Ruptures and repairs of group therapy alliance. An untold story in psychotherapy research.
Although previous studies investigated the characteristics of therapeutic alliance in group treatments, there is still a dearth of research on group alliance ruptures and repairs. The model by Safran and Muran was originally developed to address therapeutic alliance in individual therapies, and the usefulness of this approach to group intervention needs to be demonstrated. Alliance ruptures are possible at member to therapist, member to member, member to group levels. Moreover, repairs of ruptures in group are quite complex, i.e., because other group members have to process the rupture even if not directly involved. The aim of the current study is to review the empirical research on group a…
How do individual attachment patterns of both members of couples affect their perceived infertility stress? An actor–partner interdependence analysis
Abstract There exists a lack of dyadic research examining how the attachment characteristics of infertile individuals influence their experience of infertility-related distress. The actor partner interdependence model was used to test a theoretical model by examining whether both infertile wives and husbands, who display high levels of attachment avoidance and/or attachment anxiety, will experience infertility-related distress. Seven hundred and seventy individuals (385 couples) completed the experience in close relationships, the fertility problem inventory, and the state-trait anxiety inventory prior to infertility treatment. Wives' distress was predicted by their own and by their husband…
All bonds are not the same: A response surface analysis of the perceptions of positive bonding relationships in therapy groups
Intrapersonal split alliances were defined as discrepancies in how group members perceived their positive bonding relationships with the group leader, the other group members, and the group-as-a-whole, and were related to group members' outcome. Participants were 168 patients (116 women and 52 men) diagnosed as overweight or obese who participated in 1 of 20, 12-session, therapy groups for weight management. Group members completed the Outcome Questionnaire-45 (OQ-45, Lambert et al., 2004) pre- and posttreatment and the Group Questionnaire (GQ, Krogel et al., 2013) at early, middle and late group sessions. Early, middle, and late ratings were aggregated because bond scores were consistent a…
Bond and work ruptures in group counseling
Objective: The aim of this study is to explore the immediate effects of group counseling ruptures. Group ruptures were defined as discrepancies between (1) the member’s bonding and working ratings in a session and the member’s average bonding and working across all sessions, (2) the member’s bonding and working in a session and the group-as-a-whole’s (across all members and sessions) bonding and working, and (3) the member’s average bonding and working across all sessions and the group-as-a-whole’s bonding and working. Method: Participants were 232 counseling students (199 women and 33 men; age: M = 22.78, SD = 3.51) who participated in one of 13, 7-session, interpersonal process groups. At…
Congruence of group therapist and group member alliance judgments in emotionally focused group therapy for binge eating disorder.
We used West and Kenny's (2011) Truth-and-Bias (TB) model to examine how accurately group therapists' judge their group members' alliances, and the effects of therapist-patient congruence in alliance ratings on patient outcomes. Were considered: (a) directional bias - therapists' tendency to over- or underrate their clients' alliances, (b) truth strength - clients' alliance ratings, and (c) bias strength - therapists' tendency to conflate their alliance ratings for a specific group member with the average alliance ratings for the other members of the group. There were 118 obese adult patients with binge-eating disorder that were treated by 8 therapists with Emotionally Focused Group Therapy…
Is there a group effect? It depends on how you ask the question: Intraclass correlations for California Psychotherapy Alliance Scale–Group items.
California Psychotherapy Alliance Scale-Group (CALPAS-G) data were collected from 1,138 group sessions attended by 248 group members in 16 counseling groups. Hierarchical linear modeling (HLM) was used to derive between-groups, between-member, and between-session variance components and intraclass correlation coefficients (ICCs) for the 12 CALPAS-G items. Using Ledermann and Kenny's (2012) descriptions of variable types, we examined differences in between-groups variance for the 6 CALPAS-G items classified as "Individual" items and the 6 CALPAS-G items classified as "Group" items. A Related-Samples Wilcoxon's Signed Ranked Test showed that the ICCs for the Group items were significantly lar…
Group as a Social Microcosm: The Reciprocal Relationship Between Intersession Intimate Behaviors and In-Session Intimate Behaviors
The social microcosm is defined as group members replicating their everyday (intersession) interpersonal behaviors in group sessions and new behaviors, learned in the group (in-session), replicating in the members' everyday life. We examined intersession and in-session intimate behaviors, at the within-member (differences in intimate behaviors between weeks/sessions), between-member (average differences in intimate behaviors between group members) and between-groups (group-level differences in intimate behaviors). Participants were 178 graduate students (86% identifying as women and 14% as men) participating in 10 5-session growth groups led by experienced group therapists. Before group ses…
From telescope to binoculars. Dyadic outcome resulting from psychological counselling for infertile couples undergoing ART
Objective This longitudinal study aims to evaluate the effect of psychological counselling on quality of life, marital satisfaction and need for parenthood in couples undergoing fertility treatments (ART). Background Recent guidelines on the ART suggest that psychological counselling should target both members of the infertile couple in order to improve their conjoint management of the infertility-related stress. However, studies on the dyadic outcome of couples are scarce. Methods 262 patients were originally considered in the study and completed questionnaires on quality of life, need for parenthood and marital satisfaction, before treatment (T1) and at the day of intrauterine inseminatio…
The relationship between working alliance with peer mentors and eating psychopathology in a digital 6‐week guided self‐help intervention for anorexia nervosa
Objective: The quality of working alliance (WA) is associated with treatment outcomes across several types of psychiatric disorders and psychological interventions. This study examined the role of WA with peer mentors (people with lived experience of illness) and student mentors (graduated psychology students) in a 6-week, digital, guided self-help (GSH) intervention for anorexia nervosa. Method: Ninety-nine patients rated weekly, for 6 weeks: (a) eating psychopathology using the short version of the Eating Disorder Examination Questionnaire (EDE-QS) and (b) WA with a student mentor (n = 14) or a peer mentor (n = 10). WA was assessed by asking patients the extent to which they felt comforta…
Attachment anxiety and avoidance and perceptions of group climate: an actor-partner interdependence analysis.
There is a lack of research examining group members’ attachment styles and group climate perceptions in the context of the attachment styles and group climate perceptions of the other group members. In the current study, the actor–partner interdependence model (APIM) was used to examine the relationships among (a) a group member’s attachment pattern, (b) the aggregated attachment patterns of the other group members, (c) a group member’s perceptions of the group’s climate, and (d) the aggregated group climate perceptions of the other group members. One hundred ten Italian graduate students in six 10-session interpersonal growth groups were studied. Group members filled out the Attachment Sty…
Examining patients' and other group members' agreement about their alliance to the group as a whole and changes in patient symptoms using response surface analysis.
There is a lack of research examining patients' and other group members' agreement about their therapeutic alliance. In the present study, the person-group (P-G) fit model was adopted to predict that the group member symptom reduction will be greater when the group member's and the other group members' perceptions of their alliance to the group-as-a-whole fit and are high. In addition, the effect of disagreement between the group member and the other group members in their perceptions of the group alliance on the individual's outcome was investigated by using response surface analysis. Thirty-two patients from 5 long-term (> 1 year) psychodynamic group treatments were studied. Participants …
The Codevelopment of Group Relationships: The Role of Individual Group Member's and Other Group Members' Mutual Influence and Shared Group Environment
Although recent research has provided empirical support for the codevelopment of group interaction (defined as development in a common direction of perceptions of group relationships), no studies have yet investigated the "causes" of codevelopment among group members in the long term. The aim of the current study is to examine how the perceptions of an individual group member, and other group members, regarding group relationships influence each other over the course of treatment. We analyzed group data from 168 adult obese patients who participated in (1 of 20) 12-session therapy groups for weight management. Group relationships were measured by the Group Questionnaire (Krogel et al., 2013…
The relationship between attachment dimensions and perceptions of group relationships over time: An actor–partner interdependence analysis.
A group member’s attachment, anxiety, and avoidance is related to how the group member and the other group members (OGMs) perceive group relationships. In addition, the collective attachment strategies of the OGMs may also be related to how the individual group member and the others perceive the relationships in the group. We extend previous research, using the actor partner interdependence model (APIM), to examine how group members’ and aggregated OGMs’ attachment anxiety and avoid- ance were related to group members’ and OGMs perceptions of positive bonding, positive working, and negative relationships measured early and late in interpersonal growth groups. Three hundred twenty-five Itali…
Examining the relationship between group member gender, gender composition, and outcomes of weight management therapy groups
Presently there is a lack of evidence regarding the impact of gender composition of mixed-gender weight management therapy groups on members' posttreatment outcomes. As such, the current study tested the association between the gender composition of mixed-gender narrative therapy groups for weight management and members' posttreatment outcomes. Specifically, we examined the variability in group members' adjusted posttreatment psychological (Outcome Questionnaire-45 [OQ-45]) and obesity-related (Obesity Related Well-Being [ORWELL 97]) symptoms as a function of the quadratic proportion of female members in a group, and the interaction between group member gender and the quadratic proportion o…
Sex composition and group climate: A group actor−partner interdependence analysis.
There is a lack of research examining how the proportion of women and men in a group effects both the group member’s perception of group climate and the aggregated perceptions of group climate for the other group members. We adapted the group actor–partner interdependence model (GAPIM; Kenny & Garcia, 2012) to examine how the perception of the group’s climate by a group member and by the other group members are related to the group member’s sex and the sex of the other group members. In addition, we examined how similar the group member’s sex was to the sex of the other group members by analyzing the interaction between the two sex variables. A total of 110 Italian graduate students (96 wom…
Group relationships in early and late sessions and improvement in interpersonal problems.
Groups are more effective when positive bonds are established and interpersonal conflicts resolved in early sessions and work is accomplished in later sessions. Previous research has provided mixed support for this group development model. We performed a test of this theoretical perspective using group members' (actors) and aggregated group members' (partners) perceptions of positive bonding, positive working, and negative group relationships measured early and late in interpersonal growth groups. Participants were 325 Italian graduate students randomly (within semester) assigned to 1 of 16 interpersonal growth groups. Groups met for 9 weeks with experienced psychologists using Yalom and Le…
Attachment Anxiety and Attachment Avoidance: Members’ Attachment Fit with Their Group and Group Relationships
We compared each individual group member’s attachment fit with the attachment of the other group members. Participants were 201 members of 20 therapy groups who sought treatment because they were overweight or obese. Group members completed the Attachment Style Questionnaire before commencing treatment and the Group Questionnaire at three points during group treatment. Multilevel polynomial regression followed by response surface analysis was used to examine how the attachment anxiety and avoidance of the individual group member and the aggregated attachment anxiety and avoidance of the group members were related to individual group members’ perceptions of the positive bonding, positive wor…