Benzodiazepines and group transdiagnostic cognitive-behaviour therapy for anxiety disorders: A mixed methods study.

Background: Cognitive behavioural therapy (CBT) is an evidence-based treatment for anxiety disorders. Patients engaging in CBT often have an ongoing pharmacological treatment, generally antidepressants. Benzodiazepines are also commonly used, although they are recommended as short-term adjunctive treatment due to side effects. : Exploring the influence of benzodiazepine use prior to group transdiagnostic CBT (tCBT) and the participants’ experience of their use before, during and after therapy. : Mixed methods study embedded in a randomized controlled trial of group tCBT. The experimental arm received tCBT and treatment-as-usual (TAU) (n = 117) for 12 weeks while the control arm received TAU (n = 114). Anxiety symptoms were assessed with the Beck Anxiety Inventory (BAI). Multiple linear regression analysis examined BAI pre-post differences with benzodiazepine use in the past 12 months, tCBT and their interaction. Semi-structured interviews were conducted with 13 participants reporting the use of benzodiazepines at baseline and analyzed using an interpretive descriptive method. : tCBT had a significant effect on anxiety symptoms change, but this effect was non- differential according to benzodiazepine use in the past 12 months. Qualitative results provided nuances about the perceived helpfulness of benzodiazepines. Participants reported that benzodiazepines facilitated the experience of sharing in group therapy and conducting exposure exercises. Despite some benefits, participants perceived that benzodiazepines may have interfered with the effectiveness of exposure exercises and the acquisition of concepts due to a sedative effect. Conclusions: Results highlight the importance of sensitizing therapists and patients to the potential effects of benzodiazepines on the experience of tCBT.