Mark E. Beecher

The Group Questionnaire: A clinical and empirically derived measure of group relationship

Abstract The Group Questionnaire (GQ) is a recently developed self-report measure of the therapeutic relationship based on Johnson and colleagues (2005) three-factor model; Positive Bonding, Positive Working, and Negative Relationship. This study validated Johnsons model with a new and extended sample and created a shorter 40-item trial version. SEM analysis of the GQ tested whether it produced the same three-factor structure found in three earlier studies with 486 participants from three populations—outpatient university counseling center, non-patient AGPA process groups, and inpatient state hospital. Results of further SEM refinements demonstrated that a final 30-item version had good fit to the three-factor model although distinct differences in response pattern were found between the three populations. Implications for future utility and clinical relevance of the GQ are discussed.

New directions and resources in group psychotherapy: introduction to the issue

Establishing an evidence-based practice (EBP) is a central byproduct of the ever-increasing emphasis on accountability in mental health services. Though much has been written and developed for individual psychotherapists who wish to develop EBPs, there are far fewer resources for group psychotherapists. This article introduces a series of articles designed to provide EBPs and resources for group psychotherapists. We discuss how therapists can develop and apply the following aspects of EBPs: research-supported treatments (RSTs), practice guidelines, practice-based evidence, and multicultural competence.

The Group Selection Questionnaire: A Qualitative Analysis of Potential Group Members

Abstract The Group Selection Questionnaire (GSQ) has been shown to predict which individuals will improve during group psychotherapy. The present study sought to quantitatively and qualitatively describe those who are predicted to benefit (low scorers) and not benefit (high scorers) from group, based on their GSQ scores. High and low scorers were selected from two samples–a “non-clinical” group of undergraduates in an introductory psychology course and a “clinical” group of clients from a university counseling center. Analyses of differences in GSQ scores and interview transcripts indicated that low scorers anticipated benefits from groups, found it easy to share feelings and opinions, felt they were a part of groups, and described themselves as open. High scorers reported being passive, private, reserved, and unlikely to share feelings.

Differential effectiveness of group, individual, and conjoint treatments: An archival analysis of OQ-45 change trajectories

Abstract Objective: While empirically-supported treatment (EST) choices are continually expanding, choices regarding formats for delivery (individual only, group only, or conjoint [simultaneous individual & group]) are often determined by agency resources or clinician preference. Studies comparing individual and group formats have produced mixed results, while recent meta-analytic reviews support format equivalence. Method: We employed a multilevel model to test for outcome differences using the OQ-45 on an outpatient archival data set of clients receiving individual-only (n = 11,764), group-only (n = 152) or conjoint (n = 1557). Results: Individual and group outcomes were equivalent with some analyses showing conjoint trailing. Moderators of change included initial distress, treatment duration, intra-group dependency, and format. Conclusions: Results support meta-analytic findings of format equivalence in a naturalistic setting for group and individual. Referral practices and future results are discussed.

The effects of relationship and progress feedback in group psychotherapy using the Group Questionnaire and Outcome Questionnaire–45: A randomized clinical trial.

Routine outcome monitoring (ROM) systems that identify clients at-risk for treatment failure using outcome and therapeutic process measures are a recognized evidence-based practice. However, only 3 empirical studies have tested ROMs in group therapy, producing mixed results. This randomized clinical trial tested the Outcome Questionnaire System, the ROM system with the most empirical support for individual therapy patients, with 430 group therapy patients who were randomly assigned to 2 experimental arms (Group Questionnaire [GQ] + Outcome Questionnaire–45 [OQ-45] vs. OQ-45). Given the strong evidence for progress feedback, the primary purpose of this study was to ascertain if therapeutic relationship feedback using the GQ reduced rates of relationship deterioration and failure when progress feedback was held constant. Group leaders simultaneously ran pairs of groups that were randomly assigned to the 2 conditions. Of the 430 patients enrolled in 58 groups, 374 attended more than 4 sessions. Results showed that therapeutic relationship predicted improvement in outcome and that feedback reversed the course of relationship deterioration and reduced rates of relationship failure. Although there were no effects on attendance and dropout for feedback, the 2 experimental arms produced mixed results for the OQ-45 not-on-track cases. The combined relationship and progress feedback (GQ/OQ-45) was associated with fewer outcome deterioration cases, while the progress feedback condition (OQ-45) showed higher outcome improvement cases. Findings are discussed with respect to previous group ROM studies, clinical implications, and future research.

A clinician's take on evidence-based group psychotherapy: a commentary

Each of the articles in this issue of the Journal of Clinical Psychology: In Session provides valuable resources to group psychotherapists looking to develop an evidence-based practice. This article provides a summary of and commentary on this information from a clinicians point of view. I discuss the clinical utility of these resources, while acknowledging and addressing the practitioner concerns associated with them.

Practice-based evidence can help! Using the Group Questionnaire to enhance clinical practice.

Practice-based evidence (Burlingame & Beecher, 2008) is an approach to evidence-based practice that addresses treatment efficacy to remediate clinicians’ inability to predict treatment response (Chapman et al., 2012; Hannan et al., 2005). The Group Questionnaire (GQ; Bormann, Burlingame, & Straub, 2011; Johnson, Burlingame, Olsen, Davies, & Gleave, 2005) is one practice-based evidence measure that supports clinical judgment to enhance psychotherapy outcomes by measuring 3 important group constructs: Positive Bond, Positive Work, and Negative Relationship. A clinical example of how one group leader used GQ data provided by group members regarding their weekly group experiences to support her interventions in a process-oriented therapy group for adults includes verbatim clinical exchanges among group members and the leader. The example also includes a GQ report with explanations of the group members’ scores and numerical and graphical data. The authors detail how the leader used the data from the measure to promote curiosity about group cohesion and movement toward treatment goals, to reframe perceptions of group interaction, and to gauge outcomes of shared group experience. The group leader’s examination of the GQ data outside the group allowed her to use this information for positive impact inside the group to guide interventions and explore content and process, warranting additional attention. The authors encourage curiosity about other interactions among other group members reflected in the GQ report and how this information could be used to positively impact the group in other ways.

Psychotherapy Utilization and Presenting Concerns Among Polynesian American College Students

In this study, we examined psychotherapy utilization, presenting concerns, reported distress levels, and psychotherapy outcomes among Polynesian American students presenting for services at a counseling center. We collected data at intake, during therapy sessions, and at termination for 415 Polynesian American and 18,117 European American students over a 17-year period. Polynesian American students were equally likely to utilize counseling services as European American students but were more likely to drop out earlier. At intake, these students reported higher numbers of presenting concerns and greater levels of emotional and psychological distress than European American students. Polynesian American students reported significantly higher scores on racial discrimination, physical abuse, and family dependence. Implications for counseling center programs and services are discussed.

Beyond English only: Addressing language interpretation in professional psychology training.

Professional guidelines direct that psychologists working with clients with limited English proficiency should involve an interpreter if a mental health professional fluent in the client’s language is unavailable. However, complexities of interpreted therapy require training. We describe 9 relevant areas of trainee skill acquisition and also surveyed 102 multicultural course instructors in American Psychological Association–accredited psychology programs regarding current professional training. Only 55 (54%) instructors reported providing any training on working with language interpreters, with 16 (16%) providing more than 2 hr of training. Instructors ranked 9 proposed skill areas and gave recommendations for overcoming barriers and working with interpreters to assist clients with limited English proficiency. The proposed areas of professional competence provide starting points for therapists learning the complexities of interpreted therapy.

International Student Support Groups: Learning from Experienced Group Members and Leaders

ABSTRACT A multisite qualitative study investigated the experiences of six group leaders and 10 group members who participated in seven different university counseling center international student support groups. Analyses of interview data using hermeneutic interpretation resulted in nine major themes and 10 subthemes organized into four sections: (a) recruitment and group design, (b) experiences of group members, (c) experiences of group leaders, and (d) additional considerations.