(PS5-70) Effectiveness of Informed Dialectical Behavior Therapy (DBT) Skills Group Training for Adolescents with Depression in Singapore

Abstract Text: Aim: It has been established from the literature on Western populations that patients who undergo group therapy produce statistically equivalent outcomes to those in individual therapy. However, there have been limited publications about the effectiveness of group interventions such as Skills Group Training as part of Dialectical Behavior Therapy (DBT) in Singapore. Singapore is a multi-racial society, that is predominantly Asian in our population, which raised the question of group interventions are as effective as individual therapy given the cultural differences of Western populations. This is a gap in the literature that we hope to address, about the effectiveness of individual versus group interventions in our study with an Asian population. 
Background: The integrated program for the management of depression in adolescents (IPMDA) at the National University Hospital (NUH) was established to increase participation in group-based interventions so that more patients can have access to psychological care as Singapore faces a shortage of clinical psychologists. The ratio of clinical psychologists per 100,000 population in Singapore is 9.7 while other countries such as the United States of America (USA) and Canada have a ratio of 28.9 and 48.74 respectively. 
Method: Patients enrolled in IPMDA would either receive individual psychotherapy, skills group training, or both as part of their psychological treatment. The skills group training curriculum has been designed as stepwise modules to consider the various patients’ needs as IPMDA serves a wide range of patients such as those who have been diagnosed with adjustment disorder to patients diagnosed with borderline personality disorder (BPD) traits. Patients’ scores on the Patient Health Questionnaire modified for Adolescents (PHQ-A) at intake and discharge were used to measure their depressive symptoms. 
Results: As the group of patients that completed both individual therapy and skills group training was small (N = 8), their scores were not included in the statistical analysis. The patients had a mean age of 15.1 years of age, and 81% of them were females. All patients that received psychological treatment, 1) individual psychotherapy (M = -6.36, SD = 8.2, t(20) = 18.13, p < .001), and 2) skills group training (M = -6.76, SD = 7.02, t(36) = 18.08, p < .001) showed a significant reduction in PHQ-A scores upon discharge. A one-way ANOVA showed that there was not a statistically significant difference in the reduction of PHQ-A scores on discharge between the patients who underwent individual psychotherapy or skills group training (F(1, 56) = 0.031, p > .05). 
Conclusion: This showed that skills group training was as effective as individual psychotherapy in reducing the severity of depressive symptoms for Singaporean adolescents suffering from depression. Further study of patients’ specific concerns and beliefs about group interventions would be beneficial as it will help to inform the psychoeducation materials that can be produced for patients to reduce their unfounded concerns about the effectiveness of group interventions, and at a systemic level, allow more to access care for their psychological needs.