Cited by 290Psychotherapy Techniques and ApplicationsPsychoanalysis and Psychopathology ResearchTeam Dynamics and Performance

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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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“Thus, they didn’t achieve a good enough group cohesion (Burlingame et al., 2018).”
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“As another example, the overall level of cohesiveness between members in a therapy group predicts individual-level treatment outcomes for the individuals in that group (Burlingame et al., 2018).”
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“Furthermore, it has been posited that stronger cohesion tends to emerge when group leaders promote an emotionally secure and collaborative safe space for feedback and support (Burlingame et al., 2018).”
Influential
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“…therapeutic settings; for example, facilitators noted an absence of opportunities for rapport-building between facilitators and participants and among participants themselves, which is consistent with treatment approaches that emphasize the importance of therapeutic alliance and cohesion [1, 12].”
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“Moderators could also be trained to facilitate group cohesion (sense of belonging, influence, mutual support, and identification with other group members [101,219]), which has been associated with better outcomes in professionally led support groups [220].”
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“Furthermore, when it comes to format, evaluation should include feasibility and retention patterns; when group-based delivery is used, group process indicators (e.g., attendance, interaction quality/cohesion, and facilitator ﬁdelity) should also be assessed (86).”
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“Group cohesion is the best nonspeci ﬁ c factor to explain positive outcomes in group psychotherapy – it is analogous to the treatment alliance in individual therapy (65).”
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“…group cohesion—defined as the sense of belonging, trust, and emotional connection among group members—has been consistently identified as a central therapeutic process in group psychotherapy and has been associated with improved treatment outcomes across different clinical populations [19].”
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“…linked to task achievement have been assessed by such measures as the “Engagement” scale of the Group Climate Questionnaire, the “Positive Working” scale of the Group Questionnaire (cf. Miles et al., 2023) and measures of cohesion and alliance (Burlingame & Strauss, 2021; Burlingame et al., 2018).”
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“The alliance individuals form with a therapist and their peers in a group treatment context is considered to be a critical mechanism of change in psychotherapy (Baier et al., 2020; Burlingame et al., 2018).”
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“…revealed that leader interventions to increase cohesion moderated the association between group cohesion and treatment outcome, such that studies that reported using strategies to build safety and group cohesion were associated with a stronger cohesion-outcome association (Burlingame et al., 2018).”
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“Studies have shown that positive group dynamics—such as group cohesion, emotional bonding, and empathy—are associated with improved emotional functioning among group members in group therapy settings [ 81].”
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“From a clinical perspective, individuals with higher levels of hopelessness as well as personality dysfunction may need an especially reliable feeling of affiliation with other group members (Burlingame et al., 2018) to benefit from group psychotherapy.”
Background
For Worse or for Better: Predicting Deterioration in a Relationship Education Program for Low-Income, Racially Diverse Couples
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“For example, group cohesion has been found to have an impact on treatment outcomes in group therapy in general (Burlingame et al., 2018), as well as in relationship satisfaction following relationship education interventions (Kivlighan et al., 2017; Owen et al., 2013).”
Background
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PVEMCERP Proceeding
(2021) · doi:10.32437/pvemcerpproceeding-2021
Références bibliographiques
Bernaud, J.-L. (2021) · Dunod eBooks · doi:10.3917/dunod.berna.2021.01.0317
The influence of members’ attachment style on group cohesion in substance use therapy groups
Naeli, A., Skentzos, M., & Hronis, A. (2022) · Discover Psychology · doi:10.1007/s44202-022-00022-w
Addressing Insomnia Using Group CBT‐I
Spiegelhalder, K. (2022) · doi:10.1002/9781119891192.ch22
Programa psicoeducativo para pessoas com diabetes (PROPSID): intervenção em grupo on-line para ansiedade e depressão
Ohno, P. M., de Jesus, R. S. M., Medeiros, H. M. D. F., & Teodoro, M. L. M. (2022) · Revista Brasileira de Terapias Cognitivas · doi:10.5935/1808-5687.20220006
“Fatores como coesão grupal, possibilidade de compartilhar as mesmas dificuldades do dia a dia e de criar vínculos sociais dão mais força ao tratamento (Burlingame et al., 2018).”
Group psychotherapy
Kharrazi, N., Moffett, L. A., & Denduluri, M. S. (2022) · Elsevier eBooks · doi:10.1016/b978-0-323-91497-0.00116-8
Effects of social support processes during implementation of community‐based randomized controlled trials: An example from a culturally adapted replication trial for Latino families
Cobb, C. L., Martínez, C. R., Schwartz, S. J., & Montero‐Zamora, P. (2022) · Journal of Community Psychology · doi:10.1002/jcop.22977
The feasibility of a emotional regulation group conducted with virtual adaptations within an adult community learning disability service
Ash, K., Cawthorne, T., Crabtree, J. W., & Boddington, E. (2023) · FPID Bulletin The Bulletin of the Faculty for People with Intellectual Disabilities · doi:10.53841/bpsfpid.2023.21.1.17
Personalisierte Gruppenpsychotherapie
Strauss, B. M. (2023) · Ärztliche Psychotherapie · doi:10.21706/aep-18-2-127
Gruppenpsychotherapie zur Reduktion posttraumatischer Belastungssymptome
Rosendahl, J., Gawlytta, R., & Strauss, B. M. (2023) · Trauma und Gewalt · doi:10.21706/tg-17-2-92
Mentaliser les conflits en thérapie de groupe : détruire et survivre, au service de la cohésion
Cherrier, J.-F., Francisco, A., & Lahaie, F.-S. (2022) · Santé mentale au Québec · doi:10.7202/1098899ar
Group Psychotherapy
Malát, J., Cheng, S. E. T., & Tay, A. T. S. (2023) · Springer eBooks · doi:10.1007/978-3-030-42825-9_37-1
Examining a Cohesion-Focused Model in Experiential Growth Groups: A Single Case Research Design
Zhu, P., Liu, Y., & Xiong, Y. (2023) · The Journal for Specialists in Group Work · doi:10.1080/01933922.2023.2248635
“Interpersonally oriented groups with a size of five to nine members were found to show the strongest cohesion-outcome relationships (Burlingame et al., 2018).”
Background

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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