A Pilot Evaluation of Collectivistic Behaviors in Distress Reduction During Group Therapy

Culturally informed therapy (CIT) is a 15-week therapy that was created for people with serious mental illness (SMI) and their families and subsequently adapted for transdiagnostic groups. Past research has found that CIT increased collectivistic tendencies and religious/spiritual practice and that these changes were associated with better mental health posttreatment. However, these findings have yet to be examined on a weekly basis. It is also unclear if group differences may exist in skill utilization across age and for clients with SMI. Thus, utilizing a growth curve model, we hypothesized that psychological distress would decline as more sessions were attended, in part due to increased collectivistic behaviors and spiritual practice. Further, we expected this effect to be moderated by age and treatment group. Our pilot study consisted of a sample of 61 individuals (469 observations) placed in treatment groups for transdiagnostic difficulties (n = 40) or SMI (n = 21). More sessions attended coincided with decreased distress. Younger individuals benefitted from engaging in more collectivistic behaviors, but average-aged (i.e., early 50s) and older adults (i.e., late 60s) did not. Spiritual practice was unrelated to psychological distress. Results suggest that engaging in collectivistic behaviors is one mechanism for improvement in CIT for both transdiagnostic and SMI groups. Future research should examine weekly spiritual practice such that adaptive and maladaptive strategies are distinguishable. Ultimately, younger clients benefit from therapy that encourages actionable behaviors in line with collectivistic values, though more research is needed to determine the factors underlying these age-related differences. Public Significance Statement This group therapy study found that, overall, clients' distress reduced with increased sessions of culturally informed therapy. Increasing collectivistic behaviors may also confer additional benefit, but more follow-up research is needed.