Multicultural group work has received growing attention over the past two decades; however, there is a lack of conceptual frameworks to guide therapists' cultural processes within group therapy at present. As such, we extend the multicultural orientation (MCO) to group therapy in an effort to provide a conceptual framework for group therapists to effectively engage multicultural group work. The MCO framework was developed in an effort to operationalize therapists' cultural processes of cultural humility, cultural comfort, and cultural opportunity. Although the MCO framework has been empirically tested within an individual psychotherapy context, application to alternative therapeutic modalities is needed. Given the inherent multicultural nature of group therapy and calls for group therapist to be culturally competent in the delivery of group-based services, we extend the MCO framework to the practice of group therapy. In this article, we provide a rationale for the application of the MCO framework to the practice of group therapy, and illustrate how group therapists' cultural humility, comfort, and opportunities can assist in establishing a multicultural group orientation throughout the development of the group. (PsycINFO Database Record

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Although it is well established that group cohesion is important for client improvement in group psychotherapy, less is known about how the cohesion-outcome relationship varies over the course of group therapy. No known study has formally tested the association between group cohesion and outcome as a dynamic relationship over the course of group therapy. Moreover, previous research has not routinely monitored cohesion and outcome session-to-session, which has limited researcher's ability to study the cohesion-outcome relationship at the session and member levels. Therefore, as part of a larger randomized clinical trial evaluating the efficacy of feedback in group therapy, the current study examined the cohesion-outcome relationship over time within-clients and between-clients. More specifically, we partitioned session-to-session cohesion data from 41 members across 5 interpersonal process groups into within-client and between-client predictors of well-being, and modeled interactions with time to test the development of the cohesion-outcome relationship across the span of the groups. Model fit comparisons indicated that a model testing within and between cohesion effects over time was a better fitting model compared to a model that tested within and between components that did not include a time effect. Additionally, our main analyses indicated that time significantly moderated the cohesion-outcome relationship at the client level (between-client effect), but not the session level (within-client effect). This means the between-client cohesion-outcome effect significantly increased over the course of the group. Implications for group practice and future directions are discussed.

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The use of client feedback, via self-report measures of psychological functioning and working alliance, is an effective way to improve therapy outcomes. Despite this progress, there are many questions about the mechanisms of change for these systems. The current study employed a case study approach to examine the effectiveness of feedback informed treatment within a psychodynamic therapy. We examined the case based on therapy outcomes, alliance processes, and verbatim dialogue of in-session exchanges. We also conducted a semistructured interview with the therapist to understand how she used and interpreted the feedback within her psychodynamic approach. The results demonstrated positive therapy outcomes and that feedback assisted with alliance formation, specifically decision making about therapeutic tasks and managing negative countertransference. The therapist reported that the feedback enhanced her ability to work in the here and now and to identify relational patterns. Implications for theory and practice are discussed.