Process-Outcome Relationships in Short- and Long-Term Psychodynamic Group Psychotherapy: Results From a Randomized Clinical Trial

摘要

This study focuses on the associations between cohesion, baseline predictors (e.g., symptoms, interpersonal problems, psychosocial functioning, presence of personality disorders [PDs]), and outcomes in short-term (6 months) and long-term (24 months) group-analytic psychotherapy (called STG and LTG, respectively). This study is part of a project investigating the impact of treatment duration on outcome in a randomized trial and relates to a subsample of 144 outpatients with complex diagnoses. Cohesion, commonly investigated in nonpsychodynamic short-term groups, was measured using the cohesiveness subscale of the Therapeutic Factors Inventory. We used hierarchical linear models for statistical analyses. Cohesion in STGs appeared to be sensitive to the patients' initial impairment (i.e., a higher level of interpersonal problems was associated with lower cohesion). The initial level of symptom distress and presence of PDs did not significantly affect cohesion in any of the therapy formats. Higher cohesion was associated with improvement in symptoms and interpersonal problems at the end of treatment in the STG, but not at follow-up. In the LTG cohesion was not significantly associated with outcome at any time-point. Thus, cohesion is an important predictor of improvement in STG. There were no significant differences between cohesion-%%%predictor/outcome associations in STG and LTG. More research on larger samples using more frequent process measures and updated group relationship measures are needed to gain more knowledge of the possible change mechanisms within process-%%%outcome research and the impact of duration of therapies on the cohesion-outcome associations.