality sources dedicated to depression and group therapy to justify the choices made for the group. In this section, the group’s focus and initial stage will be discussed, including the key elements of the group, functions of its members, announcement, and screening concerns.
Announcement
Since the group targets a particular population that is likely to be visiting mental health institutions, advertising within such institutions is key to identifying the people who could benefit from the intervention. For this group, a specific health center is proposed as the advertising spot. The group will be using flyers that will be distributed at the receptionist’s desk among the people who are interested. The advertisements will include a short description of the group and contact information.
Screening
As a part of the initial stage, the screening procedures will be carried out. Examples and guidelines for pre-group screening interviews, especially those by Damer (2009), Hepner et al. (2000), and PsychotherapyNet (2013), will be used to structure the encounter. Based on the sources, it will be necessary to gather enough data about the participants’ mental health (especially depression) and provide them with all the information about the group. The group leader will test the participants’ eligibility during individual face-to-face interviews. This format is necessary for an in-depth discussion with each patient that would allow covering all the required screening topics.
First, the potential participants’ diagnosis will be checked; the National Institute for Health and Care Excellence [NICE] (2017) guidelines will be considered to determine the applicability of the group to each patient’s situation. Furthermore, the detailed information about the group, as well as its benefits and limitations, will be provided. Any patients’ concerns will be addressed, and the topics of rules and confidentiality will be covered (Damer, 2009). Then, potential members will be asked about the goals, expectations, and motivations that lead them to join the group. The aim of the procedure will be to ensure that the potential members can benefit from participating; also, it will help the participants to decide if they want to enroll.
Elements
The group will consist of a brief CBT for patients with mild or moderate depression. The condition is very common, has high relapse risks, lowers the quality of life of the afflicted, and can be associated with multiple negative outcomes (American Psychiatric Association, 2013; Chiang et al., 2015; Tanoue et al., 2018). Group therapy is well-suited for the targeted population; evidence indicates that it is effective in reducing depressive symptoms in patients scoring 10 points or more in Beck and Hamilton inventories (Chiang et al., 2015; Tanoue et al., 2018). Such scores correspond to mild, moderate, and severe depression, and the presented studies investigate both short- and long-term perspectives, which is especially important for a relapse-prone disorder.
A recent article by Tong et al. (2019) suggests that a specific feature of group CBT is that it can help to reduce the stigma associated with the diagnosis in patients with moderate to severe depression. Furthermore, the authors found that group CBT also motivated the participants to adhere to other treatments, which consisted of pharmacotherapy for the experimental and control groups. Finally, group therapy, especially CBT therapy, is recommended by NICE (2017) for subthreshold, mild, and moderate depression. In summary, the use of group CBT for patients with mild-to-moderate depression is fully justified by recent research and can lead to additional positive outcomes, including treatment adherence and reduced perceived stigma.
Psychoeducation in depression management is a helpful asset. This type of groups is dedicated to equipping members with the means of managing their concerns, which may include useful information and skills (Pessagno, 2013). CBT is a common tool employed by such groups (Corey, 2009). The study by Tong et al. (2019) was dedicated to investigating a psychoeducational group, which provided members with the necessary knowledge about depression and its management. This study demonstrates that the approach is helpful for people with depression in multiple ways, which justifies the choice of a psychoeducation CBT group for the targeted population.
Since the participants will share the same concern, the group will be homogenous, although some heterogeneity is expected; the members are likely to be diverse from multiple perspectives. Still, the focus of the group will be on the common issue, which is a reasonable decision that is evidenced to improve the efficacy of group therapy (Pessagno, 2013). Furthermore, the group will be closed; this way, it will be easier to structure the therapeutic process and build cohesion and trust, especially since few sessions are planned. Based on NICE (2017) recommendations, from eight to ten people will be recruited.
It is also intended to consider employing two group leaders due to the suggestions of the same organization; some authors, including Tanoue et al. (2018), describe groups with several leaders that were effective in treating depression.
The meeting place and frequency of sessions will be negotiable, but the current plan consists of gathering once a week for about 12 weeks. Most likely, the group leader will get access to a room in a health center; as a neutral ground, this location is a preferable session location. The intervention will last for about 10-12 sessions; some evidence indicates that group CBT of this form and duration is helpful for the targeted population (Chiang et al., 2015). In fact, even eight-session interventions appear to be effective (Tong et al., 2019), which is why the duration of the intervention can be negotiated. However, NICE (2017) recommends having at least ten sessions, and this number will be viewed as the preferable minimum. To summarize, the decisions about the group elements are rooted in evidence and existing guidelines.
Functions
There are multiple functions that group members and leaders perform. For this group, the leader will direct the therapy, and the members will be expected to engage in it. To be more specific, the leader will guide and assist the members in developing and carrying out their plans. In turn, active engagement will be required from the participants; they will need to draft their plans and goals, do the homework, and perform the necessary activities during meetings. It is a common approach to structuring the roles of the members and leaders of CBT groups (Corey, 2009). Thus, the leader will function as a guide, and the members will use this support to achieve positive outcomes.
Conclusion
The proposed group will focus on a very common disorder and use well-established, evidence-based, and approved methods of CBT-based psychoeducation to assist people with mild-to-moderate depression. The announcement of the group, as well as advertising, will be carried out in a specific health center that the group leader has access to; flyers will be employed for this purpose. Up to 12 sessions will be carried out within the same center; the group will be closed and homogenous. The leader will act as a guide, and the participants will be actively engaged in achieving their goals and resolving specific problems that psychoeducation can address. Individual screening interviews will help to form a group of up to ten people who can benefit from the intervention.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders; DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.
Chiang, K., Chen, T., Hsieh, H., Tsai, J., Ou, K., & Chou, K. (2015). One-year follow-up of the effectiveness of cognitive behavioral group therapy for patients’ depression: A randomized, single-blinded, controlled study. The Scientific World Journal, 2015, 1-11. Web.
Corey, G. (2009). Theory and practice of group counseling (8th ed.). Belmont, CA: Thomson Brooks/Cole.
Damer, D. E. (2009). Information sessions: A ridiculously easy way to screen for group. Web.
Hepner, K. A., Miranda, J., Woo, S., Watkins, K. E., Lagomasino, I., Wiseman, S. H., & Muñoz, R. F. (2000). Pre-group individual client interview: Orientation form.
National Institute for Health and Care Excellence. (2017). Depression in adults: Recognition and management.
Pessagno, R. (2013). Group therapy. In K. Wheeler (Ed.), Psychotherapy for the Advanced Practice Psychiatric Nurse (pp. 407-420). New York, NY: Springer.
PsychotherapyNet. (2013). Understanding group therapy: Interview with Irvin Yalom video [Video file].
Tanoue, H., Yoshinaga, N., Kato, S., Naono-Nagatomo, K., Ishida, Y., & Shiraishi, Y. (2018). Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study. International Journal of Nursing Sciences, 5(3), 218-222. Web.
Tong, P., Bu, P., Yang, Y., Dong, L., Sun, T., & Shi, Y. (2019). Group cognitive behavioural therapy can reduce stigma and improve treatment compliance in major depressive disorder patients. Early Intervention in Psychiatry, 2019, 1-7. Web.