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Cohesion in group therapy: A meta-analysis.

Burlingame, Gary M., McClendon, Debra Theobald, Yang, Chongming·2018·Psychotherapy

DOI 10.1037/pst0000173

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Abstract

Cohesion is the most popular of the relationship constructs in the group therapy literature. This article reviews common definitions of cohesion, the most frequently studied measures, and a measure that may clarify group relations using two latent factors (quality and structure) to explain common variance among frequently used group relationship instruments. We present the results of a meta-analysis examining the relation between group cohesion and treatment outcome in 55 studies. Results indicate that the weighted aggregate correlation between cohesion and treatment outcome was statistically significant, r = .26, z = 6.54 (p < .01), reflecting a moderate effect size (d = .56). Heterogeneity of effect sizes was significant (Q = 260.84, df = 54, p < .001) and high (I2 = 79.3%), supporting moderator analyses. Six moderator variables were found to significantly predict the magnitude of the cohesion-outcome association (type of outcome measure, leader interventions to increase cohesion, theoretical orientation, type of group, emphasis on group interaction, and dose or number of group sessions). Patient contributions, diversity considerations, and evidence-based therapeutic practices are highlighted. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

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Rosenberg, M. (1965) · doi:10.1515/9781400876136 · Cited by 30,126
Fixed-and random-effects models in meta-analysis.
Hedges, L. V., & Vevea, J. L. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.4.486 · Cited by 2,977
Profile of mood states
McNair, D. M. (1992) · Medical Entomology and Zoology · Cited by 2,527
Inventory of interpersonal problems: Psychometric properties and clinical applications.
Horowitz, L. M., Rosenberg, S. E., Baer, B. A., Ureño, G., & Villaseñor, V. S. (1988) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.56.6.885 · Cited by 2,026
Encounter Groups: First Facts.
Touhey, J. C., Lieberman, M. A., Yalom, I. D., & Miles, M. B. (1974) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2063566 · Cited by 731
Assessing adult attachment.
Feeney, J. A., Noller, P., & Hanrahan, M. U. (1994) · Cited by 687
Cohesion in group psychotherapy.
Burlingame, G. M., Fuhriman, A., & Johnson, J. E. (2001) · Psychotherapy: Theory, Research, Practice, Training · doi:10.1037/0033-3204.38.4.373 · Cited by 263
Self-citation
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Johnson, J. E., Burlingame, G. M., Olsen, J. A., Davies, D. R., & Gleave, R. L. (2005) · Journal of Counseling Psychology · doi:10.1037/0022-0167.52.3.310 · Cited by 263
Self-citation
Cohesion as a Basic Bond in Groups
Piper, W. E., Marrache, M., Lacroix, R., Richardsen, A. M., & Jones, B. (1983) · Human Relations · doi:10.1177/001872678303600201 · Cited by 219
Group environment scale manual
Moos, R. H. (1986) · Consulting Psychologists Press eBooks · Cited by 212

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“This procedure, and resulting heterogeneity in measurement, is typical of recently published meta-analyses (e.g., Alldredge et al., 2021; Burlingame et al., 2018; Lo Coco et al., 2022), including heterogeneity in outcome measures.”
InfluentialSelf-citation
An Integrative Systems-Oriented Interpersonal/Relational Group Approach to Understanding and Treating Mass Trauma, Dissociation and Enactments During the COVID-19 Pandemic
Leiderman, L. M., & Klein, R. H. (2021) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2021.1991234 · Cited by 7
“…an approach is consistent with accumulating empirical evidence on the value of the therapeutic relationship (DeAngelis, 2019), cohesiveness, and interpersonal learning, all of which have been correlated with successful outcome in group psychotherapy (Burlingame et al., 2018; Yalom & Leszcz, 2020).”
Result
An exploratory investigation of predictors of outcome in face‐to‐face and online cognitive‐behavioural therapy for bulimia nervosa
Matherne, C. E., Watson, H. J., Fassnacht, D. B., Ali, K., Zerwas, S. C., Peat, C. M., Runfola, C. D., Levine, M. D., Marcus, M. D., Zimmer, B., et al. (2022) · European Eating Disorders Review · doi:10.1002/erv.2898 · Cited by 7
Improving the Safety Performance of Construction Workers through Individual Perception and Organizational Collectivity: A Contrastive Research between Mainland China and Hong Kong
Meng, X., & Chan, A. H. S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192114599 · Cited by 14
“The former refers to the relation of harmony and cooperation among organizational members [25,26].”
Background
Group brief cognitive behavioral therapy for suicide prevention compared to dialectal behavior therapy skills group for military service members: a study protocol of a randomized controlled trial
Baker, J. C., Grover, S. G., Gunn, L. H., Charles, C., Rikli, H., Franks, M. J., Khazem, L. R., Williams, S. R. M., Ammendola, E., Washington, C., et al. (2023) · BMC Psychiatry · doi:10.1186/s12888-023-05282-x · Cited by 8
“Group therapy can also build cohesion among patients, leading to better outcomes [17].”
Background
Group Cohesion and Necessary Adaptations in Online Hearing Voices Peer Support Groups: Qualitative Study With Group Facilitators
Branitsky, A., Longden, E., Bucci, S., Morrison, A. P., & Varese, F. (2024) · JMIR Formative Research · doi:10.2196/51694 · Cited by 7
An examination of referrals declined for chronic pain care: There is increasing mental health complexity within care-seeking patients with chronic pain over time
Bosma, R. L., Rosenbloom, B. N., Burke, E., Aquino, C., Stanley, C., Coombs, K., Nella, A., James, S., Clarke, H. A., Flamer, D., et al. (2024) · Canadian Journal of Pain · doi:10.1080/24740527.2024.2337074 · Cited by 7
“18,19 To tackle the complexity of the patient population, further specialized resources that combine both pain and mental health care are required.”
Background
A Brief History of Group Therapy as a Field and the Representation of Women in Its Development
Paquin, J. D., Abegunde, C., Hahn, A., & Fassinger, R. E. (2020) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2020.1798176 · Cited by 7
Peacefull: A French mindfulness-based intervention for adolescents with chronic pain a feasibility study
Suc, A., Cayzac, D., Iannuzzi, S., Garnier, C., Bonneau, B., & Sommet, A. (2022) · Archives de Pédiatrie · doi:10.1016/j.arcped.2022.06.006 · Cited by 7
Instrumente und Materialien zur Unterstützung gruppenpsychotherapeutischer Praxis
Strauss, B. M. (2020) · Psychotherapeut · doi:10.1007/s00278-020-00433-x · Cited by 7
“In neuen Studien wurden als die am häufigstengenutzten Instrumente zurErfassung von Prozessaspekten inGruppen dasWorkingAlliance Inventar(WAI),die Empathie-Skala (ES), die Kurzform des Gruppenklimafragebogens (GCQ) sowie die Kohäsionsskala aus dem Therapeutic Factors Inventory (TFI) identifiziert.”
BackgroundInfluential
Italian adaptation of the Group Questionnaire: validity and factorial structure
Giannone, F., Guarnaccia, C., Gullo, S., Blasi, M. D., Giordano, C., Coco, G. L., & Burlingame, G. M. (2020) · Research in Psychotherapy Psychopathology Process and Outcome · doi:10.4081/ripppo.2020.443 · Cited by 7
Self-citation
The use of Australian SMART Recovery groups by people who use methamphetamine: Analysis of routinely-collected nationwide data
Beck, A. K., Larance, B., Deane, F. P., Baker, A., Manning, V., Hides, L. M., Shakeshaft, A. P., Argent, A., & Kelly, P. J. (2021) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2021.108814 · Cited by 8
MDMA-Assisted Group Therapy for PTSD: Development of a Novel Protocol
Stauffer, C. S., Bouleh, P., & Anderson, B. T. (2025) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2025.03.001 · Cited by 7
Wechselseitige Effekte von Gruppenkohäsion und Symptomen
Dinger, U., Zilcha‐Mano, S., & Schauenburg, H. (2020) · Psychotherapeut · doi:10.1007/s00278-020-00436-8 · Cited by 6
The Impact of an Intensive Summer Treatment Program for Adolescents with ADHD: A Qualitative Study of Parent and Young Adult Perspectives
Yegüez, C. E., Ogle, R. R., Jusko, M. L., Melendez, R., & Sibley, M. H. (2022) · Journal of Child and Family Studies · doi:10.1007/s10826-022-02384-0 · Cited by 7
“, cohesion) on functional outcomes (Burlingame et al., 2018; Karver et al., 2018), social skills, and internalizing symptoms within group-based treatments for ADHD.”
Background
Is there an optimal level of positive and negative feedback in group therapy? A response surface analysis.
Kivlighan, D. M., Ali, R. W., & Garrison, Y. L. (2019) · Psychotherapy · doi:10.1037/pst0000244 · Cited by 8
BRAVA: A randomized controlled trial of a brief group intervention for youth with suicidal ideation and their caregivers
Kennedy, A., Gray, C., Sheridan, N., Dunn, L. C., Stewart, J., Drouin, S., Elliott, H., Adeponle, A. B., Barrowman, N. J., Sucha, E., et al. (2025) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/s13034-025-00941-1 · Cited by 5
“Moreover, a meta-analysis of group cohesion in adult group therapy interventions previously found a mildly positive correlation between cohesion and outcomes in groups containing 5–9 members [54].”
Addressing the Negative Impact of Social Media on Body Image: An Online Randomized Controlled Pilot Trial
Ladwig, G., Schönhals, K., Quittkat, H. L., Dietel, F. A., & Vocks, S. (2025) · International Journal of Eating Disorders · doi:10.1002/eat.24584 · Cited by 6
Pilot study of an app-supported psychosocial prevention intervention: a mixed-methods approach
Gehrmann, J., Stephan, J., Dehner, J., Stullich, A., Richter, M., PE³PP study group, Ballaschke, O., Finke, F., Gabel, F., Grossmann, A., et al. (2025) · Pilot and Feasibility Studies · doi:10.1186/s40814-025-01737-y · Cited by 5
The efficacy of a facilitated support group intervention to reduce the psychological distress of individuals experiencing family estrangement
Blake, L., Bland, B., & Gilbert, H. (2022) · Evaluation and Program Planning · doi:10.1016/j.evalprogplan.2022.102168 · Cited by 5
Women-only versus mixed-gender groups in multimodal, day clinic treatment of trauma-related disorders
Philipps, A., Hepp, T., Silbermann, A., Morawa, E., Stemmler, M., & Erim, Y. (2022) · Zeitschrift für psychosomatische Medizin und Psychotherapie · doi:10.13109/zptm.2022.68.4.378 · Cited by 5
Feasibility of a multidisciplinary group videoconferencing approach for chronic low back pain: a randomized, open-label, controlled, pilot clinical trial (EN-FORMA)
Garreta-Catala, I., Planas, R., Abouzari, R., Carnaval, T., Solé, J. M. N., Videla, S., Agulló, J.-L., the EN-FORMA study group, Calvis-Garcia, P., Carmezim, J., et al. (2023) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-023-06763-6 · Cited by 8
“Group experience itself contains therapeutic phenomena [20] ( e.g. , altruism, group cohesion, interpersonal learning), and group cohesion improves outcomes in both in-and outpatient settings [21] and should be encouraged.”
Background
Renewed Feedback-Informed Group Treatment for Patients with Anxiety and Depressive Disorders
Vos, M. M. W. K.-D., Tiemens, B. G., Engelsbel, F., de Jong, K., Witteman, C. L. M., & Nugter, A. (2024) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-023-01338-y · Cited by 5
“It is indeed found that the relationship between cohesion and outcomes is higher when groups are longer and is the highest in groups with > 20 sessions (Burlingame et al., 2018a).”
Influential
Group Cohesion and Climate in Cognitive Behavioral Therapy for Individuals with a First-Time DUI
Cruz, M., Osilla, K. C., & Paddock, S. M. (2019) · Alcoholism Treatment Quarterly · doi:10.1080/07347324.2019.1613941 · Cited by 5
“Yet measures of cohesion and climate tend not to be simultaneously analyzed, making it impossible to determine if similar relationships are being assessed (Burlingame et al., 2018).”
Background
Basale Wirkmodelle in der Psychotherapie
Flückiger, C. (2021) · Psychotherapeut · doi:10.1007/s00278-020-00478-y · Cited by 5
Group cohesion in group-based personal practice
Maaß, U., Kühne, F., Hahn, D., & Weck, F. (2021) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465821000369 · Cited by 6
“Two meta-analyses have confirmed the positive impact of cohesion on therapy outcomes, with average correlations of r = 0.25 – 0.26, based on up to 55 studies and 6.055 clients (Burlingame et al ., 2011; Burlingame et al ., 2018).”
MethodInfluential
Can you see what I see? A comparison of client and observer perspectives of the alliance and group cohesion in CBT
Luong, H. K., Drummond, S. P. A., & Norton, P. J. (2021) · Cognitive Behaviour Therapy · doi:10.1080/16506073.2021.1898463 · Cited by 5
“While decades of research have established client-rated alliance and cohesion as predictors of outcome (Burlingame et al., 2018; Flückiger et al., 2018), observer perspectives may provide additional unique and critical information about therapeutic processes.”
BackgroundInfluential
The unified protocol: patient and therapist perspectives on the utility of the group manual
Christensen, A. B., Gryesten, J. R., Kokholm, J., Vislie, K., Reinholt, N., Dichmann, K., Poulsen, S., & Arnfred, S. (2022) · Clinical Psychologist · doi:10.1080/13284207.2022.2061340 · Cited by 7
Are group identity and sense of belonging relevant for group pain management programmes? An exploratory pilot study
Wilson, D., Mackintosh, S. F., Nicholas, M. K., Moseley, G. L., Costa, D. S. J., & Ashton-James, C. E. (2022) · British Journal of Pain · doi:10.1177/20494637221098941 · Cited by 7
Group Cognitive–Behavioral Therapy in a Sample of Dutch Intimate Partner Violence Perpetrators: Development of a Coding Manual for Therapist Interventions
van Tilburg, C. A., van Dam, A., de Wolf-Jacobs, E., de Ruiter, C., & Smeets, T. (2022) · International Journal of Group Psychotherapy · doi:10.1080/00207284.2022.2105702 · Cited by 6
“Study outcomes show significant correlations between therapeutic alliance and treatment outcomes, and similar correlations are found for group cohesion and treatment outcomes, including CBT approaches to group therapy (Alldredge et al., 2021; Burlingame et al., 2018).”
Background
Feasibility of online group stress management training compared to web-based individual training for employees—a randomized pilot study
Boß, L., Hannibal, S., & Lehr, D. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1524285 · Cited by 5
Increasing motivation and well-being among medical students using curricular self-experience group sessions—a randomized controlled trial
Spitzer, P., Mittmann, C., Utz, J., Mestermann, S., Wietek, T. F., Kornhuber, J., & Herrmann‐Werner, A. (2025) · Medical Education Online · doi:10.1080/10872981.2025.2519386 · Cited by 6
“This finding is consistent with many other reports in the field of psychotherapy that suggest that group cohesion is one of the general, nonspecific factors in group therapy [52].”
Effects of Religious Versus Non-religious Self-compassion Interventions on Anxiety and Quality of Life of Iranian Infertile Women: A Randomized Controlled Trial
Rezapour-Mirsaleh, Y., Abolhasani, F., Amini, R., Rezai, M. J., Choobforoushzadeh, A., & Shameli, L. (2024) · Journal of Religion and Health · doi:10.1007/s10943-024-02045-0 · Cited by 4
A Self-Applied Psychological Treatment for Gambling-Related Problems via The Internet: A Pilot, Feasibility Study
Díaz-Sanahuja, L., Suso‐Ribera, C., Lucas, I., Jiménez‐Múrcia, S., Tur, C., Gual-Montolio, P., Paredes-Mealla, M., García‐Palacios, A., & Bretón-López, J. M. (2024) · Journal of Gambling Studies · doi:10.1007/s10899-024-10318-2 · Cited by 5
“According to Burlingame et al. (2018), participating in group sessions offers numerous advantages, including opportunities for interpersonal connections, individuality, collaboration, and team dynamics among participants.”
Background
The Group Questionnaire (GQ)—Psychometric properties among outpatients with personality disorders.
Pedersen, G., Kvarstein, E. H., Wilberg, T., Folmo, E. J., Burlingame, G. M., & Lorentzen, S. (2021) · Group Dynamics Theory Research and Practice · doi:10.1037/gdn0000176 · Cited by 4
Self-citation
Comparing People’s Experience of Therapy for Complex Trauma Across Three Modalities: Face-to-Face, Mixed, and Online
Maloney, E., Dowling, C., Deehan, T., & Reilly, G. O. (2022) · OBM Integrative and Complementary Medicine · doi:10.21926/obm.icm.2204051 · Cited by 4
The Therapy Process Observational Coding System: Group cohesion scale in youth anxiety treatment: Psychometric properties
Fjermestad, K. W., McLeod, B. D., Silverman, W. K., Bjaastad, J. F., Lerner, M. D., & Wergeland, G. J. (2023) · Journal of Clinical Psychology · doi:10.1002/jclp.23496 · Cited by 4
Group Radical Openness: Participants' attributions of change
Johnstone, V., McDonough, C., Egan, R., Browne, K., & Corbett, A. B. (2024) · Counselling and Psychotherapy Research · doi:10.1002/capr.12750 · Cited by 4
Abbreviated Dialectical Behavior Therapy Virtual Skills Group for Caregivers of Adolescents: An Exploratory Study of Service User and Clinical Outcomes
Hare, M. M., Conroy, K., Georgiadis, C., & Shaw, A. M. (2024) · Child Psychiatry & Human Development · doi:10.1007/s10578-024-01681-7 · Cited by 4

Authors: Burlingame, G. M., McClendon, D. T., & Yang, C.
Affiliations: Brigham Young University (US)
ORCID: Burlingame, Gary M.
Yang, Chongming
Venue: Psychotherapy
Publisher: American Psychological Association (APA)
Published: 2018-12
Volume: 55
Issue: 4
Pages: 384-398
ISSN: 0033-3204 (ISSN-L)
1939-1536
DOI: 10.1037/pst0000173
OpenAlex: W2895900470
Cited by: 290
References: 96
Citations by year: 2026: 53 · 2025: 60 · 2024: 38 · 2023: 39 · 2022: 37 · 2021: 34 · 2020: 17 · 2019: 12
FWCI: 18.54
Type: journal article
Language: en
Open access: closed
Locations: Psychotherapy (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Social Sciences › Psychology › Social Psychology › Team Dynamics and Performance
Keywords: group cohesion, group therapy, treatment outcomes, group relations, group interaction, theoretical orientation, group types, patient diversity, evidence-based treatment
MeSH terms: Mental Disorders, Humans, Interpersonal Relations, Psychotherapy, Group, Treatment Outcome

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Cohesion in group therapy: A meta-analysis.

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