Simply Effective CBT

Tag: Group CBT

  • ‘Don’t Tell Me Shoving All Trauma Victims Into a Group Is Harmful!’

    But it is – despite what form the group takes Devilly et al (2026). For some the intervention is termed Critical Incident Stress Debriefing (CISD) and for others Psychological First Aid (PFA).

    I’ve just seen J ack who was savagely attacked by a dog. Understandably he had severe PTSD and was referred to routine psychological treatment. He underwent 6 group sessions of 90 minutes with 8-10 participants online. Jack said the group didn’t help at all, no discussion of personal trauma was allowed and he endured weekly education on PTSD via Powerpoint. My thoughts were ‘death by Powerpoint’.

    Devilly et al (2026 concluded ‘

    ‘a major problem is that the current study raises the possibility that PFA deleteriously affects the most highly distressed following traumatic events (similar to the debriefing literature) and should not be routinely administered. In large Western cultures, PFA workshops are currently being offered by the very institutions who are evaluating best practice. This practice may be borne out of a necessity to raise funds in a society that increasingly sees science as just one alternative to advancement and one where funds are routinely withheld from research institutes. However, it raises concern for both the intervention at a general level and the evaluation of it by those providing the training’.

    Groups are the answer to a Manager’s prayer, promising massive throughput. There is no doubt that perceived social support is a major predictor of outcome in the treatment of PTSD. But there is no evidence that this can be manufactured by simply putting all trauma victims together. When I was leading the BABCP special interest group, on group work I found an ideological belief in the value of groups. There was scant recognition that the evidence base for group CBT was diagnosis specific and limited [ see Simply Effective Group CBT Scott (2011)]. Low intensity workers were particularly scathing of the need for reliable diagnosis. Nothing it seemed should interfere with ‘getting people together’. Workshops have included ‘Transference and Groups’ . There has been an absence of critical appraisal and I have absented myself from the SIG.

    Dr Mike Scott

  • Group Psychological Treatments for Children – The Promise and the Reality

    Group treatments are a response to long waiting lists for individual therapy. They can also help to normalise a child’s difficulty and help parents to feel less isolated. In recent years there has been a trend away from diagnosis specific groups to transdiagnostic groups. But a just published paper in the Clinical Psychology Review of 80 studies suggests they are no more effective than active controls. Rather than answer whether ‘going transdiagnostic’ represents added value over traditional disorder specific interventions, (the appropriate counterfactual), these authors simply make a case for more rigorous research.! In this vacuum marketing is likely to win – 29 of the studies were by author’s of the developed protocols.

    Caution is needed in translating these studies to routine practice:.

    • Only 1 of the 80 studies was conducted in the Uk, a mentalisation based treatment for youth.
    • Half the studies had parental involvement an average of 8 sessions. The children had on average 11 sessions.
    • 59 of the studies were of CBT consisting of mindfulness, emotional regulation and cognitive restructuring. But the author’s of the studies, self-labelled their interventions. The meaning of ’emotional regulation’ was unclear.
    • 14 of the studies involved children with ASD or ADHD.There is a bottleneck in the UK for ASD and ADHD assessments, as they are the passport to extra help at school. In this context Group Transdiagnostic approaches are likely to be heralded as, at least a ‘first-line approach’. Welcomed by schools to head-off the extra staffing investment this ‘passport’ would confer. Parents may be led to believe that their children are getting a new evidence-based treatment. Service providers are likely to seize upon transdiagnostic group interventions as a simple solution to the pressure of referrals. There is a need to look beyond convenience. 

    In ‘Simply Effective Group CBT’ London: Routledge (2011) I detailed how it was perfectly possible to address the commonplace additional disorders in this modality with Adults, without losing focus on the principal disorder. But over the last decade the conventional wisdom has been to label the additional disorders as constituting ‘complexity’, with a supposed need for a ‘complex’ intervention. However there is no empirical evidence that this shift in focus has resulted in better group CBT for adults. Unfortunately the ‘complexity’ myth has spread to interventions with the young.

    Dr Mike Scott