Addie Fuhriman

Cohesion in group psychotherapy

Insight into the therapeutic relationship in group psychotherapy requires an understanding of the treatment context. Cohesion is defined as the therapeutic relationship in group psychotherapy emerging from the aggregate of member-leader, member-member, and member-group relationships. Using this defi

The Differential Effectiveness of Group Psychotherapy: A Meta-Analytic Perspective

The differential effectiveness of group psychotherapy was estimated in a meta-analysis of 111 experimental and quasi-experimental studies published over the past 20 years. A number of client, therapist, group, and methodological variables were examined in an attempt to determine specific as well as generic effectiveness. Three different effect sizes were computed: active versus wait list, active versus alternative treatment, and pre- to posttreatment improvement rates. The active versus wait list overall effect size (0.58) indicated that the average recipient of group treatment is better off than 72% of untreated controls. Improvement was related to group composition, setting, and diagnosis. Findings are discussed within the context of what the authors have learned about group treatment, meta-analytic studies of the extant group literature, and what remains for future research. Researchers’ understanding regarding the effectiveness of group psychotherapy has evolved over the past century. Case studies and anecdotal reports characterized the group literature in the first half of the 20th century, with the first comparative studies emerging in the 1960s (Barlow, Burlingame, & Fuhriman, 2000). Early reviews (Pattison, 1965; Rickard, 1962; Stotsky & Zolik, 1965) concluded that group therapy was a helpful adjunctive treatment, although little empirical evidence supported its use as a robust independent treatment. Reviewers in the latter part of that decade (Anderson, 1968; Mann, 1966) began to give group a heartier endorsement, describing it as capable of producing objectively measurable change in patient attitude, personality, and behavior. Throughout the 1970s, researchers repeatedly concluded that group outcomes were consistently superior to those of control groups (Bed

Curative Factors in Group Therapy: A Review of the Recent Literature

This article reviews studies of the group curathe process that have employed Yaloms description of group curative factors. Similarities and differences in the findings of the studies are discussed and future directions for research in this area are indicated.

Consistency of Matter A Comparative Analysis of Individual and Group Process Variables

This article presents a comparative analysis of individual and group psychotherapy process research. Commonalities between these to treatment formats are identified across the therapeutic dimensions of relationship, interventions, and factors. The distinctive characteristics of group treatment are explored, and conceptual implications are tendered for the practice and study, of group counseling and psychotherapy.

Cohesion An Odyssey in Empirical Understanding

This article is third in a series of four describing and integrating a multidimensional approach for measuring and understanding small group process. The construct of cohesion is reviewed and the multidimensional approach is applied to evidence, both conceptual and empirical, resulting from studies of cohesion. Observations and conclusions are discussed regarding cohesion and its current state.This article is third in a series of four describing and integrating a multidimensional approach for measuring and understanding small group process. The construct of cohesion is reviewed and the multidimensional approach is applied to evidence, both conceptual and empirical, resulting from studies of cohesion. Observations and conclusions are discussed regarding cohesion and its current state.

Refining the Measurement of Curativeness: An Empirical Approach.

This article presents a rationale for and the implementation of a factor analytic study of a revised curative factor instrument. Valuing of the three factors of catharsis, cohesion, and insight by 161 group members in four settings (community mental health [CMH], Veterans Administration [VA], university counseling center [UCC], and group behavior class [GBC] are reported. Results show CMH group members valuing these factors more than group members from VA, UCC, and GBC. Across all settings, cohesion and catharsis are consistently valued higher than insight. Possible explanations of the findings are given.

Group Psychotherapy Training and Effectiveness

Abstract This study surveyed accredited programs in psychiatry, psychology, and social work, replicating and extending previous work in group training. Results detail the curriculum, group faculty/student participation, and predicted future therapy trends in four different formats of group treatment. The number of group courses in the curriculum, the number required, and the percent of students participating in these courses significantly varies among the three disciplines, indicating a discrepancy among those disciplines responsible for training in group therapy regarding the value and role of group training. Consensus does exist among the disciplines in forecasting that individual therapy will decrease and group treatment will increase, but what programs deliver in their training does not coincide with their predicted trends for group therapy use in the future. Ratings of the differential effectiveness of the four group modalities vs. individual are not consistent with empirical evidence. Results call for consensual clarity, accord of values and knowledge, and the integration of science, training, and practice across the three disciplines.

Measuring Small Group Process: A Methodological Application of Chaos Theory

Research on group therapy typically defines one dimension of the therapeutic process (i.e., cohesion, feedback, self-disclosure) in space or evolving through time. As a result, little is learned regarding the interconnectedness, relatedness, or interaction of these important dimensions of what is occurring within the group. In recent years, the articulation of chaos theory-the science of process rather than of state-has unfolded andfound application in the behavioral sciences. In this article, central principles underlying chaos theory are described and the mathematics of chaos are applied to interaction from a short-ternm psychotherapy group. Differences in the pattern of complexity inherent in interactions of group members werefound in the individual sessions when compared to the group as a whole.

A survey of mental health care provider's and managed care organization attitudes toward, familiarity with, and use of group interventions.

Abstract Managed Care has had a significant impact on delivery systems for mental health services. Direct and indirect persuasion to provide more cost-effective treatments has been one consequence. The cost-saving qualities and the effectiveness of group interventions have produced clear expectations for an increased use of therapy groups. This study compared perceptions and uses of group treatments on a national sample of managed care organizations and mental health providers. Because group psychotherapy encompasses such a broad definition, five specific types of group interventions were defined: problem-focused homogenous, process-oriented heterogeneous, psycho-educational, self-help, and short-term groups. Implications of differences and similarities between directors of managed care organizations and treatment providers are examined and discussed across five response categories (familiarity/training, perceived effectiveness, likelihood of reimbursement/referral, daily use, and expectation for future use).

Conceptualizing Small Group Process.

This article is the prelude to a four-article sequence that will define, illustrate, and critique a multidimensional approach for measuring and understanding small group process. Problems associated with process analysis are presented with a specific focus on definitional and methodological concerns. The need for a comprehensive system that will help researchers to separate and comprehend the individual parts of a group and their relationship to the whole group is articulated. (The second in the series also appears in this issue of SGB).