Unwanted effects within a cognitive behavioral therapy group in comparison with a recreational group - A cluster-randomized controlled trial

Abstract

Background: Group interventions can have negative effects for patients with anxiety disorders. Stimuli which provoke side effects may be the group setting, the content, or the interaction between the participants in the group. This study is the first to report negative effects from a cognitive behavioral group intervention, in comparison with an unspecific, recreational group for anxiety patients. Subjects and methods: 107 patients with work-related anxiety disorders were randomized to either a cognitive behavioral group therapy (work-coping group WG) or an unspecific group encounter aimed at increasing recreational activities (recreational group RG). Patients completed the Unwanted Events in Group Therapy Scale (UE-G scale). Results: In the work-coping group, 41.9% of the patients reported at least one relevant side effect, as compared to 28.9% in the recreational group. These included an increase in the perception of anxiety and work-problems, feelings of exposure to criticism and the development of negative views on group therapy as such. Conclusions: This is the first randomized, controlled, therapy study in anxiety patients to systematically investigate side effects. Work-coping group interventions have, despite their useful main effects, specific negative effects, when compared with group encounters. Group psychotherapists or group moderators should be aware of the potential side effects in anxiety patients.