Cognitive Behavioral Therapy-Based Group Counseling

Study Overview
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Brief Summary
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The university environment presents a valuable opportunity to reach the young population of society, which has a high risk of depression, and to provide protective mental-health services. This study aimed to evaluate the effectiveness of cognitive behavioral therapy-based group counseling focused on the depressive symptoms, anxiety levels, automatic thoughts, and coping ways among undergraduate nursing students with mild to moderate depressive symptoms.

Detailed Description
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This study aimed to evaluate the effectiveness of cognitive behavioral therapy-based group counseling focused on the depressive symptoms, anxiety levels, automatic thoughts, and coping ways among undergraduate nursing students with mild to moderate depressive symptoms. The study was completed with a total of 63 participants (n=31 for the intervention group and n=32 for the control group) in the 2017-2018 academic year. The effect of the intervention was evaluated with the Beck Depression Inventory, Beck Anxiety Inventory, Automatic Thoughts Questionnaire, and Ways of Coping Questionnaire. The measurements were taken 3 times: pre-test, post-test, and 2-months post-test.

Official Title
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Controlled, Randomized, Cognitive Behavioral Therapy-Based Group Counseling for Nursing Students With Depressive Symptoms

Conditions
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Depression Moderate, Depression Mild

Intervention / Treatment
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* Behavioral: Cognitive Behavioral Therapy-Based Group Counseling


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Having mild depressive symptoms according to the BDI Having moderate depressive symptoms according to the BDI Being native speakers of Turkish Agreeing to participate in the entire intervention process Exclusion Criteria: Having substance abuse Having another psychiatric diagnosis Using psychotropic drugs Receiving other counseling or therapy

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study used a randomized control clinical trial design. In the BDI pre-test, 80 of the students with mild or moderate depressive symptoms met the other inclusion criteria of the study and volunteered to participate in the study. Out of 80 participants, 40 were randomly assigned to the intervention group and 40 to the control group using computer-generated random number sequences. The study was completed with a total of 63 participants (n=31 for the intervention group; n=32 for the control group). While CBT-based group counseling was given to the intervention group, no counseling was given to the control group during the study. The participants were evaluated at three time points: at screening (pre-test), six weeks after screening (post-intervention/post-test), and two months after the post-test. The measurements were taken simultaneously in the intervention and control groups.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Cognitive Behavioral Therapy-Based Group Counseling<br>The CBT-based group counseling provided to the intervention group was carried out as a group intervention with structured sessions in which various techniques and methods of CBT, having mainly educational content, were applied, including an experiential interaction process. The counseling was performed in a total of six 60- to 90-minute sessions, comprising one session per week for four groups consisting of six to 10 members each. | Behavioral: Cognitive Behavioral Therapy-Based Group Counseling<br>* Relaxation techniques Providing personal development books Sharing the factors affecting the situation defined as depression (brainstorming) Explaining the link between depressive symptoms, thoughts, feelings, and behaviors Explaining automatic thoughts Application of relaxation techniques; deep-breathing exercises Identifying alternative thoughts Explaining the correlation between alternative thoughts and mood Introduction of the Automatic-Thought Registration Form and distribution to students Describing the effects of depression on social interaction Explaining activities that could be done individually and with the group Distribution of the activity list to students Description of ways of coping with stress Determination of individual stressors and their effects Planning for the future: preventing depression Discussion of assumptions/expectations about life Homeworks related to session contents<br>|
| No Intervention: Control group<br>No counseling was given to the control group during the study. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Beck Depression Inventory (BDI) | It measures the risk level of depression. It has 21 items. Each item is scored 0-3 points and the total score ranges from 0-63 (0-9=no; 10-16= mild; 17-20= moderate; 21-26=high; 27 or more points severe depressive symptoms) | Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline) | 
| Beck Anxiety Inventory (BAI) | This self-assessment scale determines anxiety level. It consists of 21 items. Each item is scored 0-3 points and the total score ranges from 0-63. As the total score increases, the anxiety level increases. | Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline) | 
| Automatic Thoughts Questionnaire (ATQ) | It measures the thought patterns and negative self-assessments commonly seen in depression. It consists of 30 items. Each item is scored 1-5 points and the total score ranges from 30-150 points. A high score indicates that the frequency of automatic thoughts related to depression is high. | Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline) | 
| Ways of Coping Questionnaire (WCQ) | It measures the thought patterns and negative self-assessments commonly seen in depression. It consists of 30 items. Each item is scored 1-5 points and the total score ranges from 30-150 points. A high score indicates that the frequency of automatic thoughts related to depression is high. | Change from baseline to 6 weeks (also assessed at 14 weeks post-baseline) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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depression, cognitive behavioral therapy, group counseling, nursing students