Cognitive Restructuring Group

We recently received the following update from Kevin Benbow about the positive effects of teaching Cognitive Restructuring in a group format:

About six months ago I came up with the idea to create a group based on the premises of Greenberger and Padesky’s “Mind Over Mood.”  This was a pilot program, and the intention of the group was to solely teach the basics of cognitive restructuring to the participants.   This was done via handouts, movie clips, and a power point presentation. The group ran for 12 sessions and we systematically taught all participants to make the connection between situations, moods and automatic thoughts.  The BDI* and BAI* were administered prior to beginning group and were also administered at the last session.

It should be noted that in addition to the teaching of CR techniques these clients would also receive individual therapy as well as psychotropic medication if needed.

While I have seen the power and utility of CR before, I was pleasantly surprised to see how group dynamics can be used to reinforce the completion of homework and normalize symptoms of depression and anxiety.  Once the basic concepts were taught, we would complete thought records on the white board using actual stressors from the clients’ lives.  This enabled them to learn from each other, as well as from me, how to identify and respond to dysfunctional thoughts.

We had one client who showed no improvement on the final measures.  However, the other participants completing the BAI and BDI showed marked improvement from the beginning of the group through to completion.  They seemed to be socialized much more quickly into the cognitive model.  As has been reported in numerous publications, those who completed homework consistently showed the most improvement.

One participant came to us with a rather severe case of major depressive disorder.  She had been depressed on and off, without interepisode recovery for most of her life.  She received individual, the CR group, and outpatient psychiatric services.  She scored very high on the BDI and BAI initially, but upon conclusion of the CR group scored subclinical on both measures.  We had our last individual session, and when we reviewed her relapse plan I was encouraged to hear her state that should her symptoms return she would first try to challenge her thinking before considering a change in medication dosage or coming back for a booster session.  While her medication is doubtlessly affecting her, she attributes a significant portion of her treatment gains to learning to apply CR to her life stressors.  She was also surprised that these types of gains could be realized in a period of a little more than 4 months.

Loving my work:

Kevin L. Benbow, MA, LAC

* BDI = Beck Depression Inventory; BAI = Beck Anxiety Inventory

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