There are mixed findings regarding the differential efficacy of the group and individual format. One explanation of these mixed findings is that nearly all-recent meta-analyses use between-study effect sizes to test format equivalence introducing uncontrolled differences in patients, treatments, and outcome measures. Only 3 meta-analyses were located from the past 20 years that directly tested format differences in the same study using within-study effect sizes; mixed findings were reported with a primary limitation being the small number of studies. However, we located 67 studies that compared both formats in the same study. Format equivalence (g = -0.01) with low effect size heterogeneity (variability) was found in 46 studies that compared identical treatments, patients, and doses on primary outcome measures. Format equivalence (g = -0.06) with moderate effect size heterogeneity was found for 21 studies that compared nonidentical treatments; however, allegiance to a specific format moderated differences in effect sizes. There were no differences between formats for rates of treatment acceptance, dropout, remission, and improvement. Additionally, there were no differences in outcome between formats by patient diagnosis; however, differences in pre-to-post improvement were explained by diagnosis with depression, anxiety, and substance disorder posting the highest outcomes and medical and childhood disorders the lowest. Findings are discussed with reference to the practical challenges of implementing groups in clinical practice from an agency, clinician, and reimbursement perspective. (PsycINFO Database Record

Firefighters face increased rates of mental health disorders secondary to traumatic exposure yet consistently report that stigma interferes with help-seeking. We examined whether firefighters who are by disposition more self-forgiving would exhibit less stigma and fewer mental health challenges. Dispositional self-forgiveness is a personality trait characterized by nonintropunitive responding, self-acceptance/positivity, and resolution of negative states following perceived failure. A community sample of professional firefighters (n = 72) completed measures of trait self-forgiveness, stigma, PTSD symptoms, depressive symptoms, and suicidality. Consistent with expectations, self-forgiveness was associated with less self-stigma (r = −.38) and internalized stigma (r = −.42). Consistent with theory, no substantive link was found between self-forgiveness and public stigma. Also consistent with expectations, substantive relationships were found with wellbeing: self-forgiveness predicted fewer depressive symptoms, less suicidality, and fewer PTSD symptoms. Surprisingly, these relationships existed largely independent of relationships with stigma. Overall, trait self-forgiveness was an important predictor of both stigma and mental health symptoms among professional firefighters. Implications for theory and practice are discussed.

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Attachment has been shown to play a significant role in adult romantic relationships, and there is substantial evidence supporting the use of attachment-based interventions with couples. Prevailing conceptualizations of dyadic functioning often incorporate biological and psychological factors, such as attachment, but often limit their scope of social factors to the dyad itself. Such conceptualizations do not attend to the relationship between couples and their wider community. Awareness of social and community values is much more common in individual therapy but has not been integrated into couple's work. In this article, we propose a biopsychosocial foundation for viewing the relationship between couples and their wider community through the lens of attachment, in which securely attached couples are more likely to have community interest congruence and insecurely attached couples are more likely to experience incongruence. Translating this theoretical foundation into practice, we also propose a stepwise approach for integrating community interest work into the established framework of emotionally focused therapy with couples.