An evaluation of large group cognitive behaviour therapy with mindfulness (CBTm) classes
Open accessAbstract
BACKGROUND: Ensuring equitable and timely access to Cognitive Behaviour Therapy (CBT) is challenging within Canada's service delivery model. The current study aims to determine acceptability and effectiveness of 4-session, large, Cognitive Behaviour Therapy with Mindfulness (CBTm) classes. METHODS: A retrospective chart review of adult outpatients (n = 523) who attended CBTm classes from 2015 to 2016. Classes were administered in a tertiary mental health clinic in Winnipeg, Canada and averaged 24 clients per session. Primary outcomes were (a) acceptability of the classes and retention rates and (b) changes in anxiety and depressive symptoms using Generalized Anxiety Disorder 7-item (GAD-7) and Patient Health Questionnaire 9-item (PHQ-9) scales. RESULTS: Clients found classes useful and > 90% expressed a desire to attend future sessions. The dropout rate was 37.5%. A mixed-effects linear regression demonstrated classes improved anxiety symptoms (GAD-7 score change per class = - 0.52 [95%CI, - 0.74 to - 0.30], P < 0.001) and depressive symptoms (PHQ-9 score change per class = - 0.65 [95%CI, - 0.89 to - 0.40], P < 0.001). Secondary analysis found reduction in scores between baseline and follow-up to be 2.40 and 1.98 for the GAD-7 and PHQ-9, respectively. Effect sizes were small for all analyses. CONCLUSIONS: This study offers preliminary evidence suggesting CBTm classes are an acceptable strategy to facilitate access and to engage and maintain clients' interest in pursuing CBT. Clients attending CBTm classes experienced improvements in anxiety and depressive symptoms. Symptom improvement was not clinically significant. Study limitations, such as a lack of control group, should be addressed in future research.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Extant research suggests that mindfulness can have positive effects when practiced for 10 minutes daily, but shorter periods can also be associated with benefits.
“It should be noted that the extant research suggests that mindfulness can have positive effects when practiced for 10 minutes daily, but shorter periods can also be associated with benefits [39-41].”
From Web-Based Mindfulness Meditation as an Adjunct to Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Feasibility Evaluation Study (2024) · cites this paper as [39]
The Methods > Intervention section says clients were encouraged to practice mindfulness for five minutes twice a day, totaling 10 minutes daily. The Discussion reports possible improvements in anxiety and depressive symptoms from the combined CBT-and-mindfulness classes, but does not isolate the effect of mindfulness practice or report benefits from less than 10 minutes daily. (LLM, conf=0.83)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
The PHQ-9: Validity of a brief depression severity measure
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001) · Journal of General Internal Medicine · doi:10.1046/j.1525-1497.2001.016009606.x · Cited by 44,910 · see citing works
A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006) · Archives of Internal Medicine · doi:10.1001/archinte.166.10.1092 · Cited by 31,765 · see citing works
Mindfulness-based interventions in context: Past, present, and future
Kabat-Zinn, J. (2003) · Clinical Psychology: Science and Practice · doi:10.1093/clipsy.bpg016 · Cited by 8,615 · see citing works
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2003) · JAMA · doi:10.1001/jama.289.23.3095 · Cited by 7,988 · see citing works
Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008) · Medical Care · doi:10.1097/mlr.0b013e318160d093 · Cited by 4,527 · see citing works
Kabat-Zinn, J. (1982) · General Hospital Psychiatry · doi:10.1016/0163-8343(82)90026-3 · Cited by 4,255 · see citing works
The effect of mindfulness based therapy on anxiety and depression: A meta analytic review
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0018555 · Cited by 3,846 · see citing works
(2001) · Cited by 3,666 · see citing works
New Effect Size Rules of Thumb
Sawilowsky, S. S. (2009) · Journal of Modern Applied Statistical Methods · doi:10.22237/jmasm/1257035100 · Cited by 3,254 · see citing works
The empirical status of cognitive-behavioral therapy: A review of meta-analyses
Butler, A. C., Chapman, J. E., Forman, E. M., & Beck, A. T. (2006) · Clinical Psychology Review · doi:10.1016/j.cpr.2005.07.003 · Cited by 3,215 · see citing works
(2011) · Cited by 2,032 · see citing works
Chiesa, A., & Serretti, A. (2009) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2008.0495 · Cited by 1,681 · see citing works
Treatment gap in mental health care.
Abramowitz, M. Z., Greenberg, D., & Levav, I. (2008) · PubMed · Cited by 1,482 · see citing works
Cost of Lost Productive Work Time Among US Workers With Depression
Stewart, W. F. (2003) · JAMA · doi:10.1001/jama.289.23.3135 · Cited by 1,421 · see citing works
Hoffman, S. G., & Smits, J. A. J. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n0415 · Cited by 1,420 · see citing works
The treatment gap in mental health care.
(2004) · Europe PMC (PubMed Central) · Cited by 1,419 · see citing works
Mindfulness-Based Cognitive Therapy for Depression: A New Approach to Preventing Relapse
Hodo, D. W. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.7.1257 · Cited by 1,405 · see citing works
Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population
Martin, A., Rief, W., Klaiberg, A., & Braehler, E. (2006) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2005.07.003 · Cited by 1,379 · see citing works
Monitoring Depression Treatment Outcomes With the Patient Health Questionnaire-9
L??we, B., Un??tzer, J., Callahan, C. M., Perkins, A. J., & Kroenke, K. (2004) · Medical Care · doi:10.1097/00005650-200412000-00006 · Cited by 1,354 · see citing works
A meta-analysis of psychotherapy dropout
Wierzbicki, M., & Pekarik, G. (1993) · Professional Psychology: Research and Practice · doi:10.1037/0735-7028.24.2.190 · Cited by 1,118 · see citing works
Katzman, M. A., Bleau, P., Blier, P., Chokka, P., Kjernisted, K., Van Ameringen, M., & the Canadian Anxiety Guidelines Initiative Group on behalf of the Anxiety Disorders Association of Canada/Association Canadienne des troubles anxieux and McGill University (2014) · BMC Psychiatry · doi:10.1186/1471-244x-14-s1-s1 · Cited by 1,090 · see citing works
Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013) · The Canadian Journal of Psychiatry · doi:10.1177/070674371305800702 · Cited by 1,066 · see citing works
(1968) · Clinical Pharmacology & Therapeutics · doi:10.1002/cpt196896815 · Cited by 828 · see citing works
Professional Psychology: Research and Practice
Roberts, M. C., & Canter, K. S. (2015) · The Encyclopedia of Clinical Psychology · doi:10.1002/9781118625392.wbecp256 · Cited by 757 · see citing works
Mindfulness-Based Interventions for Anxiety and Depression
Hofmann, S. G., & Gómez, A. F. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.08.008 · Cited by 756 · see citing works
Generalized anxiety disorder: prevalence, burden, and cost to society
Wittchen, H.-U. (2002) · Depression and Anxiety · doi:10.1002/da.10065 · Cited by 733 · see citing works
Parikh, S. V., Quilty, L. C., Ravitz, P., Rosenbluth, M., Pavlova, B., Grigoriadis, S., Velyvis, V., Kennedy, S. H., Lam, R. W., MacQueen, G. M., et al. (2016) · The Canadian Journal of Psychiatry · doi:10.1177/0706743716659418 · Cited by 562 · see citing works
Self-citationMindfulness-based cognitive therapy for generalized anxiety disorder
Evans, S., Ferrando, S., Findler, M., Stowell, C., Smart, C., & Haglin, D. (2008) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2007.07.005 · Cited by 559 · see citing works
Meta-analysis of dropout from cognitive behavioral therapy: Magnitude, timing, and moderators.
Fernandez, E., Salem, D., Swift, J. K., & Ramtahal, N. (2015) · Journal of Consulting and Clinical Psychology · doi:10.1037/ccp0000044 · Cited by 551 · see citing works
Evans, C., Margison, F., & Barkham, M. (1998) · Evidence-Based Mental Health · doi:10.1136/ebmh.1.3.70 · Cited by 483 · see citing works
Anxiety disorders in adolescents and psychosocial outcomes at age 30
Essau, C. A., Lewinsohn, P. M., Olaya, B., & Seeley, J. R. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.12.033 · Cited by 384 · see citing works
The Epidemiology of Major Depressive Disorder
Kessler, R. C., Berglund, P. A., Jin, R., Merikangas, K. R., Rush, A. J., Walters, E. E., & Wang, P. S. (2009) · Cited by 288 · see citing works
Mindfulness-Based Cognitive Therapy: Theory and Practice
Sipe, W. E. B., & Eisendrath, S. J. (2012) · The Canadian Journal of Psychiatry · doi:10.1177/070674371205700202 · Cited by 285 · see citing works
Defining successful treatment outcome in depression using the PHQ-9: A comparison of methods
McMillan, D., Gilbody, S., & Richards, D. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.04.030 · Cited by 247 · see citing works
Unmet Need for Treatment of Major Depression in the United States
Mojtabai, R. (2009) · Psychiatric Services · doi:10.1176/ps.2009.60.3.297 · Cited by 200 · see citing works
Plaisier, I., Beekman, A. T. F., de Graaf, R., Smit, J. H., van Dyck, R., & Penninx, B. W. J. H. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.01.072 · Cited by 156 · see citing works
Early changes, attrition, and dose–response in low intensity psychological interventions
Delgadillo, J., McMillan, D., Lucock, M. P., Leach, C., Ali, S., & Gilbody, S. M. (2013) · British Journal of Clinical Psychology · doi:10.1111/bjc.12031 · Cited by 124 · see citing works
Delgadillo, J., Asaria, M., Ali, S., & Gilbody, S. M. (2016) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.115.171017 · Cited by 100 · see citing works
Toward a brain theory of meditation
Raffone, A., Marzetti, L., Gratta, C. D., Perrucci, M. G., Romani, G. L., & Pizzella, V. (2019) · Progress in brain research · doi:10.1016/bs.pbr.2018.10.028 · Cited by 92 · see citing works
Horrell, L., Goldsmith, K. A., Tylee, A. T., Schmidt, U. H., Murphy, C. L., Bonin, E.-M., Beecham, J., Kelly, J., Raikundalia, S., & Brown, J. S. L. (2014) · British Journal of Psychiatry · doi:10.1192/bjp.bp.112.121855 · Cited by 68 · see citing works
Major Depression and its Association with Long-Term Medical Conditions
Gagnon, L. M., & Patten, S. B. (2002) · The Canadian Journal of Psychiatry · doi:10.1177/070674370204700204 · Cited by 65 · see citing works
Anxiety Disorders and General Medical Conditions: Current Research and Future Directions
Aquin, J. P., El-Gabalawy, R. M., Sala, T., & Sareen, J. (2017) · FOCUS The Journal of Lifelong Learning in Psychiatry · doi:10.1176/appi.focus.20160044 · Cited by 62 · see citing works
Self-citationFirth, N., Barkham, M., Kellett, S., & Saxon, D. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.04.001 · Cited by 57 · see citing works
Report summary – Mood and Anxiety Disorders in Canada, 2016
McRae, L., O’Donnell, S. C., Loukine, L., Rancourt, N., & Pelletier, C. (2016) · Health Promotion and Chronic Disease Prevention in Canada · doi:10.24095/hpcdp.36.12.05 · Cited by 48 · see citing works
Delgadillo, J., Kellett, S., Ali, S., McMillan, D., Barkham, M., Saxon, D. H., Donohoe, G., Stonebank, H., Mullaney, S., Eschoe, P., et al. (2016) · Behaviour Research and Therapy · doi:10.1016/j.brat.2016.09.010 · Cited by 42 · see citing works
Payne, K. A., & Myhr, G. (2010) · Healthcare policy · doi:10.12927/hcpol.2013.21647 · Cited by 28 · see citing works
Burns, P., Kellett, S., & Donohoe, G. (2016) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465815000491 · Cited by 20 · see citing works
Alive and well: geriatric medicine in the U.K. in 1984
Coni, N. (1985) · Health Policy · doi:10.1016/0168-8510(85)90084-3 · Cited by 5 · see citing works
Feasibility of large group cognitive behavioural therapy education classes for anxiety disorders
Palay, J., Wong, J. Y., Randall, J. R., Sala, T., Bolton, J. M., Furer, P., Bolton, J. M., Whitney, D., Thakur, V. K., Parikh, S. V., et al. (2018) · European Journal for Person Centered Healthcare · doi:10.5750/ejpch.v6i2.1454 · Cited by 5 · see citing works
Self-citationImproving Access to Psychosocial Treatments—Integrating Patient, Provider, and Systems Approaches
Parikh, S. V. (2015) · The Canadian Journal of Psychiatry · doi:10.1177/070674371506000602 · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Association of serum oleic acid level with depression in American adults: a cross-sectional study
Yin, J., Li, S., Li, J., Gong, R., Jia, Z., Liu, J., Jin, Z., Yang, J., & Liu, Y. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05271-0 · Cited by 12 · see citing works
Landry, C. A., McCall, H. C., Beahm, J. D., Titov, N., Dear, B., Carleton, R. N., & Hadjistavropoulos, H. D. (2024) · JMIR Formative Research · doi:10.2196/54132 · Cited by 6 · see citing works
“…the CBT skills taught in that lesson and was based on evidence of successful implementation in other programs [22,36-39]: Each mindfulness meditation was audio-recorded by a voice actor and was designed to be approximately 10 minutes long, consistent with previous recommendations [39-41].”
BackgroundMethodLandry, C. A., McCall, H. C., Beahm, J. D., Titov, N., Dear, B., Carleton, R. N., & Hadjistavropoulos, H. D. (2023) · doi:10.2196/preprints.54132 · Cited by 6 · see citing works
Riddell, J. K., Neufeld, D. C., Kinley, J., Davidson, D., Mota, N. P., Unger, J. A., Henriksen, C., Conway, T., Jetté, J., & Jiang, D. (2025) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2025.2454677 · Cited by 4 · see citing works
Self-citationDavidson, D., Kinley, J., Wong, J. Y., Whitney, D., Thakur, V. K., Palay, J., & Sareen, J. (2021) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-021-00414-2 · Cited by 2 · see citing works
Self-citationMotivational Interviewing Enhances Group Cognitive Behavioral Therapy for Anxiety Disorders
Strodl, E. S., & Yang, J. (2021) · Journal of Cognitive Psychotherapy · doi:10.1891/jcpsy-d-20-00025 · Cited by 3 · see citing works
Yin, J., Li, S., Li, J., Gong, R., Jia, Z., Liu, J., Jin, Z., Yang, J., & Liu, Y. (2023) · Figshare · doi:10.6084/m9.figshare.24580428
Garg, B., Bolton, S.-L., Muthumuni, N., Perera, E., Sareen, J., Sala, T., & Mota, N. P. (2026) · JMIR Formative Research · doi:10.2196/59700
Self-citation
- Authors
- Thakur, V. K., Wong, J. Y., Randall, J. R., Bolton, J. M., Parikh, S. V., Mota, N., Whitney, D., Palay, J., Kinley, J., Diocee, S., Sala, T., & Sareen, J.
- Affiliations
- University of Manitoba (CA)
- University of Alberta (CA)
- University of Michigan (US)
- Corresponding author
- Sareen, Jitender
- ORCID
- Venue
- BMC Psychiatry
- Published
- 2019-05-03
- Volume
- 19
- Issue
- 1
- Pages
- 132-132
- ISSN
- 1471-244X (ISSN-L)
- PMC
- PMC6498513
- OpenAlex
- W2947418143
- Cited by
- 7
- References
- 50
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 2 · 2021: 2
- FWCI
- 0.58
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Psychiatry (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Mspace (University of Manitoba) (submittedVersion)
- Funders
- Canadian Institutes of Health Research (333252)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- group therapy, access to mental health care, acceptability, treatment retention, dropout, anxiety symptoms, depressive symptoms, outpatients, GAD-7, PHQ-9
- MeSH terms
- Adult, Anxiety Disorders, Canada, Depressive Disorder, Female, Humans, Male, Outpatients, Retrospective Studies, Cognitive Behavioral Therapy, Treatment Outcome, Mindfulness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
