20 Top Tips for Planning and Running CBT Groups

Nicola Walker, Joanne Mill

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

Scientific background
Competencies in the ability to deliver group-based interventions have been set out in the CBT generic therapeutic competencies framework (Roth & Pilling, 2008). The workshop will introduce 20 Top Tips for planning and running successful face-to-face and online groups.

Not all clients benefit from group psychotherapy (Burlingame et al. 2006; Ogrodniczuk et al. 2003), with some clients showing non-response, some deterioration, and some adverse events or side effects (Roback, 2000). For some clients, peer interaction is ‘demanding’ (Schuster et al. 2018), and some may feel ambivalent about fully opening up (Newbold et al. 2013). Observation of group sessions reveals behaviours associated with improvement or deterioration. Clients who initiate discussion, express controversial views, over-disclose in the early stages based on the expectation that group therapy requires ‘sharing deep personal information’ are likely to do worse than clients who wait to be invited to contribute to discussion, are more cautious and ‘sit on the fence’, for example (Hoffmann et al. 2009) .
When clients disclose very distressing events, this may lead to actual and vicarious traumatisation in other group members (Smokowski et al. 2001), and there is a possibility of ‘emotional contagion’ rather than empathy (Bacha, 2019). Other damaging experiences reported include clients feeling ignored, rejected, intruded upon or attacked by the therapist; clients experiencing ‘feedback overload’ or being confronted by other group members; confidentiality being broken by other group members; or clients assuming or being ascribed a ‘deviant group role’, such as the scapegoat or the identified patient (Lieberman et al. 1973). Moreover, clients from minority socio-cultural groups including the LBGTQ community may not do as well as other clients in group therapy (Chen et al. 2008), and they are more likely to report lasting bad effects (Crawford et al. 2016).
There is a higher drop-out from peer support groups due to a lack of structure with a nondirective leadership style and no agenda, whereas psycho-educational groups are more acceptable because they are structured with a directive leadership style and an agenda including a taught introduction to each session, skills practice, and an emphasis on goals and future plans (Morriss et al. 2016). Structured groups have a ‘workshop-like character’, which suits some clients who would be put off by traditional unstructured group psychotherapy that may be beset by ‘undesired group dynamics’, such as one group member monopolising the discussion (Newbold et al. 2013; Schuster et al. 2018). Whilst it is important to clients that everyone contributes (‘nobody just sat there’: Luke, 2011 p.67), some clients in IAPT express a preference for group therapy because there is less pressure to talk (Newbold et al. 2013). However, some clients may feel ‘emotionally short-changed’ in brief psycho-educational groups where the leader’s role is solely to impart facts and information (Lothstein, 2014 p.233). If leaders focus on therapeutic techniques rather than therapeutic relationships, there is a risk that this may be a sterile and isolating experience. Clients in structured groups ask for ‘more time for talking’ rather than ‘doing things’ (Schuster et al. 2018 p.9).

Key learning objectives
By the end of the class, participants will be able to:
1. Describe the overarching competences required to deliver group based interventions (Roth & Pilling, 2007).
2. Explain how to minimise the potential risks of group based intervention through skilful facilitation of peer interaction.
3. Implement the 20 Top Tips when planning and running group based interventions.

Training modalities
In this workshop the content will be taught through instruction and the process will include demonstration, simulation (skills practice), pair work and group discussion.
Original languageEnglish
Title of host publicationThe British Association of Behavioural and Cognitive Psychotherapies
Subtitle of host publicationBABCP
Publication statusAccepted/In press - 16 Jun 2021
Event2021 Annual Conference of the British Association of Behavioural & Cognitive Psychotherapies / European Association for Behavioural and Cognitive Therapies - ICC Belfast, Belfast, United Kingdom
Duration: 8 Sep 202111 Sep 2021
https://eabct2021.org/

Conference

Conference2021 Annual Conference of the British Association of Behavioural & Cognitive Psychotherapies / European Association for Behavioural and Cognitive Therapies
Country/TerritoryUnited Kingdom
CityBelfast
Period8/09/2111/09/21
Internet address

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