In order to test the effect of a psychological intervention on survival from cancer, 66 women with metastatic breast cancer, all receiving standard medical care, were randomly assigned into two groups; one group (n=30) attended the psychological intervention, consisting of 35 weekly, 2 h sessions of supportive plus cognitive behavioral therapy; the control group (n=36) received only a home study cognitive behavioral package. No significant difference was found in survival post‐randomization between the groups as assessed by a log rank test 5 years after the commencement of the study. As expected, several prognostic factors were significant predictors of survival: metastatic site, hormonal receptor status, and chemotherapy prior to randomization. While many personal and demographic variables did not influence survival, there was a significant effect of self‐reported exercise (possibly due to better health). A small subgroup of intervention subjects who attended outside support groups also survived significantly longer than those who did not. The strengths and limitations of the present study are discussed, and the results contrasted with those of a well known study by Spiegel et al. (Spiegel, D., Bloom, J.R., Kraemer, H.C. and Gottheil, E. (1989) Lancet ii, 888–891). We propose that a different experimental design (correlative) may be needed to show any effect of self‐help behaviors and psychological attributes in a small minority of patients. © 1998 John Wiley & Sons, Ltd.

This paper presents validational evidence for the Group Therapy Questionnaire (GTQ), a self-report instrument designed to detect leadership styles in group therapy. In the first experiment, the GTQ discriminated between the leadership orientations of experienced and inexperienced professionals. In the second and third experiments, the GTQ detected changes in two groups who participated in nondirectively led group process exercises and showed no changes in appropriate control groups. Moreover, the nature of the GTQ changes seemed closely related to the nature of the training experience -the trainees showed significant GTQ changes toward nondirectiveness. These studies suggest the potential value of the GTQ for investigations requiring measurement of leadership styles.

The article presents the Group Therapy Questionnaire (GTQ), a research instrument for the study of leadership in group therapy and related small group settings. The GTQ describes 20 realistic situations which may occur in the course of group therapy and asks each S to indicate how he might respond if he were the group leader confronted with such a situation. The format of this instrument constitutes an attempt to deal with the classical incompatibility between clinical meaningfulness and scientific measurability. The particular leadership variables explored by the GTQ were selected primarily because they seemed to involve fundamental decisions concerning leadership in small groups. The article describes four general situations in which the GTQ has potential usefulness: as a criterion for evaluating the effectiveness of training courses in group therapy, as a criterion measure for comparing different types of leaders, as an independent variable in outcome studies, and as a teaching device.

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