Cohesion and chronic pain: A case for assessing an overlooked process variable.

Abstract

Chronic pain management services are often provided in group formats, as they are cost effective, increase access to care, and provide unique and needed social support to patients, but mixed outcomes for these groups indicate room for improvement. A small but growing body of research suggests routine assessment of and feedback on group cohesion may improve individual patient outcomes, though this has not been studied among chronic pain groups. Provided in this article is a rationale for assessing group cohesion in pain management programs, along with considerations for how and when to use routine outcome monitoring of cohesion in clinical practice. Clinical Impact StatementQuestion: This article hopes to address using routine process feedback monitoring to improve outcomes in group therapy for chronic pain. Findings: Group clinicians in chronic pain programs can use the ideas in this article to inspire using cohesion measures in pain management programs, with the hope that it could improve their patient outcomes. Meaning: The conclusions in this article indicate that group clinicians in chronic pain programs can look at cohesion as a possible contributor to outcomes and that there are ways to improve cohesion in these groups through progress monitoring. Next Steps: Group clinicians could begin to assess cohesion and alter their interventions based on the continuous progress monitoring described.

Addressing health in psychotherapy from a community wellness framework: Introduction to the special section.

“…The fifth article within this part brings our attention to the importance of assessing for cohesion among groups for patients with chronic pain utilizing assessment tools sensitive to the complexity of pain (Woodland et al, 2021). This article applies what we know about group psychotherapy research—the critical role of cohesion (e.g., Forsyth, 2021)—to the health context.…”

Addressing health in psychotherapy: Future directions from a community wellness lens.

“…Similar to individual psychotherapy, consideration of constructs and processes specific to group psychotherapy, such as group cohesion and group climate, in relation to physical health issues or among these populations will meaningfully contribute to the literature. Group cohesion, arguably the most studied relational process in group work (Burlingame et al, 2018), shows potential in providing meaningful feedback in groups developed for people with chronic pain (see Woodland et al, 2021). This is likely the case for groups with people navigating other physical health conditions, such as cancer (Schnur & Montgomery, 2010).…”