Cohesion, Alliance, and Outcome in Group Psychotherapy: Comments on Joyce et al. (2007) and Johnson (2007)

Abstract

I have read with great interest Joyce, Piper, & Ogrodniczuk’s (2007) article about therapeutic alliance, cohesion, and outcome in group psychotherapy, where alliance emerged as a more consistent predictor of outcome than cohesion. The data were taken from a comparative trial of two forms of time–limited group psychotherapy for complicated grief (12 sessions of interpretive or supportive group psychotherapy), and patients and the therapists rated a four–item measure of the therapeutic alliance after every session. The patient and therapist scores (means of the session scores) served as two summary measures of the therapeutic alliance over the entire course of therapy. The cohesion was rated from each individual participant’s perspective and consisted of every patient’s commitment to the group (rated after every session by each patient), the compatibility between the patient and the other members of the group (both the average of the patient’s ratings of the other members, and the average of the other members’ ratings of the patient), and finally the patient–therapist compatibility (as perceived both by the patient and the therapist). The compatibility measures were administered after Sessions 4, 8, and 12. The