A multi-service practice research network study of large group psychoeducational cognitive behavioural therapy.
This was a multi-service evaluation of the clinical and organisational effectiveness of large group psychoeducational CBT delivered within a stepped care model.



Clinical outcomes for 4451 participants in 163 psychoeducational groups delivered across 5 services were analysed by calculating pre-post treatment anxiety (GAD-7) effect sizes (Cohen's d). Overall and between-service effects were compared to published efficacy benchmarks. Multilevel modelling was used to examine if variability in clinical outcomes was explained by differences in service, group and patient-level (case-mix) variables.



The pooled GAD-7 (pre-post) effect size for all services was d = 0.70, which was consistent with efficacy benchmarks for guided self-help interventions (d = 0.69). One service had significantly smaller effects (d = 0.48), which was explained by differences in group treatment length and case-mix. Variability between groups (i.e., group effects) explained up to 3.6% of variance in treatment outcomes.



Large group psychoeducational CBT is clinically effective, organisationally efficient and consistent with a stepped care approach to service design. Clinical outcome differences between services were explained by group and patient variables.
Leeds Community Healthcare NHS Trust and Department of Health Sciences, University of York, UK. Electronic address: jaime.delgadillo@nhs.net.
Jaime
J
Delgadillo
Centre for Psychological Services Research, University of Sheffield, UK; Sheffield Health & Social Care NHS Foundation Trust, UK.
Stephen
S
Kellett
Department of Health Sciences and Centre for Health Economics, University of York, UK.
Shehzad
S
Ali
Department of Health Sciences and Hull York Medical School, University of York, UK.
Dean
D
McMillan
Centre for Psychological Services Research, University of Sheffield, UK.
Michael
M
Barkham
Centre for Psychological Services Research, University of Sheffield, UK.
David
D
Saxon
Sheffield Health & Social Care NHS Foundation Trust, UK.
Gill
G
Donohoe
Sheffield Health & Social Care NHS Foundation Trust, UK.
Heather
H
Stonebank
South West Yorkshire Partnership NHS Foundation Trust, UK.
Sarah
S
Mullaney
South West Yorkshire Partnership NHS Foundation Trust, UK.
Patricia
P
Eschoe
Cumbria Partnership NHS Foundation Trust, UK.
Richard
R
Thwaites
Centre for Applied Psychological and Health Research, University of Huddersfield, UK; South West Yorkshire Partnership NHS Foundation Trust, UK.
Mike
M
Lucock
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D005260:Female; D006302:Health Services Research / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration*; D008875:Middle Aged; D008960:Models, Psychological; D011615:Psychotherapy, Group; D055815:Young Adult
Anxiety; Depression; IAPT; Low intensity cognitive behavioural therapy; Multilevel modelling; Psychoeducation