Measures of patient self-esteem were taken before the GCBT treatment programme and other measures such as the DASS were taken before and after treatment. Outcome was determined by assessing symptomchange from pre–post treatment on the DASS. Pre–post symptom level change was used as the dependent variable as Jamieson (2004, p. 281) stated, ‘For the two-phase design with a single dependent variable, it is most appropriateto simply compare the post-test minus pre-test difference scores’.