Stress inoculation training originally referred to a relatively specific set of operations (Meichenbaum & Cameron, 1972) In order to evaluate the efficacy of a skills training approach to anxiety management, a study was conducted using phobia as a target problem Treatment involved three phases It began with an educational phase that clarified the cognitive, affective, and physiological concomitants of the client’s avoidant behavior The Schachter (1966) model of emotion was presented to the client, who was encouraged to view anxiety as a reaction involving negative self-statements and images and physiological arousal It was suggested that acquisition of two skills, namely, coping self-statements and self-directed relaxation, would help ameliorate the problem This initial phase was followed by a skills training phase: specific types of coping self-statements and relaxation skills were learned and rehearsed Finally, during an application phase, the client actually tested out the skills in a stressful laboratory situation (unpredictable electric shock was administered) This treatment was found to be more effective than imaginal systematic desensitization, then the standard treatment for phobia

Stress inoculation training

In meta-analysis format the effectiveness of Beck's cognitive therapy for depression was reviewed. Twenty-eight studies were identified that used a common outcome measure of depression, and comparisons of cognitive therapy with other therapeutic modalities were made. The results document a greater degree of change for cognitive therapy compared with a waiting list or no-treatment control, pharmacotherapy, behavior therapy, and other psychotherapies. The degree of change associated with cognitive therapy was not significantly related to the length of therapy or the proportion of women in the studies, and although it was related to the age of the clientele, a lack of adequate representativeness of various age groups renders these results equivocal. Implications for further outcome and process studies in cognitive therapy are discussed.

A meta-analysis of the efficacy of cognitive therapy for depression.

Children (aged 8–14 years) with anxiety disorders were randomly assigned to cognitive-behavioral individual treatment, cognitive-behavioral group treatment, or a wait-list control. Treatment outcome was evaluated using diagnostic status, child self-reports, and parent- and teacher-reports. Analyses of diagnostic status revealed that significantly more treated children (73% individual, 50% group) than wait-list children (8%) did not meet diagnostic criteria for their primary anxiety disorder at posttreatment. Other dependent measures demonstrated the superiority of both treatment conditions compared to the wait-list condition. However, a child-report of anxious distress demonstrated only the individual treatment to effect significant improvement. Measures of social functioning failed to discriminate among conditions. Analyses of clinical significance revealed that notable proportions of treated cases were returned to nondeviant limits at posttreatment. Treatment gains were maintained at a 3-month follow-up.

Group and Individual Cognitive-Behavioral Treatments for Youth with Anxiety Disorders: A Randomized Clinical Trial

Recent reviews of the group psychotherapy literature indicate that group is a beneficial and cost-effective treatment format However, collective findings on the differential efficacy of group when compared with individual therapy remain problematic, incomplete, or controversial To remedy this problem, the authors conducted a meta-analysis of 23 outcome studies that directly compared the effectiveness of the individual and group therapy formats when they were used within the same study Results were consistent with previous reports that indicated no difference in outcome between the group and individual formats This finding generally held true when client, therapist, methodology, treatment, and group variables were examined for possible relationship with effect sizes comparing group and individual therapy Results bolster past findings that group therapy can be used as an efficacious cost-effective alternative to individual therapy under many different conditions

Comparative efficacy of individual and group psychotherapy: A meta-analytic perspective.

The efficacy of cognitive behavior therapies was assessed in a quantitative review. Analysis based on 48 studies indicated that cognitive behavior therapies were superior to no treatment; however, there was no firm evidence that these therapies were superior to other psychotherapies. Our analyses failed to find cognitive behavior therapies emphasizing behavioral techniques to be more effective than primarily cognitive approaches. Also, the efficacy of cognitive behavior therapies appeared relatively uniform across diagnostic categories and equally effective when administered in a group or individual format. Additional evidence would be necessary to justify the contention that cognitive behavior therapies are either better than other psychotherapies or the treatment of choice for particular disorders.

The efficacy of cognitive behavior therapies: a quantitative review of the research evidence

The primary purpose of this study was to evaluate the relative efficacy of both group and individual cognitive behavior therapy (CBT) approaches in treating anxiety and depression. A secondary purpose was to compare these treatments to an interpersonal group therapy approach. Several outcome studies with various patient populations have compared the effectiveness of CBT in both individual and group formats with waiting list controls and other psychotherapy comparison groups. Generally, regardless of format, CBT has been found to be more effective than the various other treatments (Beck, Rush, Shaw, & Emery, 1979). To date only two studies have examined the relationship between format (group or individual) and outcome of CBT treatment (Rush & Watkins, 1981; Shaw & Hollon, 1978). Treatment outcomes for these two studies were similar in that individual CBT appeared to produce a greater reduction in depressive symptomatology than group CBT. However, both group and individual treatments were associated with significant remission of symptoms. These results are not considered conclusive, however, since in the Shaw and Hollon study patients were not randomly assigned to treatments, and in the Rush and Watkins study the group patients were not part of the same randomly assigned subject pool as the individual patients.

Donna J. Coghlan

Papers

Positive changes in depression, anxiety, and assertion following individual and group cognitive behavior therapy intervention