The development of group cohesion and its relation to outcome in cognitive-behavioral and mutual support interventions for depression.

摘要

Although the concept of cohesion in group psychotherapy has been the topic of extensive theoretical discussion and empirical investigation, the development of cohesion and its relationship to treatment outcome remains unclear. The aim of the present study was to examine the role of group structure on the development of cohesiveness in group psychotherapy for depression and to investigate the relationship between group cohesion and therapy outcome. A total of 98 subjects were randomly assigned to either a highly structured cognitive-behavioral therapy group or an informally structured mutual support group. Cohesion was assessed using Affiliativeness composites from Mackenzie's (1983) Group Climate Questionnaire (GCQ-S) and an adaptation of Kelly's (1955) repertory grid.;Subjects in the highly structured therapy groups reported experiencing higher levels of cohesion in the early phases of treatment compared to subjects in the informally structured groups. Further, the higher levels of cohesiveness reported by cognitive-behavioral clients were maintained. In contrast, individuals in the mutual support groups initially reported high levels of cohesion, followed by a phase of reduced cohesion, and then a return to cohesiveness. The pattern observed in the mutual support groups is discussed in terms of A. P. Beck's (1986) theory of group development. Finally, subjects who experienced their groups as highly cohesive overall, evidenced greater alleviation of general distress and a reduction of depressive symptomatology.