The Need To Tailor Group CBT To Make A Socially Significant Difference

Given the scarcity of therapeutic resources Group CBT is an attractive option.  But to make a real world, socially significant difference in a client’s life a group intervention has to be tailored to each individual. The resources section of this forum contain free content materials for depression and the anxiety groups. Client’s want a real world change, to be free of whatever disorder/problem led them into treatment, not a change on a psychometric test.

Over the past year I’ve given about half a dozen Workshops titled ‘Delivering Group CBT’ to IAPT ( really enjoyed the last one on September 6th to North East Essex IAPT, great group!) and non-IAPT audiences, two points struck me a) most of the audience have been involved in groupwork, for a wide range of problems from low self-esteem to OCD, though most have been for anxiety and depression and b)  the groups that have been run have been more like classes than groups, in that there has been no tailoring of homework assignments in the way one would in individual therapy.  Without such tailoring it is unlikely that there will be any transfer of learning from the ‘group’ setting to the  client’s social context. Clients may express satisfaction with attending a ‘class’ with comments like ‘interesting’ and ‘useful’ but there is no independent evidence that they make a lasting real world difference. I have found it interesting how many therapists are harking for real world observable change in client’s lives and are unhappy with the psychometric test yardstick.

The need to tailor homework places a limit on the number of people that can be treated in a group, as opposed to the number of people that can be ‘taught in a ‘group’. I will return to the issue of tailoring in groups in a later post.

Dr Mike Scott

38 replies on “The Need To Tailor Group CBT To Make A Socially Significant Difference”

Hi Mike. Your post on “CBT groups” highlights two fault lines running through both CBT and arguably psychology as a whole and which is frequently writ large within IAPT services- 1. Didactic psychoeducation vs guided discovery and 2. (The broader issue of) A nomothetic vs an idiographic approach to client work ( which often gets expressed as an individual formulation vs a protocol driven approach. Not easy to resolve

Really interesting Paul, I think the problem is ‘black and white thinking’ dealing in polar opposites e.g protocol driven vs idiographic approach, when what is most beneficial is a subtle intertwining of the two. I think that the opposite pole to didactic is not guided discovery but experiential and again I would argue for a subtle blending.

Best wishes

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