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An evaluation of group cognitive behaviour therapy for low self-esteem in primary care

Published online by Cambridge University Press:  13 May 2014

Stuart Pack*
Affiliation:
Oxleas NHS Foundation Trust, Greenwich Time to Talk, Eltham, London, UK
Emma Condren
Affiliation:
Oxleas NHS Foundation Trust, Greenwich Time to Talk, Eltham, London, UK
*
*Author for correspondence: Mr S. Pack, Oxleas NHS Foundation Trust, Greenwich Time to Talk, 135 Eltham High Street, Eltham London SE9 1TQ, UK ([email protected]).

Abstract

Low self-esteem is widely acknowledged to be associated with the phenomenology of a number of mental health diagnoses, including those which are treated under the umbrella of Improving Access to Psychological Therapies (IAPT) services. To evaluate the effectiveness of group Cognitive Behaviour Therapy (CBT) based on the work of Fennell in treating low self-esteem 50 participants attended a 10-week group programme. Pre- and post-group measures of depression, anxiety and self-esteem were compared using Mann–Whitney U tests. The results indicated that there was a statistically significant and clinically meaningful change across all pre- and post-group measures. Mean post-group measures indicated levels of depression and anxiety which were below caseness and a healthy level of self-esteem. Results indicated that gains were well maintained at 3-month follow-up. The results from this study highlight the effectiveness of group CBT for low self-esteem and thus contribute to the limited evidence base in this area. Results are discussed with consideration of the existing evidence base, implications for clinical practice, and future research.

Type
Practice article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2014 

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References

Recommended follow-up reading

Fennell, M (1997). Low self-esteem: a cognitive perspective. Behavioural and Cognitive Psychotherapy 25, 125.CrossRefGoogle Scholar
Fennell, M (1999). Overcoming Low Self-esteem. London: Constable & Robinson Ltd.Google Scholar
Lim, L, Saulsman, L, Nathan, P (2005). Improving Self-Esteem. Perth, Western Australia: Centre for Clinical Interventions.Google Scholar

References

Beck, AT (1967). Depression: Clinical, Experimental and Theoretical Aspects. New York: Harper & Row.Google Scholar
Beck, AT (1976). Cognitive Therapy and the Emotional Disorders. New York: Penguin Books Ltd.Google Scholar
Covin, R, Ouimet, AJ, Seeds, PM, Dozois, DJ (2008). A meta-analysis of CBT for pathological worry among clients with GAD. Journal of Anxiety Disorders 22, 108116.Google Scholar
Department of Health (2001). Treatment choice in psychological therapies and counselling: evidence-based clinical practice guideline. London: Stationery Office.Google Scholar
Feinstein, L (2000). The relative economic importance of academic, psychological and behavioural attributes developed in childhood. London, Centre for Economic Performance London School of Economics and Political Science.Google Scholar
Fennell, M (1997). Low self-esteem: a cognitive perspective. Behavioural and Cognitive Psychotherapy 25, 125.Google Scholar
Fennell, M (1998). Cognitive therapy in the treatment of low self-esteem. Advances in Psychiatric Treatment 4, 296304.Google Scholar
Fennell, M (1999). Overcoming Low Self-esteem. London: Constable & Robinson Ltd.Google Scholar
Fennell, M (2004). Depression, low self-esteem and mindfulness. Behaviour Research and Therapy 42, 10531067.CrossRefGoogle ScholarPubMed
Gaffan, EA, Tsaousis, I, Kemp-Wheeler, SM (1995). Researcher allegiance and meta-analysis: the case of cognitive therapy for depression. Journal of Consulting and Clinical Psychiatry 63, 966980.CrossRefGoogle ScholarPubMed
Gorey, KM, Cryns, AG (1991). Group work as interventive modality with the older depressed client: a meta-analytic review. Journal of Gerontological Social Work 16, 137157.CrossRefGoogle Scholar
Gould, RA, Otto, MW, Pollack, MH (1997). Cognitive behavioral and pharmacological treatment of generalized anxiety disorder: a preliminary meta-analysis. Behaviour Therapy 28, 285305.Google Scholar
Hewitt, JP (2009). Oxford Handbook of Positive Psychology. Oxford: Oxford University Press.Google Scholar
Hunot, V, Churchill, R, Silva de Lima, M (2007). Psychological Therapies for Generalised Anxiety Disorder. Chichester, UK: John Wiley & Sons, Ltd.CrossRefGoogle ScholarPubMed
Kroenke, K, Spitzer, RL, Williams, JBW (2001). The PHQ-9: Validity of a brief depression severity measure. Journal of General Internal Medicine 16, 606613.Google Scholar
Kung, S, Alarcon, RD, Williams, MD, Poppe, KA, Moore, MJ, Frye, MA (2013). Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ-9) depression measures in an integrated mood disorders practice. Journal of Affective Disorders 145, 341343.Google Scholar
Lim, L, Saulsman, L, Nathan, P (2005). Improving Self-Esteem. Perth, Western Australia: Centre for Clinical Interventions.Google Scholar
Makikangas, A, Kinnuen, U (2003). Psychosocial work stressors and well-being: self-esteem and optimism as moderators in a one-year longitudinal sample. Personality and Individual Differences 35, 537557.CrossRefGoogle Scholar
McManus, F, Waite, P, Shafran, R (2009). Cognitive-behaviour therapy for low self-esteem: a case example. Cognitive and Behavioural Practice 16, 266275.CrossRefGoogle Scholar
Morton, L, Roach, L, Reid, H, Stewart, SH (2011). An evaluation of a CBT group for women with low self-esteem. Behavioural and Cognitive Psychotherapy 40, 221225.Google Scholar
National IAPT Programme Team (2010). The IAPT Data Handbook. Guidance on Recording and Monitoring Outcomes to Support Local Evidence-based Practice. London: National IAPT Programme Team Mental Health.Google Scholar
NICE (2005). Obsessive-compulsive disorder: core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. London: National Institute for Health and Clinical Excellence.Google Scholar
NICE (2009). Depression in adults with a chronic physical health problem. London: National Institute for Health and Clinical Excellence.Google Scholar
NICE (2010). Depression: the NICE guideline on the treatment and management of depression in adults (updated edition). London: The British Psychological Society & The Royal College of Psychiatrists.Google Scholar
Rigby, L, Waite, S (2006). Group therapy for self-esteem, using creative approaches and metaphor as clinical tools. Behavioural and Cognitive Psychotherapy 35, 361364.Google Scholar
Robinson, JP, Wrightsman, LS, Andrews, FM (eds) (1991). Measures of Personality and Social Psychological Attitudes. London: Elsevier.Google Scholar
Robinson, LA, Berman, JS, Neimeyer, RA (1990). Psychotherapy for the treatment of depression: a comprehensive review of controlled outcome research. Psychological Bulletin 108, 3049.CrossRefGoogle ScholarPubMed
Roth, A, Fonagy, P (1996). What Works for Whom? New York: Guilford.Google Scholar
Rosenberg, M (1965). Society and the Adolescent Self-image. Princeton, N.J: Princeton University Press.Google Scholar
Rosenberg, M (1989). Society and the Adolescent Self-Image (revised edition). Middletown, CT: Wesleyan University Press.Google Scholar
Scogin, F, McElreath, L (1994). Efficacy of psychosocial treatments for geriatric depression: a quantitative review. Journal of Consulting and Clinical Psychology 62, 6974.CrossRefGoogle ScholarPubMed
Spitzer, R, Kroenke, K, Williams, J (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. Journal of the American Medical Association 282, 17371744.Google Scholar
Spitzer, RL, Kroenke, K, Williams, JBW, Löwe, B (2006). A brief measure for assessing generalised anxiety disorder: The GAD-7. Archives of Internal Medicine 166, 10921097.Google Scholar
Stuart, S, Bowers, WA (1995). Cognitive therapy with inpatients: review and meta-analysis. Journal of Cognitive Psychotherapy 9, 8592.Google Scholar
Waite, P, McManus, F, Shafran, R (2012). Cognitive behaviour therapy for low self-esteem: A preliminary randomized controlled trial in a primary care setting. Journal of Behavior Therapy and Experimental Psychiatry 43, 10491057.Google Scholar
Westen, D, Morrison, KA (2001). Multidimensional meta-analysis of treatments for depression, panic and generalized anxiety disorder: an empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology 69, 875889.CrossRefGoogle ScholarPubMed
Whitfield, G, Williams, C (2003). The evidence base for cognitive-behavioural therapy in depression: delivery in busy clinical settings. Advances in Psychiatric Treatment 9, 2130.CrossRefGoogle Scholar
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