Context for Creating this Resource

The evidence-based group treatment (EBGT) literature has matured and strengthened over the past few decades producing multiple treatment protocols for common psychiatric disorders (Burlingame & Strauss, 2021). In some cases, these protocols are direct applications of individual therapy manuals that can be found on the American Psychological Association’s Society of Clinical Psychology webpage. In other cases, unique group-based approaches have been developed independent of individual format treatment approaches. The evidence for the effectiveness of these approaches have been tested by enough studies to support meta-analytic summaries.  Indeed, the results from group treatment meta-analyses focusing on common psychiatric disorders were summarized by Rosendahl and her colleagues (2021). 

A second contextual factor is the recognition of Group Psychology and Group Psychotherapy as a formal specialty by the American Psychological Association (APA) in 2018. This recognition allows for doctoral, internship, and postdoctoral programs to provide group psychology and group psychotherapy as formal specialties. Post-licensure psychologists can obtain the specialty designation through the American Board of Group Psychology. The creation of an evidence-based group treatment (EBGT) website that parallel’s the Society of Clinical Psychology’s resource not only supports the aforementioned training sites included in the specialty, but it also addresses a key facet of the reaccreditation review process for the Group Psychology and Group Psychotherapy specialty scheduled for 2025; specifically documentation of a strong literature base.

Given the breadth of group treatment implementation and training, three different organizations sponsored the creation of this EBGT resource: APA’s Society of Group Psychology and Group Psychotherapy (Division 49), American Group Psychotherapy Association (AGPA), and the German Health Ministry. The taskforce empowered to develop this resource was chaired by Gary Burlingame’s lab at Brigham Young University and Bernhard Strauss’s lab at Institute of Psychosocial Medicine, Psychotherapy, and Psycho-oncology at Jena University Hospital in Germany. In most cases, Burlingame and Strauss recruited the senior author of recent meta-analyses testing the effectiveness of group treatment protocols for common psychiatric disorders. Each senior author worked with members of their lab to produce a unique website resource to summarize empirically supported group treatments.  With some disorders (obsessive-compulsive disorder—OCD) there was a heavy reliance on individual treatment protocols and significant overlap of treatments found on the Society of Clinical Psychology webpage. With other disorders (substance-use disorders—SUD) there were many unique group-treatment approaches producing less overlap.

Introduction to this Resource

What appears on the home page are three tabs: Treatments, Therapeutic Relationship as Evidence-based Treatment (EBT) and Alternatives to Randomized Controlled Trials (RCT). Phase I of the project populated the Treatment tab, summarizing treatments for five anxiety disorders (OCD, generalized anxiety, social anxiety, panic and post-traumatic stress disorders), two mood disorders (major depressive and bipolar disorders), two severe or chronic disorders (schizophrenia and borderline personality disorders) as well as eating, substance use, chronic pain and youth behavioral disorders. Each disorder webpage parallels information found on the Society of Clinical Psychology (APA Division 12) webpage, including: a brief description of the disorder, key summative citations used in study selection, a list of evidence-based psychological treatments that were judged to have sufficiently strong empirical evidence to be included and, promising treatments that did not have sufficient empirical support but where research was sufficiently encouraging to include. Since this is the first release of this resource, we’ve invited each web-page team to “show their work” on the disorder landing page. More specifically, to tell the reader about their inclusion and exclusion criteria and how they approached the task of identifying treatments. Since the disorder teams came from different countries and worked with different disorders, there was some variability in their approaches.

Two more development phases are planned which will populate the remaining two tabs. The Therapeutic Relationship as EBT tab addresses the strong evidentiary foundation that the therapeutic relationship (e.g., cohesion, alliance, climate, empathy, etc.) often explains as much improvement as the treatment protocol. There is a small but growing body of group research incorporating measure-informed care principles that focuses on identifying group members who have deteriorating relationships with their leader and/or group. This literature parallels the alliance rupture literature in individual therapy where identification of ruptures is the first step to rupture repair. Content in this tab will include meta-analytic support of the multi-faceted therapeutic relationship in group therapy and how the relationship can predict treatment process and outcome. Like the treatment tab, links to measures that have been empirically supported predictors of group member outcome will be provided to enable group practitioners to implement measure-informed group treatment. Phase II of the website development will establish content for this tab.

The third tab was created in response to discussions with the three sponsoring organizations. More specifically, the discussions identified the strengths and weaknesses of relying on randomized clinical trials (RCTs) as the sole source of evidence for effectiveness. The Alternatives to RCT tab will include other compelling sources of evidence such as the growing research base supporting routine-outcome monitoring that includes feedback to reduce treatment failures and improve outcomes. Other potential topics in this tab will include a discussion of the limitations of having RCTs be the sole criterion to establish effectiveness. Phase III of the website development will develop content for this tab.

Important Considerations

This list does not include all treatments that are empirically supported. Many of the treatments found on this list have been evaluated in meta-analytic studies which do not create a comprehensive list of treatments given idiosyncratic inclusion and exclusion criteria. Those involved in this project were primarily volunteers who had published at least one meta-analytic summary, and we encouraged them to use their meta-analysis as a basis for the webpage. Some conducted comprehensive literature searches that identified treatments not included in their original meta-analysis while others use the published meta-analysis as the primary source. As a result, some treatments were reviewed years ago, and may not reflect more recent research. 

In addition, there are some treatments that have been developed with evidentiary support that are not on this list or included in the promising treatment page. We’ve identified members from each sponsoring organization that will be part of a steering committee to evaluate and implement revisions to the website. If you are a psychological researcher interested in suggesting a treatment for consideration, please contact the steering committee here: ebgtfeedback@gmail.com 

Disclaimer

This website is for informational and educational purposes. It does not represent the official policy of Division 49 or the American Psychological Association, nor does it render individual professional advice or endorse any treatment. We recommend a consultation with a mental health professional for an accurate diagnosis and discussion of various treatment options. When you meet with a professional, be sure to work together to establish clear treatment goals and to monitor progress toward those goals. When seeking a group supervisor or group therapist, please ensure they are either Certified Group Psychotherapists (CGP, offered by the International Board for Certified Group Psychotherapists, part of the American Group Psychotherapy Association) or have the necessary training and supervision in group therapy and group dynamics. Feel free to print information from this website and take it with you to discuss your treatment plan with your therapist. Even treatments that have scientific support will not work for everyone, and carefully monitoring your progress will help you and your therapist decide when it is time to try a different approach.

Citations