Cohesion
COHESION
DEFINING COHESION
- The American Psychological Association (2020) defines group cohesion as “the unity or solidarity of a group.” However, there are many dimensions of cohesion, evident in the trouble pinning down a precise definition (see Burlingame et al., 2018 p. 384-385). Burlingame and colleagues (2018) found evidence for “two definitional dimensions of cohesion.” The first dimension is the relationship between group member and leader (vertical cohesion), combined with the relationship among group members (horizontal cohesion). The second dimension is the quality of these relationships, namely interpersonal and emotional support present in the group. Despite differing definitions, the impact of group cohesion on treatment outcome is evident.
TREATMENT RESOURCES
- Burlingame and Strauss (2021), in reviewing group therapy literature, remark that “cohesion predicts outcome across most theoretical orientations.” In 2018 Burlingame and colleagues found that cohesion was significantly associated with outcome in five group treatment orientations: interpersonal, psychodynamic, cognitive behavioral, supportive, and eclectic. Importantly, correlation between cohesion and outcome were higher when group leaders emphasized member-to-member interaction.
As the number of group sessions increases, the power of cohesion predicting client improvement increases (Burlingame et al., 2018). When groups met for 20 or more sessions, cohesion correlation with outcome was at its highest (r = .41, k = 11). Groups that met for 13 to 19 sessions had smaller relative estimates (r = .27; k = 7). Groups meeting fewer than 13 sessions showed a small cohesion correlation with outcome (r = .21; k = 27); Thus, there is solid evidence that cohesion and the leader interventions intended to increase it are evidence-based practices. This also supports the importance of therapists using measurement to gauge the level of cohesion in the group.
PROMISING MEASURES OF COHESION IN GROUP TREATMENT
- There are four cohesion measures that produced a statistically significant weighted correlation. The four measures were Profile of Mood States, Harvard Group Cohesiveness Scale, Stuttgarter Bogen, and Group Environment Scale. There were no reliable differences in the size of this correlation between measures. What can be drawn from these findings is that any of these five measures appear to be a suitable choice to measure correlation between cohesion and treatment outcome. However, the Group Climate Questionnaire–Engaged (GCQ-E) seems to be the most commonly used.
Cohesion Scale Revised (CSR) (Lieberman et al.,1973)
Group Atmosphere Scale (Silbergeld, S., Koenig, G. R., Manderscheid, R. W., Meeker, B. F., & Hornung, C. A. (1975). Assessment of environment-therapy systems: the Group Atmosphere Scale. Journal of Consulting and Clinical Psychology, 43(4), 460.)
Group Climate Questionnaire (MacKenzie, K. R. (1981). Measurement of group climate. International Journal of Group Psychotherapy, 31(3), 287-295.)
Group Cohesion (Piper, W. E., Marrache, M., Lacroix, R., Richardsen, A. M., & Jones, B. D. (1983). Cohesion as a basic bond in groups. Human Relations, 36(2), 93-108.)
Group Environment Scale (Moos, R. H. (1986). Group Environment Scale manual (2nd ed.). Palo Alto, CA: Consulting Psychologists Press.)
Harvard Group Cohesiveness Scale (Budman, S. H., Soldz, S., Demby, A., Feldstein, M., Springer, T., & Davis, M. S. (1989). Cohesion, alliance and outcome in group psychotherapy. Psychiatry, 52(3), 339-350.)
Profile of Mood States (POMS; McNair, Lorr, & Droppleman, 1981)
Stuttgarter Bogen (Czogalik, D., & Koltzow, R. (1987). Zur Normierung des Stuttgarter Bogens [For the standardization of the Stuttgarter Bogen]. Gruppenpsychotherapie und Gruppendynamik, 23, 36 – 45.)
Therapeutic Factor Inventory Cohesion subscale (Lese, K. P., & MacNair-Semands, R. R. (2000). The therapeutic factors inventory: development of a scale. Group, 24(4), 303-317.)