Is Group More Cost Effective than Individual Cognitive Behaviour Therapy? The Evidence is not Solid Yet
Abstract
This paper critically evaluates the empirical evidence of 36 studies regarding the comparative cost-effectiveness of group and individual cognitive behaviour therapy (CBT) as a whole, and also for specific mental disorders (e.g. depression, anxiety, substance abuse) or populations (e.g. children). Methods of calculating costs, as well as methods of comparing treatment outcomes were appraised and criticized. Overall, the evidence that group CBT is more cost-effective than individual CBT is mixed, with group CBT appearing to be more cost effective in treating depression and children, but less cost effective in treating drugs and alcohol dependence, anxiety and social phobias. In addition, methodological weaknesses in the studies assessed are noted. There is a need to improve cost calculation methodology, as well as more solid and a greater number of empirical cost-effectiveness studies before a firm conclusion can be reached that group CBT is more cost effective then individual CBT.
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Group therapy offers the potential for cost savings.
“and offers the potential for cost savings (Morrison, 2001;Tucker & Oei, 2007).”
From Better living with illness: A transdiagnostic acceptance and commitment therapy group intervention for chronic physical illness (2016) · cites this paper as Tucker & Oei, 2007
In depression care, group therapy has been shown to be more economic than individual therapy.
“In depression care, group therapy has been shown to be more economic than individual therapy [23].”
Possible advantages of group compared to individual face-to-face therapy may include more time in therapy at less cost, learning from the struggles and progress of others, and social support offered by group treatment.
“Possible advantages of group compared to individual face-to-face therapy, may include more time in therapy at less cost, as well as the experience of learning from the struggles and progress of others and the social support offered by group treatment [12,13].”
From A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma (2017) · cites this paper as [12]
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“, 2018) and can serve more students with better cost-effectiveness (Myhr and Payne, 2006; Tucker and Oei, 2007) for some autistic learners.”
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“One way to increase the availability of treatment is to offer group therapy, which can be more cost-effective as it allows a larger number of patients to be treated at the same time (Tucker and Oei, 2007).”
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“In depression care, group therapy has been shown to be more economic than individual therapy [23].”
BackgroundMoore, L. M., Carr, A., & Hartnett, D. (2016) · Journal of Contemporary Psychotherapy · doi:10.1007/s10879-016-9351-6 · Cited by 11 · see citing works
“In a review of 36 treatment studies of varying disorders in a range of populations, Tucker and Oei (2007) concluded & Alan Carr Alan.carr@ucd.ie 1 School of Psychology, University College Dublin, Belfield, Dublin 4, Ireland that gCBT can be both cost-effective and time-efficient.”
Bélanger, C., Courchesne, C., Leduc, A. G., Dugal, C., El-Baalbaki, G., Marchand, A., Godbout, N., Marcaurelle, R., & Perreault, M. (2017) · Behavior Modification · doi:10.1177/0145445516656614 · Cited by 9 · see citing works
“Wittchen, Gloster, Beesdo-Baum, Fava, and Craske (2010) highlighted several reasons for separating the two disorders, such as the existence of agoraphobia without any evidence of panic symptoms. Despite this change in terminology, the diagnosis panic disorder with or without agoraphobia is used in this article when re…”
BackgroundMethodMackenzie, C. S., Wiprzycka, U. J., Khatri, N., & Cheng, J. (2013) · Journal of Gerontological Social Work · doi:10.1080/01634372.2013.834857 · Cited by 9 · see citing works
“Group CBT is an efficacious and costeffective way to treat depression in an aging population (Tucker & Oie, 2007).”
BackgroundArgiros, A. P., Venanzi, L., Dao, A., Dickey, L., Herman, N. M., Pegg, S. L., Hill, K. E., Stewart, J., & Kujawa, A. (2023) · International Journal of Cognitive Therapy · doi:10.1007/s41811-023-00159-z · Cited by 9 · see citing works
“In addition to potential social benefits, group CBT is more cost effective in treating depression in youth compared to individual CBT (Tucker & Oei, 2007) and allows for more efficiency in administering interventions to multiple patients at once.”
BackgroundFanous, M., & Daniels, J. (2020) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x20000045 · Cited by 8 · see citing works
“Whilst Scott and Stradling (1990) suggest that gCBT modalities can result in 50% cost savings, it should be noted that research on the fiscal advantages of gCBT are not yet fully supported, due to the complexity of such calculations (Tucker and Oei, 2007).”
BackgroundInfluentialLiu, S., Xiao, H., Duan, Y., Shi, L., Wang, P., Cao, L., Li, H., Huang, X., & Qiu, C. (2025) · Translational Psychiatry · doi:10.1038/s41398-025-03414-3 · Cited by 7 · see citing works
“Group therapy has many advantages such as in structured group format can save time and reduce waiting lists, and also cut down the cost of helping people who are not receiving treatment for fi nancial problems [21].”
McGlashan, H. L., Thompson, K. M., Lam, M., Cruwys, T., Walter, Z. C., Beadle, E. J., & Haslam, C. (2025) · Neuropsychology Review · doi:10.1007/s11065-025-09670-w · Cited by 9 · see citing works
“Moreover, group psychotherapy stands as a recognised method in holistic care, demonstrating therapeutic efficacy comparable to many forms of individual therapy (McRoberts et al., 1998; Tucker & Oei, 2007).”
Muskat, B. (2013) · Social Work With Groups · doi:10.1080/01609513.2012.753837 · Cited by 7 · see citing works
“At the same time, it appears that group-based programs have increased, partially due to an assumption that groups are less costly than one-to-one service (McDermott, 2003; McCrone et. al., 2005; Tucker & Oei, 2007).”
BackgroundA Treatment Pathway for High Security Offenders with a Personality Disorder
Evershed, S. (2011) · doi:10.1002/9780470973110.ch5 · Cited by 4 · see citing works
Kingdon, D., & Mander, H. (2015) · Elsevier eBooks · doi:10.1016/b978-0-08-097086-8.27011-6 · Cited by 7 · see citing works
Rukure, H., & Husted, M. (2025) · BMC Women s Health · doi:10.1186/s12905-025-04142-y · Cited by 8 · see citing works
“From a health systems perspective, group-based CBT can be cost-effective by serving multiple patients at once, and it has been noted to be economically viable [59].”
Gruppenpsychotherapieforschung und Wirksamkeitsnachweise von Gruppenbehandlungen
Strauss, B. M., & Burlingame, G. M. (2012) · Springer eBooks · doi:10.1007/978-3-642-03497-8_16 · Cited by 6 · see citing works
Christensen, A. B., Svart, N., Bokelund, H., Reinholt, N., Eskildsen, A., Poulsen, S., Hvenegaard, M., Simonsen, E. H., & Arnfred, S. (2020) · Psychiatry · doi:10.1080/00332747.2020.1800292 · Cited by 6 · see citing works
Baroi, B., & Muhammad, N. (2024) · Discover Psychology · doi:10.1007/s44202-024-00265-9 · Cited by 6 · see citing works
Fukumori, M., Kikuchi, T., Zhou, Y., Hattori, S., & Kudo, T. (2024) · Acta Neuropsychiatrica · doi:10.1017/neu.2024.45 · Cited by 7 · see citing works
“Moreover, group interventions are more cost-effective than individual sessions in treating depression (Shapiro et al ., 1982; Tucker et al ., 2007).”
Gruppenpsychotherapieforschung und Wirksamkeitsnachweise von Gruppenbehandlungen
Strauss, B. M., & Burlingame, G. M. (2017) · Springer eBooks · doi:10.1007/978-3-662-54644-4_16 · Cited by 6 · see citing works
An Examination of Individual Versus Group Treatment in Correctional Settings
Davies, J. (2019) · doi:10.1002/9781119139980.ch36 · Cited by 7 · see citing works
Kusec, A., Murphy, F. C., Peers, P. V., Bennett, R., Carmona, E., Korbacz, A., Lawrence, C., Cameron, E., Bateman, A., Watson, P., et al. (2023) · BMC Medicine · doi:10.1186/s12916-023-03128-7 · Cited by 6 · see citing works
“If shown to be effective, group approaches have clear economic advantages [16–18] and, indeed, in some cases can show enhanced intervention efficacy, e.g., due to the added benefits of peer support [19, 20].”
BackgroundSoares, T., Camargo, J., & Pizzinato, A. (2013) · Revista Brasileira de Terapia Comportamental e Cognitiva · doi:10.31505/rbtcc.v15i1.567 · Cited by 5 · see citing works
“Overall, group-based treatments have been regarded by the academic community as a good answer to these issues (Tucker & Oei, 2007).”
Tsai, J., & Rosenheck, R. A. (2013) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2012.04.0073 · Cited by 5 · see citing works
“For example, in psychotherapy, group therapy can be more cost and time effective than individual therapy [15–16].”
BackgroundFarver-Vestergaard, I., Johannesen, G., & ter Beek, L. (2021) · European Respiratory Society eBooks · doi:10.1183/2312508x.10017820 · Cited by 5 · see citing works
Cecil Pak Shun, W. O. N. G., Yeung, J. T. K., Fong, D., Smith, R. D., Ngan, A. H. Y., Lam, Y. Y. L., Chan, K. S. S., Leung, H. H. Y., Wang, M. P., & Wong, J. Y. H. (2024) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2024.2313741 · Cited by 5 · see citing works
“Typically, gCBT is delivered to six to ten participants in a session (Tucker & Oei, 2007), providing direct support and facilitating peer support to expand participants’ social networks and normalize their dysphoric experiences (Huntley et al., 2012; Moore et al., 2017).”
Background
- Authors
- Tucker, M., & Oei, T. P. S.
- Affiliations
- The University of Queensland (AU)
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2007-01
- Volume
- 35
- Issue
- 1
- Pages
- 77-91
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W1899727040
- Cited by
- 154
- References
- 0
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 6 · 2023: 10 · 2022: 9 · 2021: 10 · 2020: 7 · 2019: 7 · 2018: 8 · 2017: 9 · 2016: 13 · 2015: 9 · 2014: 10 · 2013: 13 · 2012: 7
- FWCI
- 13.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- QUT Business School
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- group cognitive behavioral therapy, cost-effectiveness, depression, anxiety disorders, substance abuse, alcoholism, drug addiction, social anxiety disorder, children, cost calculation methods, treatment outcome comparison
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