Jaime Delgadillo1, Stephen Kellett2, Shehzad Ali3, Dean McMillan4, Michael Barkham5, David Saxon5, Gill Donohoe6, Heather Stonebank6, Sarah Mullaney7, Patricia Eschoe7, Richard Thwaites8, Mike Lucock9. 1. Leeds Community Healthcare NHS Trust and Department of Health Sciences, University of York, UK. Electronic address: jaime.delgadillo@nhs.net. 2. Centre for Psychological Services Research, University of Sheffield, UK; Sheffield Health & Social Care NHS Foundation Trust, UK. 3. Department of Health Sciences and Centre for Health Economics, University of York, UK. 4. Department of Health Sciences and Hull York Medical School, University of York, UK. 5. Centre for Psychological Services Research, University of Sheffield, UK. 6. Sheffield Health & Social Care NHS Foundation Trust, UK. 7. South West Yorkshire Partnership NHS Foundation Trust, UK. 8. Cumbria Partnership NHS Foundation Trust, UK. 9. Centre for Applied Psychological and Health Research, University of Huddersfield, UK; South West Yorkshire Partnership NHS Foundation Trust, UK.
Abstract
BACKGROUND: This was a multi-service evaluation of the clinical and organisational effectiveness of large group psychoeducational CBT delivered within a stepped care model. METHOD: Clinical outcomes for 4451 participants in 163 psychoeducational groups delivered across 5 services were analysed by calculating pre-post treatment anxiety (GAD-7) effect sizes (Cohen's d). Overall and between-service effects were compared to published efficacy benchmarks. Multilevel modelling was used to examine if variability in clinical outcomes was explained by differences in service, group and patient-level (case-mix) variables. RESULTS: The pooled GAD-7 (pre-post) effect size for all services was d = 0.70, which was consistent with efficacy benchmarks for guided self-help interventions (d = 0.69). One service had significantly smaller effects (d = 0.48), which was explained by differences in group treatment length and case-mix. Variability between groups (i.e., group effects) explained up to 3.6% of variance in treatment outcomes. CONCLUSIONS: Large group psychoeducational CBT is clinically effective, organisationally efficient and consistent with a stepped care approach to service design. Clinical outcome differences between services were explained by group and patient variables. Copyright Â
BACKGROUND: This was a multi-service evaluation of the clinical and organisational effectiveness of large group psychoeducational CBT delivered within a stepped care model. METHOD: Clinical outcomes for 4451 participants in 163 psychoeducational groups delivered across 5 services were analysed by calculating pre-post treatment anxiety (GAD-7) effect sizes (Cohen's d). Overall and between-service effects were compared to published efficacy benchmarks. Multilevel modelling was used to examine if variability in clinical outcomes was explained by differences in service, group and patient-level (case-mix) variables. RESULTS: The pooled GAD-7 (pre-post) effect size for all services was d = 0.70, which was consistent with efficacy benchmarks for guided self-help interventions (d = 0.69). One service had significantly smaller effects (d = 0.48), which was explained by differences in group treatment length and case-mix. Variability between groups (i.e., group effects) explained up to 3.6% of variance in treatment outcomes. CONCLUSIONS: Large group psychoeducational CBT is clinically effective, organisationally efficient and consistent with a stepped care approach to service design. Clinical outcome differences between services were explained by group and patient variables. Copyright Â
Authors: Mike Lucock; Michael Barkham; Gillian Donohoe; Stephen Kellett; Dean McMillan; Sarah Mullaney; Andrew Sainty; David Saxon; Richard Thwaites; Jaime Delgadillo Journal: Adm Policy Ment Health Date: 2017-11
Authors: Raphael Schuster; Inanna Kalthoff; Alexandra Walther; Lena Köhldorfer; Edith Partinger; Thomas Berger; Anton-Rupert Laireiter Journal: J Med Internet Res Date: 2019-04-28 Impact factor: 5.428