Group CBT Therapy for Depression

Everyone has felt sad or down at one point or another. Sometimes, these emotions become so intense that they can impact our day-to-day interactions with family and friends or our work, and lead to a variety of other problems such as changes in our eating or sleeping habits. If this is the case, these feelings of sadness may actually be a sign of depression. 

No matter who we are, where we come from, or what life looks like, we are vulnerable to depression. In terms of mental health diagnoses, depression impacts the most people globally (Reichenberg & Seligman, 2016). Luckily, there are a variety of evidence-based treatments available. In this post we will define depression, examine treatment options, and explore how to get started if you think treatment might be right for you.

What is Depression? 

Depression is common and is the most common reoccurring mental health diagnosis (Moloud et al., 2022). Although people can be diagnosed with depression at any age it is most commonly diagnosed in individuals in their 20s, and within a year, up to 7% of the US population will experience depression (APA, 2022).

Depression is characterized by feelings of sadness, hopelessness, and/or a loss of interest or pleasure in almost all activities, which last at least two weeks Additional symptoms of depression may also include sleeping too much or too little, weight loss or gain, a noticeable increase or decrease in physical movement, low energy or fatigue, feelings of worthlessness or guilt, trouble concentrating or making decisions, and/or recurrent thoughts of death or suicide (APA, 2022). On most days, these feelings persist for most of the day.

Depressive symptoms cause significant distress or challenges with functioning at work, socially, or in other important areas of functioning. In some individuals, getting through the day may require additional effort by the person with depression, but that effort is not observable by others. Feelings of depression may be experienced either during prolonged periods of time or occur during brief periods of time, known as episodically (APA, 2022). 

Can Depression be treated? 

Treatment for depression will depend on a variety of factors, including but not limited to the age of the client, the number and severity of symptoms, and any other existing mental or physical health diagnoses (Reichenberg & Seligman, 2016). Options for treatment of depression have been well-researched and there are many different options.

Most are types of talk therapies, and sometimes medication is used as well. Talk therapies for depression can vary, though many share similar underlying principles. You can read more about types of treatment for depression at New York Behavioral Health.

The most well-researched treatment for adult depression is Cognitive Behavioral Therapy (CBT), and CBT is considered an effective treatment for adult depression (Cuijpers, 2013). CBT is also considered an effective treatment for children and adolescents with depression (Reichenberg & Seligman, 2016). Treatment for depression with CBT can occur in individual therapy sessions, in group therapy sessions, or using a combination of both formats, and research shows that CBT is an effective treatment for depression in both individual and in group formats (Bryde Christensen et al., 2021; Feng C. Y. et al., 2012). 

What is CBT?

Cognitive Behavioral Therapy, or CBT, is a type of talk therapy that draws from both cognitive and behavioral approaches to therapeutic treatment. Although many clinicians contributed to the development of CBT, Dr. Albert Ellis is generally considered the founder of CBT (DiGiuseppe et al., 2014), which is typically a time-limited, problem-oriented, and present-focused form of therapy.

Research has shown that CBT is effective in treating a wide range of mental health disorders. According to the theory behind CBT, our emotions, thoughts, and behaviors are inextricably linked and have reciprocal influences on one another. It is our own perception and interpretation of internal (e.g. thoughts) and external (e.g. things that happen to us) events that impacts how we experience these events. According to CBT theory, because of the interconnectedness between thoughts, feelings, and behaviors, changing one of these will have an impact on the others. 

All individuals are vulnerable to faulty systems of thinking and belief, which can cause maladaptive behaviors. Moreover, these unhelpful thought patterns and beliefs can cause people to negatively appraise the future, the world, and themselves. When a client is working with a CBT therapist, the client and therapist collaboratively set treatment goals.

These goals often include building skills to manage distressing emotions and urges, and altering unhelpful thinking patterns so that the client is able to respond to life’s inevitable struggles more effectively and in healthier ways. Therapists will individualize cognitive-behavioral techniques according to each client, and will often assign homework in order to facilitate additional skill-building and reinforcement of learned skills in between sessions. 

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How does group therapy differ from individual therapy?

In both individual and group therapy a person works with a therapist to address whatever challenges feel the most emergent. Research shows that individual therapy, the relationship between the client and therapist is an important factor for treatment, and may be the most important factor with regard to treatment outcomes (Bryde Christensen et al., 2021).

While the relationship between client and therapist is also important in group therapy, the relationship between the group members also becomes an important part of treatment ,and group cohesion has been linked to positive treatment outcomes (Bryde Christensen et al., 2021). Group cohesion refers to feelings of commitment, respect, and belonging between group members.

As opposed to individual CBT therapy, group CBT therapy can provide additional elements during the course of treatment, including peer modeling, mutual support, and feelings of responsibility to others in the group (Bryde Christensen et al., 2021). The format for individual and group CBT therapy sessions is similar, and may include setting an agenda at the beginning of session, reviewing homework, and skill-building exercises. New York Behavioral Health offers both individual and group therapy treatment options.  

How do I know if group CBT therapy is right for me?

If you are considering individual or group therapy, it might be helpful to first connect with a therapist who practices CBT. There are a variety of therapists at New York Behavioral Health that specialize in CBT. Once you connect with a therapist, they can provide you with feedback about what type of sessions might best meet your needs and goals. Together, you and your therapist can explore options and create a customized treatment plan to maximize your quality of life.

References

American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th ed., Text Revision). 

Bryde Christensen, A., Wahrén, S., Reinholt, N., Poulsen, S., Hvenegaard, M., Simonsen, E., & Arnfred, S., (2021). “Despite the differences, we were all the same”. Group cohesion in diagnosis-specific and transdiagnostic CBT groups for anxiety and depression: A  qualitative study. International Journal of Environmental Research and Public Health18(10), 5324. https://doi.org/10.3390/ijerph18105324

Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58(7), 376–385. https://doi.org/10.1177/070674371305800702

DiGiuseppe, R.A., Doyle, K. A, Dryden, W., and Backx, W. (2014). A practitioner’s guide to rational emotive behavior therapy, 3rd ed. Oxford. 

Feng, C. Y., Chu, H., Chen, C. H., Chang, Y. S., Chen, T. H., Chou, Y. H., Chang, Y. C., & Chou, K. R. (2012). The effect of cognitive behavioral group therapy for depression: A meta-analysis 2000-2010. Worldviews on Evidence-Based Nursing9(1), 2–17. https://doi.org/10.1111/j.1741-6787.2011.00229.x

Moloud, R., Saeed, Y., Mahmonir, H. (2022). Cognitive-behavioral group therapy in major depressive disorder with focus on self-esteem and optimism: An interventional study. BMC Psychiatry, 22(299). https://doi.org/10.1186/s12888-022-03918-y

Reichenberg, L. W. & Seligman (2016) Selecting effective treatments: A comprehensive, systemic guide to treating mental disorders. Wiley.

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