Group CBT for Social Anxiety Disorder: A Meta-Analysis

OBJECTIVE: A few meta-analyses have examined psychological treatments for a social anxiety disorder (SAD). This is the first meta-analysis that examines the effects of cognitive behavioural group therapies (CBGT) for SAD compared to control on symptoms of anxiety.

METHOD: After a systematic literature search in PubMed, Cochrane, PsychINFO and Embase was conducted; eleven studies were identified that met the inclusion criteria. The studies had to be randomized controlled studies in which individuals with a diagnosed SAD were treated with cognitive-behavioural group therapy (CBGT) and compared with a control group. The overall quality of the studies was moderate.

RESULTS: The pooled effect size indicated that the difference between intervention and control conditions was 0.53 (96% CI: 0.33-0.73), in favour of the intervention. This corresponds to a NNT 3.24. Heterogeneity was low to moderately high in all analyses. There was some indication of publication bias.

CONCLUSIONS: It was found that psychological group-treatments CBGT are more effective than control conditions in patients with SAD. Since heterogeneity between studies was high, more research comparing group psychotherapies for SAD to control is needed.

Wersebe, H., Sijbrandij, M., & Cuijpers, P. (January 01, 2013). Psychological group-treatments of social anxiety disorder: a meta-analysis. Plos One, 8, 11.)

Group Cognitive Behavior Therapy

In this video from a recent CBT workshop at the Beck Institute, Dr. Aaron Beck explains how CBT techniques used during individual therapy can be effectively applied in the group setting. Dr. Beck discusses the “the 3 C’s”, a CBT technique in which patients are taught how to “catch”, “check”, and “correct” their automatic thoughts. In group-based cognitive behavior therapy, patients can use the “the 3 C’s” to help each other recognize and modify automatic thoughts they experience.

To learn more about cognitive behavior therapy training and workshops, visit

Group CBT for Social Phobia is Effective in Community Mental Health Clinics

According to a recent study published in Behaviour Research and Therapy, cognitive behaviour group therapy (CBGT) is effective within the community mental health setting. The current study compared outcomes from a CBGT 12-session protocol used within a research unit to outcomes from the same protocol used within a community mental health clinic (CMHC). Though participants in the CMHC sample had more severe symptomology and life interference; were more likely to use medication, have lower education attainment and socioeconomic backgrounds, and suffer from comorbid disorders, most of these differences were unrelated to outcomes. Results suggest that CBGT is transportable to and comparably effective within the CMHC setting.

McEvoy, P. M., Nathan, P., Rapee, R. M., & Campbell, B. N. C. (April 01, 2012). Cognitive behavioural group therapy for social phobia: Evidence of transportability to community clinics. Behaviour Research and Therapy, 50, 4, 258-265.

For children and adolescents, psychological harm of traumatic events reduced by CBT

In a review in the American Journal of Preventive Medicine, it was noted that children and adolescents who experience psychological harm caused by traumatic events are often treated by practitioners who are not aware of, and do not employ, treatments that are “based on the best available evidence.”

Meta-analyses were conducted on interventions that included cognitive behavioral therapy (CBT) in individual and group settings, play therapy, psychodynamic therapy, and others.

The traumas themselves covered a wide range and included sexual abuse, domestic violence, serious illness, and natural disasters. The CBT methods included exposure techniques, modification of inaccurate cognitions, reframing counterproductive cognitions regarding the trauma, and others.

Based on their analyses, the review authors concluded there was “strong evidence … that individual and group CBT can decrease psychological harm among symptomatic children and adolescents exposed to trauma.”

Review authors: H. R. Wethington, R. A. Hahn, D. S. Fuqua-Whitley, et al.

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.  Read more