A Qualitative Assessment of the Quantitative Group Psychotherapy Research: Past, Present, and Future

Abstract

A Qualitative Assessment of the Quantitative Group Psychotherapy Research: Past, Present, and Future Les R. Greene1 issn 0362-4021 © 2016 Eastern Group Psychotherapy Society group, Vol. 40, No. 1, Spring 2016 23 1 Staff Psychologist, VA Connecticut Healthcare System; Clinical Faculty, Yale University Department of Psychiatry; and private practice, Hamden, CT. Correspondence should be addressed to Les R. Greene, PhD, 35 Laurel Road, Hamden, CT 06517. E-mail: lesrgreene@peoplepc.com. “Never make predictions, especially about the future.” These words of wisdom, believed to have been uttered by the late philosophical luminary Yogi Berra, often go unheeded. Such was the case when I was asked on the dawn of the new millennium to set down some thoughts about future directions of group psychotherapy research (Greene, 2000). I had agreed to that request then, and now, 15 years later, I am asked to evaluate the accuracy of those predictions. Humbling though this new request might be, I agreed to take it on. The overarching question that I hope to address here in this qualitative overview is what is going on with group psychotherapy research. What was its status back in 2000, what was my forecast, and how well did my predictions match the current research landscape? With PsychInfo and PubMed databases as my archeological tools, I’ve reviewed the recent empirical journal literature to draw inferences about the trajectory of group psychotherapy research over these intervening years and develop some impressions about where we are and where we may be going. Back then, in 2000, outcome research—the research design that seeks to answer whether a particular treatment package is, in fact, effective—reigned supreme, not only for group psychotherapy but for all psychotherapeutic modalities. I estimated that about two-thirds of the quantitative group therapy studies published in the journal literature in that year focused exclusively on this question. Not surprisingly, given the pressures on journal editors to publish only those research papers that will have significant impact on the field, the studies all provided empirical support, in varying degrees, for the effectiveness of therapeutic group work across a diverse array of clinical populations and a range of therapeutic orientations. It is important 24 greene also to point out that most of these works were quite modest in methodological design, many dubbed as “preliminary” or “pilot” studies that were more akin to small-scale program evaluation surveys than to rigorous experimental research. Often characterized by their use of small samples of patients, inadequate or absent control or comparison conditions, and naive statistical analyses, these works necessarily can provide only very tentative conclusions about their findings, which are often euphemistically referred to as “promising.” Very few of the studies came close to meeting the gold standard of psychotherapy outcome research, the randomized control trial (RCT) with its checklist array of methodological safeguards designed to prevent spurious or false-positive results. Nevertheless, taken as a whole, the accumulated findings from that index year consistently showed that patients improve on such dimensions as clinical symptoms and interpersonal functioning following their participation in psychological work in a group context. Assessment of the current research literature from 2014 (the last complete year as of this writing) reveals that not much has changed with this picture over the intervening years. Outcome research is still the name of the game. Again, we found that approximately two-thirds of the quantitative studies published in the journal literature exclusively focused on pre–post differences. And while the overall quality of these studies seems to have improved in terms of methodological rigor (cf. Burlingame, Strauss, & Joyce, 2013), still relatively few studies meet the exacting criteria of an RCT design. Even more distressing, as Burlingame and colleagues observed, most of the recent research is being conducted by researchers with expertise either with a particular clinical population (such as depression, posttraumatic stress disorder, or substance abuse) or with a particular school of psychotherapy (most often a version of cognitive behavioral therapy) but not with respect to the group qua group. In a subtle but important way, the research question seems to have changed from “Does group therapy for these particular patients work?” to “Do patients who have been administered this particular intervention improve...