Cohesion in group therapy: A meta-analysis.

Abstract

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.

A new treatment for eating disorders combining physical exercise and dietary therapy (the PED-t): experiences from patients who dropped out

“…Challenges in establishing a mutual relationship between individuals in a treatment group are, however, generic, and not confined to ED or the PED-t (Hummelen, Wilberg, & Karterud, 2007) or to patients who actually completed the PED-t (Bakland et al, 2019). Such findings align with a recent meta-analysis (Burlingame, McClendon, & Yang, 2018) demonstrating that group cohesion contributes to outcomes across a variety of clinical conditions and therapeutic settings. Group-leaders in all theoretical orientations are therefore encouraged to foster cohesion.…”

Italian adaptation of the Group Questionnaire: validity and factorial structure

“…The facility of administration of the GQ, the useful information for clinician that it provides and the possibility to analyze in detail group relationships looking at the quality and structure ( i.e ., Kivlighan et al, 2017 ; Lo Coco et al, 2016a ), are the key elements that led to using the GQ in a number of researches that monitor group process and patient’s changes during treatment as well as in training practices for group psychotherapists (Marmarosh, 2018 ). Moreover, several studies have also used member’s GQ feedback to support clinical judgment in enhancing psychotherapy outcomes (Griner et al, 2018 ) showing reduced rates of relationship deterioration and failure when progress feedback was held constant (Burlingame et al, 2018a ). Through the GQ, group members report their group experiences, making information that could facilitate the conduction in order to achieve greater effectiveness of interventions.…”

“…In recent years, the GQ has become the leading measure for providing therapists with feedback on client’s progress in therapy. Since the three GQ quality scales show high ICC values demonstrating to be sensitive in capturing the effect-group on members, the GQ-30 has demonstrated good validity in monitoring client progress over time, by generating alerts when patients are off-track and leading clinicians to make adjustments to treatment (Burlingame, McClendon, & Yang, 2018a ; Marmarosh, 2018 ). The feedback in therapy can be a useful strategy also in Italy in order to help clinicians to treat their patients more effectively and reduce the drop-out rates.…”

“Breaking Down the Wall” Patients` and Families` Experience of Multifamily Therapy for Young Adult Women With Severe Eating Disorders

“…Being able to recognise oneself in the stories of other group members and relief in knowing that someone else shared the same thoughts are important ndings in studies of different group activities and group therapy for patients with EDs (33)(34)(35). The importance of cohesion is a known phenomenon in group psychotherapy, described in a number of studies of different types of group therapy (36). All people are dependent on others and the signi cance of this dependence is increased when those closest to us are ill and vulnerable.…”