Cohesiveness has been viewed as the group psychotherapy equivalent of the therapeutic alliance in individual treatment. Although researchers have attempted to study the concept of cohesion in group treatment, understanding of this so-called "curative" group factor remains quite primitive. In this study of 12 time-limited psychotherapy groups, with a total of 90 nonpsychotic outpatients, we explore the relationships between cohesion, alliance and treatment outcome. Our cohesion measure is a new instrument, the Harvard Community Health Plan Group Cohesiveness Scale, developed for use with group therapy videotapes. To measure alliance we have modified the Penn Helping Alliance Scale (Group Alliance Scale) to be scored from videotapes of group sessions. Both of these instruments use trained observers to make ratings for the group-as-a-whole. The outcome battery for patients in these groups included a widely varied set of measures, enabling us to view change from a number of perspectives. Our findings indicate that cohesion and alliance as measured here are related concepts. We also find that both cohesion and alliance appear to have strong relationships with improved self-esteem and reduced symptomatology for patients in these groups. In addition, it appears that outcome is most related to cohesion in the first 30 minutes of a group session. Implications of these and other findings are discussed.

Data on 158 children, six and nine years old, are analyzed for the relationship between stress and behavior. Undesirable life events and intense "hassles" were particularly correlated with behavioral symptoms. Statistically, temperament appears to moderate this influence but, lacking appreciable variance of symptoms in the models including these interaction effects, the more parsimonious main-effects concept may be more useful.

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Because the average length of psychiatric hospitalization is decreasing, effective short-term treatments for patients with borderline personality disorder (BPD) are in greater demand. Of particular interest are group therapies, which have traditionally been a treatment of choice on inpatient units. We review empirical research and clinical descriptions of group psychotherapy for inpatients with personality disorders, especially BPD. Based on the existing literature on inpatient groups, supplemented by the most recent literature on outpatient groups for patients with BPD, we propose a framework within which an effective short-term group treatment may be developed for inpatients with this disorder. In particular, we discuss the advantages and disadvantages of adapting Linehan's Dialectical Behavior Therapy for short-term inpatient use.

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