難治型憂鬱症患者認知行為團體治療成效之前趨研究

A Pilot Study of the Efficacy of A Cognitive Behavioral Therapy Group for Patients with Treatment-resistant Depression

Medication and non-medication treatments are equally important for patients with chronic major depression. However, there is lacking of studies related to group-based cognitive behavioral therapy (CBT-G) for these patients. Purpose: The study used the 11 therapeutic factors of Yalom's group intervention model as the analytical tool to explore the short-term effects of the CBT-G among clinical patients with treatment-resistant depression (TRD). Method: All the participants with the diagnosis of TRD were referred to this study. Twenty-five patients with TRD were designated into one of four CBT-G groups. Each group lasted for 6 to 8 weeks and two-hour long per week. In order to promote mood stability and activity participation, the weekly themes were designed to facilitate discussion, including self-awareness of mental distress, stress management, and community reintegration. The group process was transcribed with verbatim for stepwise content analysis based on the Yalom's model. The basic units and main themes were identified. Results: The findings were categorized into four main themes that reflected the concerns or effects of the participants, including reasons and recent conditions of the mental illnesses, specific illness-related concerns for sharing, self-evaluation or awareness, and Yalom's therapeutic factors existent of these participants. Most common therapeutic factors were found to be instilling hope, universality, information transmission (both instructions and advice), and being altruistic. The majority of the participants developed an improved interpersonal skills though thought changes, awareness of the mood thermometer, and stress-management concept reflection. The participants also increased problem-solving abilities through interpersonal learning, which facilitated their recovery potentials. Conclusion: The short-term supportive cognitive behavioral therapeutic group could benefit patients with TRD to enhance self-care and recovery. The long-term effectiveness of CBT-G is suggested to be researched in future studies.