Group psychological therapies for depression in the community: systematic review and meta-analysis
Open accessAbstract
Background: Psychological therapies have been shown to be effective in the treatment of depression. However, evidence is focused on individually delivered therapies, with less evidence for group-based therapies. Aims: To conduct a systematic review and meta-analysis of the efficacy of group-based psychological therapies for depression in primary care and the community. Method: We searched MEDLINE, Embase, PsycINFO, the Cochrane Central Register of Controlled Trials and the Cochrane Collaboration Depression, Anxiety and Neurosis Review Group database from inception to July 2010. The Cochrane risk of bias methodology was applied. Results: Twenty-three studies were included. The majority showed considerable risk of bias. Analysis of group cognitive–behavioural therapy (CBT) v. usual care alone (14 studies) showed a significant effect in favour of group CBT immediately post-treatment (standardised mean difference (SMD) −0.55 (95% CI −0.78 to −0.32)). There was some evidence of benefit being maintained at short-term (SMD =–0.47 (95% CI −1.06 to 0.12)) and medium- to long-term follow-up (SMD =–0.47 (95% CI – 0.87 to −0.08)). Studies of group CBT v. individually delivered CBT therapy (7 studies) showed a moderate treatment effect in favour of individually delivered CBT immediately post-treatment (SMD = 0.38 (95% CI 0.09–0.66)) but no evidence of difference at short- or medium- to long-term follow-up. Four studies described comparisons for three other types of group psychological therapies. Conclusions: Group CBT confers benefit for individuals who are clinically depressed over that of usual care alone. Individually delivered CBT is more effective than group CBT immediately following treatment but after 3 months there is no evidence of difference. The quality of evidence is poor. Evidence about group psychological therapies not based on CBT is particularly limited.
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?
Group therapy is less effective than individual therapy at the end of treatment and has a higher dropout rate, although no differences were found at follow-up.
“However, group therapy was less effective than individual therapy at the end of treatment and had a higher dropout rate, although no differences were found at follow-up.77”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [77]
The “Group CBT v. individual CBT therapy” section reports better outcomes for individual CBT immediately after treatment and no evidence of a difference at short- or longer-term follow-up. It does not report a higher dropout rate for group therapy; the “Individual CBT v. group CBT” section instead notes that four of seven studies gave no dropout details. The comparison also concerns CBT specifically, rather than group and individual therapy generally. (LLM, conf=0.88)
Experimental — accuracy not yet measuredMeta-analyses concluded that group psychological therapy for depression is more effective than treatment as usual.
“Meta-analyses that evaluated efficacy of group psychological therapy for depression concluded that it is more effective than treatment as usual.77,78”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [77]
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
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Hamilton, M. (1960) · Journal of Neurology, Neurosurgery & Psychiatry · doi:10.1136/jnnp.23.1.56 · Cited by 32,817 · see citing works
Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1. The Cochrane Collaboration
Higgins, J., Green, S. R., & Higgins, J. (2008) · Cited by 5,544 · see citing works
The Theory and Practice of Group Psychotherapy:
Yalom, I. D., & Crouch, E. (1990) · The British Journal of Psychiatry · doi:10.1192/s0007125000062723 · Cited by 4,136 · see citing works
The National Collaborating Centre for Mental Health
Kendall, T., & Pilling, S. (2004) · UCL Discovery (University College London) · Cited by 840 · see citing works
Group Interpersonal Psychotherapy for Depression in Rural Uganda: A Randomized Controlled Trial
Bolton, P., Bass, J., Neugebauer, R., Verdeli, H., Clougherty, K. F., Wickramaratne, P., Speelman, L., Ndogoni, L., & Weissman, M. (2003) · JAMA · doi:10.1001/jama.289.23.3117 · Cited by 655 · cited 1× · see citing works
“186 Araya et al (2003)6 Banken (1993)19 Bolton et al (2003)30 Brown & Lewinsohn (1984)26 Epstein (1986)8 Feldman et al (2009)29 Hamamci (2006)9 Hamdan-Mansour et al (2009)10 Hautzinger & Welz (2004)11 Hegerl et al (2010)12 Lynch et al (2003)28 Nezu (1986)13 Ravindran et al (1999)14 Rehm et al…”
Araya, R., Rojas, G., Fritsch, R., Gaete, J., Rojas, M., Simon, G., & Peters, T. J. (2003) · The Lancet · doi:10.1016/s0140-6736(03)12825-5 · Cited by 450 · see citing works
Self-citationDialectical Behavior Therapy for Depressed Older Adults: A Randomized Pilot Study
Lynch, T. R., Morse, J. Q., Mendelson, T., & Robins, C. J. (2003) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200301000-00006 · Cited by 384 · see citing works
The Theory and Practice of Group Psychotherapy
Gilula, M. F. (1971) · JAMA · doi:10.1001/jama.1971.03180290097037 · Cited by 376 · see citing works
Efficacy of a social problem-solving therapy approach for unipolar depression.
Nezu, A. (1986) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.54.2.196 · Cited by 281 · see citing works
Cuijpers, P., van Straten, A., van Oppen, P., & Andersson, G. (2008) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v69n1102 · Cited by 219 · see citing works
Bass, J., Neugebauer, R., Clougherty, K. F., Verdeli, H., Wickramaratne, P., Ndogoni, L., Speelman, L., Weissman, M., & Bolton, P. (2006) · British Journal of Psychiatry · doi:10.1192/bjp.188.6.567 · Cited by 214 · see citing works
Efficacy of a social problem-solving therapy approach for unipolar depression.
Nezu, A. M. (1986) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.54.2.196 · Cited by 210 · see citing works
Brown, R. A., & Lewinsohn, P. M. (1984) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.52.5.774 · Cited by 202 · see citing works
(2003) · PubMed · Cited by 175 · see citing works
Cuijpers, P., van Straten, A., & Warmerdam, L. (2008) · The European Journal of Psychiatry · doi:10.4321/s0213-61632008000100005 · Cited by 137 · see citing works
Ravindran, A. V., Anisman, H., Merali, Z., Charbonneau, Y., Telner, J. I., Bialik, R. J., Wiens, A., Ellis, J., & Griffiths, J. (1999) · American Journal of Psychiatry · doi:10.1176/ajp.156.10.1608 · Cited by 130 · see citing works
Araya, R., Flynn, T., Rojas, G., Fritsch, R., & Simon, G. (2006) · American Journal of Psychiatry · doi:10.1176/ajp.2006.163.8.1379 · Cited by 128 · see citing works
Self-citationHegerl, U., Hautzinger, M., Mergl, R., Kohnen, R., Schütze, M., Scheunemann, W., Allgaier, A., Coyne, J., & Henkel, V. (2010) · International Journal of Neuropsychopharmacology · doi:10.1017/s1461145709000224 · Cited by 120 · see citing works
Hamdan-Mansour, A. M., Puskar, K., & Bandak, A. G. (2009) · Issues in Mental Health Nursing · doi:10.1080/01612840802694577 · Cited by 105 · see citing works
Group Therapy for Depression: The Coping with Depression Course
Lewinsohn, P. M., Steinmetz, J. L., Antonuccio, D. O., & Teri, L. L. (1984) · International Journal of Mental Health · doi:10.1080/00207411.1984.11448974 · Cited by 99 · see citing works
An Evaluation of Major Components in a Self-Control Therapy Program for Depression
Rehm, L. P., Kornblith, S. J., O’Hara, M. W., Lamparski, D. M., Romano, J. M., & Volkin, J. I. (1981) · Behavior Modification · doi:10.1177/014544558154002 · Cited by 90 · see citing works
Post-traumatic stress disorder and coping in veterans who are seeking medical treatment
Blake, D. D., Cook, J. D., & Keane, T. M. (1992) · Journal of Clinical Psychology · doi:10.1002/1097-4679(199211)48:6 · Cited by 84 · see citing works
Feldman, G., Harley, R., Kerrigan, M., Jacobo, M., & Fava, M. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.01.005 · Cited by 79 · see citing works
Glover, G. R., Webb, M., & Evison, F. (2010) · Durham Research Online (Durham University) · Cited by 79 · see citing works
Durham, T. W. (1982) · Journal of Clinical Psychology · doi:10.1002/1097-4679(198207)38:3 · Cited by 78 · see citing works
Amount of therapist contact and outcome in a multidimensional depression treatment program
Schmidt, M. M., & Miller, W. R. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb00349.x · Cited by 74 · see citing works
Integrating psychodrama and cognitive behavioral therapy to treat moderate depression
Hamamcı, Z. (2006) · The Arts in Psychotherapy · doi:10.1016/j.aip.2006.02.001 · Cited by 72 · see citing works
Wong, D. F. K. (2008) · Depression and Anxiety · doi:10.1002/da.20286 · Cited by 66 · see citing works
Teri, L. L., & Lewinsohn, P. M. (1986) · Behavior Therapy · doi:10.1016/s0005-7894(86)80052-1 · Cited by 64 · see citing works
Wollersheim, J., & Wilson, G. L. (1991) · Professional Psychology Research and Practice · doi:10.1037/0735-7028.22.6.496 · Cited by 56 · see citing works
The efficacy of group and individual cognitive therapy for mild depression
Wierzbicki, M. J., & Bartlett, T. S. (1987) · Cognitive Therapy and Research · doi:10.1007/bf01186284 · Cited by 53 · see citing works
Shaffer, C. S., Shapiro, J., Sank, L. I., & Donovan, D. C. (1981) · Cognitive Therapy and Research · doi:10.1007/bf01172523 · Cited by 45 · see citing works
Wong, D. F. K. (2008) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/00048670802203418 · Cited by 45 · see citing works
Kognitive Verhaltenstherapie bei Depressionen im Alter
Hautzinger, M., & Welz, S. (2004) · Zeitschrift für Gerontologie und Geriatrie (Print) · doi:10.1007/s00391-004-0262-x · Cited by 33 · see citing works
Cost-effectiveness of group psychotherapy for depression in Uganda.
Siskind, D. J., Baingana, F. K., & Kim, J. P. (2008) · PubMed · Cited by 27 · see citing works
Yang, T.-T., Hsiao, F., Wang, K.-C., Ng, S., Ho, R., Chan, C., Lai, Y.-M., & Chen, Y. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181a61594 · Cited by 27 · see citing works
Flagged first, then by citations
Research works printed but not linked: 5
- [8]8. Epstein D. Aerobic activity versus group cognitive therapy: an evaluative study contrasting interventions for the alleviation of clinical depression. Diss Abstr Int 1986; 47: 3952.
- [11]11. Hautzinger M, Welz S. Cognitive behavioral therapy for depressed older outpatients: a controlled randomized, controlled trial. Z Gerontol Geriatr 2004; 37: 427-35.
- [19]19. Banken DM. Group versus Individual Cognitive-Behavioural Treatment for Depression. Dissertation, Washington State University, 1993.
- [21]21. Shapiro J, Sank Li, Shaffer CS, Donovan DC. Cost effectiveness of individual vs. group cognitive behavior therapy for problems of depression and anxiety in an HMO population. J Clin Psychol 1982; 38: 674-7.
- [25]25. Zettle RD, Haflich JL, Reynolds RA. Responsivity to cognitive therapy as a function of treatment format and client personality dimensions. J Clin Psychol 1992; 48: 787-97.
Cited by
Sorted by citations
Otte, C., Gold, S. M., Penninx, B. W., Pariante, C. M., Etkin, A., Fava, M., Mohr, D. C., & Schatzberg, A. F. (2016) · Nature Reviews Disease Primers · doi:10.1038/nrdp.2016.65 · Cited by 2,269 · see citing works
Cuijpers, P., Noma, H., Karyotaki, E., Cipriani, A., & Furukawa, T. A. (2019) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2019.0268 · Cited by 539 · see citing works
van Ginneken, N., Tharyan, P., Lewin, S., Rao, G. N., Meera, S., Pian, J., Chandrashekar, S., & Patel, V. (2013) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd009149.pub2 · Cited by 575 · 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
Linde, K., Sigterman, K., Kriston, L., Rucker, G., Jamil, S., Meissner, K., & Schneider, A. (2015) · The Annals of Family Medicine · doi:10.1370/afm.1719 · Cited by 196 · see citing works
Rahman, A., Khan, M. N., Hamdani, S. U., Chiumento, A., Akhtar, P., Nazir, H., Nisar, A., Masood, A., Din, I. U., Khan, N. A., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(18)32343-2 · Cited by 165 · see citing works
Non-pharmacological treatment of depression: a systematic review and evidence map
Farah, W. H., Alsawas, M., Mainou, M., Alahdab, F., Farah, M. H., Ahmed, A. T., Mohamed, E. A., Almasri, J., Gionfriddo, M. R., Castaneda-Guarderas, A., et al. (2016) · Evidence Based Medicine · doi:10.1136/ebmed-2016-110522 · Cited by 141 · see citing works
van Bronswijk, S., Moopen, N., Beijers, L., Ruhe, H. G., & Peeters, F. (2019) · Psychological Medicine · doi:10.1017/s003329171800199x · Cited by 128 · see citing works
Bryant, R. A., Bawaneh, A., Awwad, M., Al-Hayek, H., Giardinelli, L., Whitney, C., Jordans, M. J. D., Cuijpers, P., Sijbrandij, M., Ventevogel, P., et al. (2022) · PLoS Medicine · doi:10.1371/journal.pmed.1003949 · Cited by 123 · see citing works
“Group-based programs may be more cost-effective than individually administered psychological interventions [57], and when they can be effectively delivered by nonspecialists, this further increases the likelihood that programs such as gPM+ could be implemented in refugee camps in poorly resourced countries [58].”
BackgroundOkumura, Y., & Ichikura, K. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.04.023 · Cited by 86 · see citing works
Verhey, I. J., Ryan, G. K., Scherer, N., & Magidson, J. F. (2020) · International Journal of Mental Health Systems · doi:10.1186/s13033-020-00372-9 · Cited by 63 · see citing works
Linde, K., Rücker, G., Sigterman, K., Jamil, S., Meissner, K., Schneider, A., & Kriston, L. (2015) · BMC Family Practice · doi:10.1186/s12875-015-0314-x · Cited by 56 · see citing works
“We searched trial registries for unpublished and ongoing studies, and screened published systematic reviews focusing on primary care studies on depression treatments [16–19] for additional trials.”
MethodNakimuli-Mpungu, E., Okello, J., Kinyanda, E., Alderman, S., Nakku, J., Alderman, J. S., Pavia, A., Adaku, A., Allden, K., & Musisi, S. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2013.05.055 · Cited by 31 · see citing works
Kunorubwe, T. (2023) · The Cognitive Behaviour Therapist · doi:10.1017/s1754470x23000302 · Cited by 15 · see citing works
Morris, L., Mansell, W., Emsley, R., Bates, R., Comiskey, J., Pistorius, E., & McEvoy, P. (2016) · Psychology and Psychotherapy: Theory, Research and Practice · doi:10.1111/papt.12070 · Cited by 14 · see citing works
Barua, U., Ahrens, J., Shao, R., MacKenzie, H., Wolfe, D., Sequeira, K., Teasell, R., Loh, E., & Mehta, S. (2024) · Brain Injury · doi:10.1080/02699052.2024.2309264 · Cited by 12 · see citing works
Outcomes of a 6-week cognitive–behavioral and mindfulness group intervention in primary care.
Craner, J. R., Sawchuk, C. N., & Smyth, K. T. (2016) · Families, Systems, & Health · doi:10.1037/fsh0000202 · Cited by 5 · see citing works
Denial Predicts Outcome in Anxiety Following Group Cognitive Behavioral Therapy.
Oei, T.-P. S., Strodl, E., Pang, J., & Cui, L. (2013) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.27.4.370 · Cited by 4 · see citing works
- Authors
- Huntley, A. L., Araya, R., & Salisbury, C.
- Affiliations
- University of Bristol (GB)
- Corresponding author
- Araya, Ricardo
- Salisbury, Chris
- Venue
- British Journal of Psychiatry
- Publisher
- Royal College of Psychiatrists
- Published
- 2012-03
- Volume
- 200
- Issue
- 3
- Pages
- 184-190
- ISSN
- 0007-1250 (ISSN-L)
- 1472-1465
- OpenAlex
- W2160954552
- Semantic Scholar
- 5ce4d8a9a5da0d9b6d6425ae8c47d15e326b3a94
- Cited by
- 132
- References
- 37
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 7 · 2023: 9 · 2022: 8 · 2021: 16 · 2020: 10 · 2019: 11 · 2018: 10 · 2017: 13 · 2016: 10 · 2015: 8 · 2014: 7 · 2013: 9 · 2012: 4
- FWCI
- 1.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The British Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Bristol Research (University of Bristol) (submittedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- depression, group cognitive behavioral therapy, primary care, community mental health, treatment efficacy, usual care comparison, long-term follow-up
- MeSH terms
- Community Mental Health Services, Cost-Benefit Analysis, Depression, Humans, Primary Health Care, Psychiatric Status Rating Scales, Psychotherapy, Group, Cognitive Behavioral Therapy, Bias, Randomized Controlled Trials as Topic, Treatment Outcome
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
