The CST group exhibited greater improvements in psychological QoL compared with controls ( p = .001 ) , including less depression ( Cohen d = 0.22 [ 95 % confidence interval , or CI = 0.08-0 .36 ] ) and anxiety ( d = 0.17 [ 95 % CI = 0.02-0 .33 ] ) , and better overall mental health ( d = 0.17 [ 95 % CI = 0.03-0 .32 ] ) , emotional role functioning ( d = 0.29 [ 95 % CI = 0.10-0 .48 ] ) , vitality ( d = 0.27 [ 95 % CI = 0.11 , 0.42 ] ) , and social functioning ( d = 0.21 [ 95 % CI = 0.03-0 .38 ] ) .