Does the cohesion–outcome relationship change over time? A dynamic model of change in group psychotherapy.

Chapman, Norah; Kivlighan, Dennis M.

doi:10.1037/gdn0000100

Cited by 9 publications

(4 citation statements)

References 41 publications

(93 reference statements)

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“…When Norton and Kazantzis (2016) assessed changes in cohesion across cognitive-behavioral treatments for anxiety they found that the relationship between cohesion and treatment gain was initially nonsignificant ( r = −0.06), but it became clinically and statistically significant over time ( r = −0.23). Chapman and Kivlighan (2019) also affirmed the strengthening of the relationship between cohesion (at the client level) and treatment efficacy; clients who considered the group to be more cohesive relative to others in the group exhibited better outcomes over time.…”

Section: Group Cohesion: Recent Advancesmentioning

confidence: 68%

Recent advances in the study of group cohesion.

Forsyth¹

2021

Group Dynamics: Theory, Research, and Practice

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Objective: Group cohesion, as a central explanatory concept in the study of groups, has provided a foundation for explaining a number of group processes that have occupied researchers' attention since the founding of the journal Group Dynamics: Theory, Research, and Practice 25 years ago. Method: This review summarizes that research, focusing on three specific topics: group performance, the effectiveness of group psychotherapy, and group-based identity processes. Results: Theory and research in these areas have yielded substantial insights into cohesion and related group processes, but definitional, methodological, and theoretical uncertainties remain to be resolved. Conclusions: Seeking to resolve some of these uncertainties, an integrative model of cohesion that defines cohesion as a group's degree of unity-and distinguishes between the causes (or antecedents) of that unity (such as attraction bonds or group pride) and indicators of cohesion-is described, as is a short inventory that can be used to assess members' perceptions of the unity of their groups. Highlights and Implications• The concept of cohesion is central to understanding groups and group processes, and recent research has yielded substantial advances in understanding the nature, the sources, and the consequences of this key group-level process.• Specifically, recent research provides a clearer understanding of when cohesion facilitates team performance, cohesion's influence on the outcome of group psychotherapy, and the relationship between cohesion and members' social identities.• To resolve continuing issues of definition and assessment, an integrative conceptualization of cohesion, unitary cohesion theory, is described; it defines cohesion as the unity of a group, and so distinguishes between the causes of cohesion, indicators of cohesion, and cohesion itself.• Recommendations for future research include identifying and documenting the type of cohesion assessed in specific instruments and using methods that are appropriate when studying a group-level process.• A unitary cohesion index is described. This set of bipolar rating scales can be used to directly assess members' estimates of their group's cohesion by separating the defining conditions of cohesion from the potential causes of cohesion.

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Section: Group Cohesion: Recent Advancesmentioning

confidence: 68%

Recent advances in the study of group cohesion.

Forsyth¹

2021

Group Dynamics: Theory, Research, and Practice

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“…Group therapists can enhance members’ cultural humility and cultural opportunities through effective group preparation. Chapman and Kivlighan (2019) argue for establishing norms and providing psychoeducation around cultural humility and cultural opportunities as early as group preparation. Leaders who introduce these concepts and model cultural humility and seek cultural opportunities may enhance member’s ability and willingness to engage in these processes with each other as the group develops.…”

Section: Discussionmentioning

confidence: 99%

Whose multicultural orientation matters most? Examining additive and compensatory effects of the group’s and leader’s multicultural orientation in group therapy.

Grimes¹,

Kivlighan²

2022

Group Dynamics: Theory, Research, and Practice

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Objective: The multicultural orientation (MCO) framework has received increased attention within the multicultural group work literature. However, most of this research has examined cultural processes between group members and how cultural processes of the group-as-a-whole directly impact outcomes of individual members. As such, the effect of group leaders' MCO on members' improvement has largely been ignored. Understanding the complex interaction between leaders' and group members' MCO is critical to advance this body of literature and further understand the dynamic interplay of cultural processes between leaders and members of therapy groups. Method: Data for this study consisted of 101 group members across 48 interpersonal process groups at 12 university counseling centers. Polynomial regression and response surface analysis were conducted to test additive and compensatory effects between members' perceptions of their group's and their leaders' MCO on their perceived improvement in group therapy. Results: Clients' estimated improvement was highest when their perceptions of their group's and leaders' cultural humility were congruent and high (i.e., additive effect). Additionally, clients' estimated improvement was highest when clients perceived either (a) the group high in cultural missed opportunities and leaders low in cultural missed opportunities or (b) the group low in cultural missed opportunities and leaders high in cultural missed opportunities (i.e., compensatory effect). Conclusions: This article grows the existing body of literature on MCO orientation by exploring how group's and leaders' MCO interact in complex and important ways with client's perceived improvement in therapy. Both leaders and members should engage in cultural aspects of the group. Highlights and Implications• This study sought to examine the effect of clients' perceptions of their other members' and their group leaders' MCO on their perceived improvement in group therapy.

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“…Research demonstrates a “well-established” relationship between cohesion and outcome (Chapman & Kivlighan, 2019, p. 91), which has been shown among various client populations, for example, clients with interpersonal concerns (Chapman & Kivlighan, 2019), trauma (Ellis et al, 2014), and anxiety (Paulus et al, 2015). Further, two meta-analyses have produced weighted aggregate correlations of r = .25 (Burlingame et al, 2011) and r = .26 (Burlingame, McClendon, & Yang, 2018).…”

Section: Literature Reviewmentioning

confidence: 98%

“…Yet, cohesion research also has limitations, with Forsyth (2021) warning of “definitional, measurement, and theoretical uncertainties” (p. 217). The lack of consensus on a definition poses a significant issue (Burlingame et al, 2011; Burlingame, McClendon, & Yang, 2018; Chapman & Kivlighan, 2019). Related to this concern, two or more cohesion measures have been not simultaneously assessed in the same study, making it “impossible to determine if different or similar relationship constructs are being assessed” (Burlingame, McClendon, & Yang, 2018, p. 385).…”

Section: Literature Reviewmentioning

confidence: 99%

The relationship of alliance, cohesion, and climate with outcome among college counseling populations.

Arnold¹,

Burlingame²,

Olsen³

2022

Journal of Counseling Psychology

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It is not yet fully understood how alliance, cohesion, and climate differentially correlate with client outcome in group therapy, especially when assessed simultaneously. This study aims to elucidate these relationships through an archival analysis of continuous Group Questionnaire (GQ) and Outcome Questionnaire-45 (OQ-45) data from 412 group therapy clients at college counseling centers, which were originally collected by Burlingame, Whitcomb, et al. (2018). We predicted that alliance, cohesion, and climate would each correlate with improvements in outcome and, further, that they would have similar relationships with change in outcome. Results indicate that greater alliance, cohesion, and climate are individually associated with lower distress. This relationship was significant regarding session-to-session fluctuations on individual client scores ( p < .01), as well as regarding differences between clients in their personal averages across sessions ( p < .01). However, when linear growth trajectories were considered, only alliance was significantly associated with improvement ( p < .05). In other words, alliance, climate, and cohesion all correlate with outcome when time is ignored; however, alliance alone significantly correlates with outcome when change over time is taken into account. This study highlights the importance of the client-therapist relationship, emphasizing how alliance is significantly related to change in group therapy. Thus, therapists should prioritize a strong bond with clients. Public Significance StatementThis study explores how clients' outcomes in therapy relate to the relationships that they form in group therapy, including relationships with other members, the group leader, and the group-as-a-whole. Results suggest that a good relationship with the group therapist is especially associated with changes in outcome over time, highlighting the importance of this relationship in group therapy.

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Does the cohesion–outcome relationship change over time? A dynamic model of change in group psychotherapy.

Cited by 9 publications

References 41 publications

Recent advances in the study of group cohesion.

Recent advances in the study of group cohesion.

Whose multicultural orientation matters most? Examining additive and compensatory effects of the group’s and leader’s multicultural orientation in group therapy.

The relationship of alliance, cohesion, and climate with outcome among college counseling populations.

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