University of Manchester, School of Psychological Sciences, Manchester, UK.
Clin Psychol Psychother. 2018 Sep;25(5):730-744. doi: 10.1002/cpp.2303. Epub 2018 Jun 26.
Despite the promising effectiveness findings for transdiagnostic groups, studies have not explored clients' experiences. There is a risk that clients could perceive that the content of transdiagnostic groups is not sufficiently tailored to their specific problems. Our aims were to examine whether a brief transdiagnostic group, the Take Control Course (TCC), was acceptable to participants and to explore participants' perceptions of psychological change.
Qualitative data were collected via 12 semistructured, in-depth interviews. Data collection and thematic analysis were concurrent and iterative.
Three superordinate themes were identified: "Style and format," "Control and flexibility," and "Change." The flexible group format was appreciated, as participants felt able to engage at their own pace and adapt relevant aspects. Greater clarity regarding what was within participants' control reduced distress and enabled effective pursuit of valued goals. Participants described significant (predominantly gradual) changes, including substantial improvements within relationships.
The transdiagnostic format did not prevent participants experiencing the TCC as individually relevant. The flexibility and consistent theoretical framework seemed to contribute to this. The results indicated that greater consideration of control and mindfulness allowed greater cognitive flexibility, an ability to reprioritize and let go of unhelpful habits, which better enabled participants to meet their goals. Implications for group therapy include (a) clearly explaining the format of such groups to clients and (b) providing flexibility in the way the group is delivered where possible. Additional qualitative studies of transdiagnostic groups are required to establish if themes generalize to other transdiagnostic groups.
尽管针对共病群组的治疗效果令人期待，但目前的研究尚未探讨患者的体验。患者可能会认为共病群组的内容没有充分针对他们的特定问题，从而存在风险。本研究旨在考察简短的共病群组治疗——掌控课程（Take Control Course，TCC）是否能被患者接受，并探讨患者对心理变化的感知。
采用 12 次半结构化深入访谈收集定性数据。数据收集和主题分析同时进行并相互迭代。
确定了三个上位主题：“风格和形式”“控制与灵活性”和“变化”。灵活的群组格式受到赞赏，因为参与者感到能够按照自己的节奏参与并适应相关方面。对自身控制范围内的内容有更清晰的认识，可以减轻痛苦并使人们能够有效地追求有价值的目标。参与者描述了重大（主要是逐渐的）变化，包括人际关系的显著改善。
共病群组的格式并未阻止患者将 TCC 视为与个人相关。灵活性和一致的理论框架似乎对此有所帮助。结果表明，更多地考虑控制和正念可以增强认知灵活性，从而能够重新调整优先级并放弃无益的习惯，使患者更好地实现目标。这对群组治疗的启示包括：（a）向患者清楚地解释此类群组的格式；（b）在可能的情况下，使群组的提供方式具有灵活性。需要对其他共病群组进行更多的定性研究，以确定这些主题是否普遍适用于其他共病群组。
