What’s holding us back? Exploring barriers in low-intensity CBT groups

Kunorubwe, Taf ORCID: https://orcid.org/0000-0002-5624-5299 2025. What’s holding us back? Exploring barriers in low-intensity CBT groups. Presented at: European Association for Behavioural and Cognitive Therapies (EABCT) Conference, Glasgow, UK, 06 September 2025.

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Abstract

Background: Low-intensity cognitive behavioural therapy (LICBT) is a brief, structured intervention using self-help materials, typically involving less than contact time, delivered by trained practitioners through various formats, including 1:1, groups, and computerized packages (Shafran et al., 2021). LICBT delivered in groups offers a practical and scalable approach to supporting individuals across the UK and Europe. LICBT group have bseen shown to effectively reduce depression, anxiety, and social impairment at minimal cost. Research highlights their clinical effectiveness in various settings, including postnatal depression (Honey et al., 2002) and primary care mental health services (Delgadillo et al., 2016), while also demonstrating high attendance and accessibility for large groups (Burns et al., 2015; Williams et al., 2018). However, anecdotally LICBT groups can face challenges that hinder accessibility and impact treatment outcomes. This poster explores key barriers to offering and engaging clients in low-intensity CBT groups and challenges faced by practitioners in group delivery. Methods: An anonymous online survey was conducted to gather insights from professionals delivering low-intensity CBT groups across the UK. Data were analysed using reflexive thematic analysis to identify recurring themes related to barriers in engagement and delivery. Results: The analysis identified several key barriers. Thematic analysis highlighted several key obstacles to the engagement and delivery of low-intensity CBT groups. Perceived stigma and the associated concern about being seen attending a LICBT group, with fears of being judged or labelled, were prominent. Anxiety around group settings was also identified, with some clients expressing discomfort in sharing personal experiences. Many participants expressed a preference for one-to-one support, and misconceptions about LICBT groups, including doubts about their efficacy compared to individual therapy, contributed to hesitancy. Practical and logistical challenges, such as scheduling conflicts, IT issues, childcare responsibilities, and transportation difficulties, further limited attendance. Group dynamics also played a role in engagement and completion, with issues such as dominant participants, lack of cohesion, and varying levels of motivation affecting group effectiveness. Finally, retention and dropout rates were influenced by factors such as lack of initial engagement, perceived lack of progress, and external life pressures. Conclusions: While low-intensity CBT (LICBT) groups offer a practical and scalable intervention for common mental health difficulties, several barriers impact both client engagement and group delivery. First and foremost, LICBT groups, while potentially beneficial for many, are not suitable for everyone; attendance should be voluntary rather than mandatory or viewed as a stepping stone to other support. Practitioners should address stigma and misconceptions by providing clear psychoeducation, normalising group participation, and offering pre-group orientation. Flexible delivery options, including online and hybrid formats, should be considered to accommodate diverse client needs. Practical challenges such as scheduling conflicts, childcare, and IT issues should be mitigated through flexible scheduling, childcare support, and technical assistance. Facilitators should receive training to manage group dynamics effectively and ensure balanced participation. Retention strategies, including follow-up support and motivation-enhancing techniques, should minimise dropout rates and enhance perceived progress. Regular feedback and outcome evaluations are critical to refining the intervention and ensuring continuous improvement in group delivery.

Item Type:	Conference or Workshop Item (Poster)
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of Acceptance:	6 September 2025
Last Modified:	16 Sep 2025 13:00
URI:	https://orca.cardiff.ac.uk/id/eprint/180952

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