The Theory and Practice of Group Psychotherapy (113 page)

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W. McFarlane et al., “Multiple-Family Groups in Psychoeducation in the Treatment of Schizophrenia,”
Archives of General Psychiatry
52 (1996): 679–87. M. Galanter and D. Brook, “Network Therapy for Addiction: Bringing Family and Peer Support into Office Practice,”
International Journal of Group Psychotherapy
51 (2001): 101–23. F. Fawzy, N. Fawzy, and J. Wheeler, “A Post-Hoc Comparison of the Efficiency of a Psychoeducational Intervention for Melanoma Patients Delivered in Group Versus Individual Formats: An Analysis of Data from Two Studies,”
Psycho
-
Oncology
5 (1996): 81–89.

3
H. Strupp, S. Hadley, and B. Gomes-Schwartz,
Psychotherapy for Better or Worse: The Problem of Negative Effects
(New York: Jason Aronson, 1977). Lambert and Bergin, “Effectiveness of Psychotherapy,” 176–80. Luborsky et al. raise a dissenting voice: In their study they found little evidence of negative psychotherapy effects. See
Who Will Benefit from Psychotherapy?
M. Lambert and B. Ogles, “The Efficacy and Effectiveness of Psychotherapy,” in
Bergin and Garfield’s Handbook of Psychotherapy and Behavior Change,
5th ed., ed. M. Lambert (New York: Wiley, 2004): 139–93.

4
D. Martin, J. Garske, and M. Davis, “Relation of the Therapeutic Alliance with Outcome and Other Variables: A Meta-Analytic Review,”
Journal of Consulting and Clinical Psychology
68 (2000): 438–50. A. Horvath, L. Gaston, and L. Luborsky, “The Therapeutic Alliance and Its Measures,” in
Dynamic Psychotherapy Research,
ed. N. Miller, L. Luborsky, and J. Docherty (New York: Basic Books, 1993): 297–373. L. Gaston, “The Concept of the Alliance and Its Role in Psychotherapy: Theoretical and Empirical Considerations,”
Psychiatry
27 (1990): 143–53.

5
J. Krupnick et al., “The Role of the Therapeutic Alliance in Psychotherapy and Pharmacotherapy Outcome: Findings in the National Institute of Mental Health Collaborative Research Program,”
Journal of Consulting and Clinical Psychology
64 (1996): 532–39. D. Orlinsky and K. Howard, “The Relation of Process to Outcome in Psychotherapy,” in Garfield and Bergin,
Handbook of Psychotherapy and Behavioral Change,
4th ed., 308–76. H. Strupp, R. Fox, and K. Lessler,
Patients View Their Psychotherapy
(Baltimore: Johns Hopkins University Press, 1969). P. Martin and A. Sterne, “Post-Hospital Adjustment as Related to Therapists’ In-Therapy Behavior,”
Psychotherapy: Theory, Research, and Practice
13 (1976): 267–73. P. Buckley et al., “Psychodynamic Variables as Predictors of Psychotherapy Outcome,”
American Journal of Psychiatry
141 (1984): 742–48.

6
W. Meissner, “The Concept of the Therapeutic Alliance,”
Journal of the American Psychoanalytic Association
40 (1992): 1059–87. “Therapeutic alliance” is a term first used by Zetsel to describe the client’s capacity to collaborate with her psychoanalyst in the tasks of psychoanalysis. The client’s objectivity and commitment to explore and work through the thoughts and feelings generated in the treatment are key aspects in this early definition. Contemporary views of the therapeutic alliance define it more specifically as the understanding shared between the client and therapist regarding the therapy’s goals and the therapy’s tasks, along with the mutuality of trust, respect, and positive regard that characterize a successful therapy experience. (Bordin; Safran and Muran) Wolfe and Goldfried view the therapeutic alliance as “the quintessential integrative variable.” It lies at the heart of every effective mental health treatment, regardless of model or therapist orientation. E. Zetsel, “The Concept of the Transference,” in
The Capacity for Emotional Growth
(New York: International Universities Press, 1956), 168–81. E. Bordin, “The Generalizability of the Psychoanalytic Concept of the Therapeutic Alliance,”
Psychotherapy: Theory, Research, and Practice
16 (1979): 252–60. J. Safran and J. Muran,
Negotiating the Therapeutic Alliance: A Relational Treatment Guide
(New York: Guilford Press, 2003). B. Wolfe and M. Goldfried, “Research on Psychotherapy Integration: Recommendations and Conclusions from an NIMH Workshop,”
Journal of Consulting and Clinical Psychology
56 (1988): 448–51.

7
A. Horvath and B. Symonds, “Relation Between Working Alliance and Outcome in Psychotherapy: A Meta-Analysis,”
Journal of Consulting Psychology
38 (1991): 139–49. F. Fiedler, “A Comparison of Therapeutic Relationships in Psychoanalytic, Non-directive, and Adlerian Therapy,”
Journal of Consulting Psychology
14 (1950): 436–45. M. Lieberman, I. Yalom, and M. Miles,
Encounter Groups: First Facts
(New York: Basic Books, 1973).

8
R. DeRubeis and M. Feeley, “Determinants of Change in Cognitive Therapy for Depression,”
Cognitive Therapy and Research
14 (1990): 469–80. B. Rounsaville et al., “The Relation Between Specific and General Dimension: The Psychotherapy Process in Interpersonal Therapy of Depression,”
Journal of Consulting and Clinical Psychology
55 (1987): 379–84. M. Salvio, L. Beutler, J. Wood, and D. Engle, “The Strength of the Therapeutic Alliance in Three Treatments for Depression,”
Psychotherapy Research
2 (1992): 31–36. N. Rector, D. Zuroff, and Z. Segal, “Cognitive Change and the Therapeutic Alliance: The Role of Technical and Non-technical Factors in Cognitive Therapy,”
Psychotherapy
36 (1999): 320–28.

9
J. Ablon and E. Jones, “Validity of Controlled Clinical Trials of Psychotherapy: Findings from the NIMH Treatment of Depression Collaborative Research Program,”
American Journal of Psychiatry
159 (2002): 775–83.

10
L. Castonguay, M. Goldfried, S. Wiser, P. Raus, and A. Hayes, “Predicting the Effect of Cognitive Therapy for Depression: A Study of Common and Unique Factors,”
Journal of Consulting and Clinical Psychology
65 (1996): 588–98. Rector et al., “Cognitive Change and the Therapeutic Alliance.”

11
G. Burlingame, A. Fuhriman, and J. Johnson, “Cohesion in Group Psychotherapy,” in
A Guide to Psychotherapy Relationships that Work
, ed. J. Norcross (Oxford, England: Oxford University Press, 2002). E. Smith, J. Murphy, and S. Coats, “Attachment to Groups: Theory and Measurement,”
Journal of Personality and Social Psychology
77 (1999): 94–110. D. Forsyth, “The Social Psychology of Groups and Group Psychotherapy: One View of the Next Century,”
Group
24 (2000): 147–55.

12
Bednar and Kaul, “Experiential Group Research.”

13
S. Bloch and E. Crouch,
Therapeutic Factors in Group Psychotherapy
(New York: Oxford University Press, 1985), 99–103. N. Evans and P. Jarvis, “Group Cohesion: A Review and Reevaluation,”
Small Group Behavior
2 (1980): 359–70. S. Drescher, G. Burlingame, and A. Fuhriman, “Cohesion: An Odyssey in Empirical Understanding,”
Small Group Behavior
16 (1985): 3–30. G. Burlingame, J. Kircher, and S. Taylor, “Methodological Considerations in Group Therapy Research: Past, Present, and Future Practices,” in
Handbook of Group Psychotherapy,
ed. A. Fuhriman and G. Burlingame (New York: Wiley, 1994): 41–82. G. Burlingame, J. Johnson, and K. MacKenzie, “We Know It When We See It, But Can We Measure? Therapeutic Relationship in Group,” presented at the annual meeting of the American Group Psychotherapy Association, New Orleans, 2002.

14
D. Cartwright and A. Zander, eds.,
Group Dynamics: Research and Theory
(Evanston, Ill.: Row, Peterson, 1962), 74.

15
J. Frank, “Some Determinants, Manifestations, and Effects of Cohesion in Therapy Groups,”
International Journal of Group Psychotherapy
7 (1957): 53–62.

16
Bloch and Crouch, “Therapeutic Factors.”

17
Researchers either have had to depend on members’ subjective ratings of attraction to the group or critical incidents or, more recently, have striven for greater precision by relying entirely on raters’ evaluations of global climate or such variables as fragmentation versus cohesiveness, withdrawal versus involvement, mistrust versus trust, disruption versus cooperation, abusiveness versus expressed caring, unfocused versus focused. See S. Budman et al., “Preliminary Findings on a New Instrument to Measure Cohesion in Group Psychotherapy,”
International Journal of Group Psychotherapy
37 (1987): 75–94.

18
D. Kivlighan and D. Mullison, “Participants’ Perceptions of Therapeutic Factors in Group Counseling,”
Small Group Behavior
19 (1988): 452–68. L. Braaten, “The Different Patterns of Group Climate: Critical Incidents in High and Low Cohesion Sessions of Group Psychotherapy,”
International Journal of Group Psychotherapy
40 (1990): 477–93.

19
D. Kivlighan and R. Lilly, “Developmental Changes in Group Climate as They Relate to Therapeutic Gain,”
Group Dynamics: Theory, Research, and Practice
1 (1997): 208–21. L. Castonguay, A. Pincus, W. Agras, and C. Hines, “The Role of Emotion in Group Cognitive-Behavioral Therapy for Binge Eating Disorder: When Things Have to Feel Worse Before They Get Better,”
Psychotherapy Research
8 (1998): 225–38.

20
R. MacKenzie and V. Tschuschke, “Relatedness, Group Work, and Outcome in Long-Term Inpatient Psychotherapy Groups,”
Journal of Psychotherapy Practice and Research
2 (1993): 147–56.

21
G. Tasca, C. Flynn, and H. Bissada, “Comparison of Group Climate in an Eating Disorders Partial Hospital Group and a Psychiatric Partial Hospital Group,”
International Journal of Group Psychotherapy
52 (2002): 419–30.

22
R. Segalla, “Hatred in Group Therapy: A Rewarding Challenge,”
Group
25 (2001): 121–32.

23
A. Roarck and H. Sharah, “Factors Related to Group Cohesiveness,”
Small Group Behavior
20 (1989): 62–69.

24
Frank, “Some Determinants.” C. Marmarosh and J. Corazzini, “Putting the Group in Your Pocket: Using Collective Identity to Enhance Personal and Collective Self-Esteem,”
Group Dynamics: Theory, Research, and Practice
1 (1997): 65–74.

25
H. Grunebaum and L. Solomon, “Peer Relationships, Self-Esteem, and the Self,”
International Journal of Group Psychotherapy
37 (1987): 475–513.

26
Frank, “Some Determinants.” Braaten, “The Different Patterns of Group Climate.”

27
K. Dion, “Group Cohesion: From ‘Field of Forces’ to Multidimensional Construct,”
Group Dynamics: Theory, Research, and Practice
4 (2000): 7–26.

28
K. MacKenzie, “The Clinical Application of a Group Measure,” in
Advances in Group Psychotherapy: Integrating Research and Practice,
ed. R. Dies and K. MacKenzie (New York: International Universities Press, 1983), 159–70. Tasca et al., “Comparison of Group Climate.”

29
E. Marziali, H. Munroe-Blum, and L. McCleary, “The Contribution of Group Cohesion and Group Alliance to the Outcome of Group Psychotherapy,”
International Journal of Group Psychotherapy
47 (1997): 475–99. J. Gillaspy, A. Wright, C. Campbell, S. Stokes, and B. Adinoff, “Group Alliance and Cohesion as Predictors of Drug and Alcohol Abuse Treatment Outcomes,”
Psychotherapy Research
12 (2002): 213–29. G. Burlingame and colleagues have completed a comprehensive review of the current group relationship measures, describing the strengths and limitations of the available rating measures. See Burlingame et al., “We Know It When We See It.”

30
H. Spitz,
Group Psychotherapy and Managed Mental Health Care: A Clinical Guide for Providers
(New York: Brunner Mazel, 1996). H. Spitz, “Group Psychotherapy of Substance Abuse in the Era of Managed Mental Health Care,”
International Journal of Group Psychotherapy
51 (2001): 21–41.

31
H. Dickoff and M. Lakin, “Patients’ Views of Group Psychotherapy: Retrospections and Interpretations,”
International Journal of Group Psychotherapy
13 (1963): 61–73. Twenty-eight patients who had been in either clinic or private outpatient groups were studied. The chief limitation of this exploratory inquiry is that the group therapy experience was of brief duration (the mean number of meetings attended was eleven).

32
I. Yalom,
The Theory and Practice of Group Psychotherapy,
1st ed. (New York: Basic Books, 1970).

33
R. Cabral, J. Best, and A. Paton, “Patients’ and Observers’ Assessments of Process and Outcome in Group Therapy,”
American Journal of Psychiatry
132 (1975): 1052–54.

34
F. Kapp et al., “Group Participation and Self-Perceived Personality Change,”
Journal of Nervous Mental Disorders
139 (1964): 255–65.

35
I. Yalom et al., “Prediction of Improvement in Group Therapy,”
Archives of General Psychiatry
17 (1967): 159–68. Three measures of outcome (symptoms, functioning, and relationships) were assessed both in a psychiatric interview by a team of raters and in a self-assessment scale.

36
Cohesiveness was measured by a postgroup questionnaire filled out by each client at the seventh and the twelfth meetings, with each question answered on a 5-point scale:

1. How often do you think your group should meet?

2. How well do you like the group you are in?

3. If most of the members of your group decided to dissolve the group by leaving, would you like an opportunity to dissuade them?

4. Do you feel that working with the group you are in will enable you to attain most of your goals in therapy?