Cohesion is the most popular of the relationship constructs in the group therapy literature. This article reviews common definitions of cohesion, the most frequently studied measures, and a measure that may clarify group relations using two latent factors (quality and structure) to explain common variance among frequently used group relationship instruments. We present the results of a meta-analysis examining the relation between group cohesion and treatment outcome in 55 studies. Results indicate that the weighted aggregate correlation between cohesion and treatment outcome was statistically significant, r ϭ .26, z ϭ 6.54 (p Ͻ .01), reflecting a moderate effect size (d ϭ .56). Heterogeneity of effect sizes was significant (Q ϭ 260.84, df ϭ 54, p Ͻ .001) and high (I 2 ϭ 79.3%), supporting moderator analyses. Six moderator variables were found to significantly predict the magnitude of the cohesion-outcome association (type of outcome measure, leader interventions to increase cohesion, theoretical orientation, type of group, emphasis on group interaction, and dose or number of group sessions). Patient contributions, diversity considerations, and evidence-based therapeutic practices are highlighted. Clinical Impact StatementQuestion: Does the quality of the group therapeutic relationship predict patient improvement? Findings: Clinical efforts to enhance the therapeutic relationship in group optimize patient outcome irrespective of theoretical orientation. Meaning: Group cohesion improves outcomes in both inpatient and outpatient settings and across a variety of patient diagnoses. Next Steps: Test cohesion measure-informed care in group on failing states of relationship.

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Cohesion is the most popular relationship construct in the group therapy literature. This chapter reviews common definitions of cohesion and the most frequently studied measures. The authors also discuss a measure that may clarify group relations using two latent factors (quality and structure) to explain common variance among frequently used group relationship instruments. The results of a meta-analysis examining the relation between group cohesion and treatment outcome in 55 studies are presented. Results indicate that the weighted aggregate correlation between cohesion and treatment outcome was statistically significant r = .26, reflecting a moderate effect size (d = .56). Six moderator variables were found to significantly predict the magnitude of the cohesion–outcome association (type of outcome measure, leader interventions to increase cohesion, theoretical orientation, type of group, emphasis on group interaction, dose or number of group sessions). Patient contributions, diversity considerations, and evidence-based therapeutic practices are highlighted.

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This study evaluated the relative sensitivity to change of the Child Behavior Checklist/6-18 (CBCL), the Behavior Assessment System for Children-2 (BASC-2), and the Youth Outcome Questionnaire 2.01 (Y-OQ). Participants were 134 parents and 44 adolescents receiving routine outpatient services in a community mental health system. Hierarchical linear modeling analyses were used to examine change trajectories for the 3 measures across 3 groups: parent informants, parent and adolescent dyads, and adolescent informants. Results indicated that for parent-report measures, the Y-OQ was most change sensitive; the BASC-2 and CBCL were not statistically different from each other. Significant differences in change sensitivity were not observed for youth self-report of symptoms. Results suggest that the Y-OQ may be particularly useful for evaluating change in overall psychosocial functioning in children and adolescents.