Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-13T12:16:36.310Z Has data issue: false hasContentIssue false

Group Cohesion and Homework Adherence in Multi-Family Group Therapy for Schizophrenia

Published online by Cambridge University Press:  03 August 2012

Frank P. Deane*
Affiliation:
Illawarra Institute for Mental Health, Wollongong
Joanne Mercer
Affiliation:
Illawarra Institute for Mental Health, Wollongong
Anahita Talyarkhan
Affiliation:
Illawarra Institute for Mental Health, Wollongong
Gordon Lambert
Affiliation:
Illawarra Institute for Mental Health, Wollongong
Judy Pickard
Affiliation:
Illawarra Institute for Mental Health, Wollongong
*
Address for correspondence: Professor Frank Deane, Illawarra Institute for Mental Health, Building 22, University of Wollongong, NSW 2500. Email fdeane@uow.edu.au
Get access

Abstract

This study examined the relationship between levels of group cohesion, defined as whole group relationships, and between-session therapeutic homework adherence in a multi-family group therapy (MFGT) for people with schizophrenia. Participants from 18 consenting families attending MFGT groups completed weekly homework adherence ratings, group cohesion and spontaneous between-session activity measures. Levels of group cohesion at each session were compared with measures of scheduled and spontaneous homework adherence reported at the next session. It was hypothesised that higher levels of group cohesion would be related to homework adherence and other spontaneous between-session therapeutic activity completed by group members. Results show higher levels of group cohesion were associated with higher rates of spontaneous between-session therapeutic activity. However, contrary to expectations no significant relationship between cohesion and scheduled homework completion was found. The implications of the findings for group processes and homework adherence are discussed.

Type
Articles
Copyright
Copyright © The Authors 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Asen, E., & Schuff, H. (2006). Psychosis and multiple family group therapy. Journal of Family Therapy, 28, 5872.CrossRefGoogle Scholar
Bishop, P., Clilverd, A., Cooklin, A., & Hunt, U. (2002). Mental health matters: a multi-family framework for mental health intervention. Journal of Family Therapy, 24, 4656.CrossRefGoogle Scholar
Braaten, L. J. (1990). The different patterns of group climate critical incidents in high and low cohesion sessions of group psychotherapy. International Journal of Group Psychotherapy, 40, 477493.CrossRefGoogle ScholarPubMed
Bryant, M. J., Simons, A. D., & Thase, M. E. (1999). Therapist skill and patient variables in homework compliance; controlling and uncontrolled variable in cognitive therapy outcome research. Cognitive Therapy and Research, 23, 381399.CrossRefGoogle Scholar
Budman, S. H., Soldz, S., Demby, A., Feldstein, M., et al. (1989). Cohesion, alliance and outcome in group psychotherapy. Psychiatry: Interpersonal and Biological Processes, 52, 339350.CrossRefGoogle ScholarPubMed
Burlingame, G. M., Fuhriman, A., & Johnson, J. E. (2001). Cohesion in group psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 38, 373379.CrossRefGoogle Scholar
Costantini, A., Picardi, A., Podrasky, E., Lunetta, S., Ferraresi, G., & Balbi, A. (2002). Validation of the Italian version of the group climate questionnaire, an instrument to measure emotional climate during group psychotherapy sessions. Rivista di Psichiatria, 37, 1419.Google Scholar
Crowe, T. P., & Grenyer, B. F. S. (2008). Is therapist alliance or whole group cohesion more influential in group psychotherapy outcomes? Journal of Clinical Psychology and Psychotherapy, 15, 239246.CrossRefGoogle ScholarPubMed
Dixon, L., McFarlane, W. R., Lefley, H., Lucksted, A., Cohen, M., Falloon, I., Mueser, K., Miklowitz, D., Solomon, P., & Sondheimer, D. (2001). Evidence-based practices for services to families of people with psychiatric disabilities. Psychiatric Services, 52, 903910.CrossRefGoogle ScholarPubMed
Dyck, D. G., Hendryx, M. S., Short, R. A., Voss, W. D., & McFarlane, W. R. (2002). Service use among patients with schizophrenia in psychoeducational multiple-family group treatment. Psychiatric Services, 53, 749754.CrossRefGoogle ScholarPubMed
Dyck, D. G., Short, R. A., Hendryx, M. S., Norell, D., Myers, M., Patterson, T., McDonell, M. G., Voss, W. D., & McFarlane, W. R. (2000). Management of negative symptoms among patients with schizophrenia attending multiple-family groups. Psychiatric Services, 51, 513519.CrossRefGoogle ScholarPubMed
Fenton, L. R., Cecero, J. J., Nich, C., Frankforter, T. L., & Carroll, K. M. (2001). Perspective is everything: the predictive validity working alliance instruments. Journal of Psychotherapy Practice & Research, 10, 262268.Google ScholarPubMed
Gaston, L., & Marmar, C. R. (1994). The California psychotherapy alliance scales. In Horvarth, A. O. & Greenberg, L. S. (Eds.). The working alliance: Theory, research and practice. Oxford, England: John Wiley & Sons.Google Scholar
Greene, C. N. (1989). Cohesion and productivity in work groups. Small Group Behavior, 20, 7086.CrossRefGoogle Scholar
Johnson, J. E., Pulsipher, D., Ferrin, S. L., Burlingame, G. M., Davies, D. R., & Gleave, R. (2006). Measuring group processes: a comparison of the GCQ and CCI. Group Dynamics: Theory, Research and Practice, 10, 136145.CrossRefGoogle Scholar
Kanas, N., & Barr, M. A. (1986). Process and content in a short-term inpatient schizophrenic group. Small Group Behavior, 17, 355363.CrossRefGoogle Scholar
Kanas, N., DiLella, V. J., & Jones, J. (1984). Process and content in an outpatient schizophrenic group. Group, 8, 1320.CrossRefGoogle Scholar
Kanas, N., & Ziegler, J. L. (1984). Group climate in a stress discussion group for medical interns. Group, 8, 3538.CrossRefGoogle Scholar
Kazantzis, N. (2000). The role of homework assignments in cognitive and behavioral therapies. Doctoral dissertation, Massey University, New Zealand.Google Scholar
Kazantzis, N., Deane, F. P., & Ronan, K. R. (2004). Assessing compliance with homework assignments: review and recommendations for clinical practice. Journal of Clinical Psychology, 60, 627641.CrossRefGoogle ScholarPubMed
Kazantzis, N., Deane, F. P., & Ronan, K. R. (2000). Homework assignments in cognitive and behavioral therapy: a meta-analysis. Clinical Psychology: Science and Practice, 7, 189202.Google Scholar
Kazantzis, N., Deane, F. P., Ronan, K. R., & L'Abate, L. (Eds.). (2005). Using homework assignments in cognitive behavior therapy. New York: Routledge.CrossRefGoogle Scholar
Kazantzis, N., & L'Abate, L. (Eds.). (2007). Handbook of homework assignments in psychotherapy: research, practice and prevention. New York: Springer Science.CrossRefGoogle Scholar
Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17, 144156.Google Scholar
Kivlighan, D. M., & Goldfine, D. C. (1991). Endorsement of therapeutic factors as a function of stage of group development and participant interpersonal attitudes. Journal of Counseling Psychology, 38, 150158.CrossRefGoogle Scholar
Kymissis, P., Bevacqua, A., & Morales, N. (1995). Multi-family group therapy with dually diagnosed adolescents. Journal of Child & Adolescent Group Therapy, 5, 107113.CrossRefGoogle Scholar
MacKenzie, K. R. (1983). The clinical application of group measure. In Dies, R. R. & MacKenzie, K. R. (Eds.). Advances in group psychotherapy: integrating research and practice. New York: International Universities Press.Google Scholar
MacKenzie, K. R., Dies, R. R., Coche, E., & Rutan, J. S. (1987). An analysis of AGPA institute groups. International Journal of Group Psychotherapy, 37, 5574.CrossRefGoogle ScholarPubMed
Maloney, M. J. (1981). The use of children's drawings in multiple family group therapy. Group, 5, 3236.CrossRefGoogle Scholar
Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance with outcome and other variables: A meta-analytic review. Journal of Consulting and Clinical Psychology, 68, 438450.CrossRefGoogle ScholarPubMed
McFarlane, W. R. (2002). Multifamily groups in the treatment of severe psychiatric disorders. Guilford Publications Inc.; New York.Google Scholar
McFarlane, W. R., Lukens, E., Link, B., Dushay, R., Deakins, S., Newmark, M., Dunne, E., Horan, B., & Toran, J. (1995). Multiple family groups and psychoeducation in the treatment of schizophrenia. Archives of General Psychiatry, 52, 679687.CrossRefGoogle ScholarPubMed
Nahum, D., & Brewer, M. M. (2004). Multi-family group therapy for sexually abusive youth. Journal of Child Sexual Abuse, 13, 215243.CrossRefGoogle ScholarPubMed
Orlinsky, D., Tarragona, M., Epstein, M., & Howard, K. (1989). Intersession Experience Questionnaire [form P]. Unpublished manuscript.Google Scholar
Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Orbach, G., & Morgan, C. (2002). Psychological treatments in schizophrenia: I. meta-analysis of family intervention and cognitive behavior therapy. Psychological Medicine, 32, 763782.CrossRefGoogle Scholar
Primakoff, L., Epstein, N., & Covi, L. (1986). Homework compliance: an uncontrolled variable in cognitive therapy outcome research. Behavior Therapy, 17, 433446.CrossRefGoogle Scholar
Rea, M. M., Tompson, M. C., Miklowitz, D. J., Goldstein, M. J., Hwang, S., & Mintz, J. (2003). Family-focused treatment versus individual treatment for bipolar disorder: results of a randomized clinical trial. Journal of Consulting & Clinical Psychology, 71, 482492.CrossRefGoogle ScholarPubMed
Safran, J. D., & Wallner, L. K. (1991). The relative predictive validity of two therapeutic alliance measures in cognitive therapy. Psychological Assessment, 3, 188195.CrossRefGoogle Scholar
Taft, C. T., Murphy, C. M., King, D. W., Musser, P. H., & DeDeyn, J. M. (2003). Process and treatment adherence factors in group cognitive-behavioral therapy for partner violent men. Journal of Consulting and Clinical Psychology, 71, 812820.CrossRefGoogle ScholarPubMed
Taube-Schiff, M., Suvak, M. K., Antony, M. M., Bieling, P. J., & McCabe, R. E. (2007). Group cohesion in cognitive-behavioral group therapy for social phobia. Behaviour Research and Therapy, 45, 687698.CrossRefGoogle ScholarPubMed
Van Andel, P., Erdman, R. A., Karsdorp, P. A., Appets, A., & Trijsburg, R. W. (2003). Psychotherapy and Psychometrics, 72, 141149.CrossRefGoogle Scholar
Woody, S. R., & Adessky, R. S. (2002). Therapeutic alliance, group cohesion, and homework compliance during cognitive-behavioral group treatment of social phobia. Behavior Therapy, 33, 527.CrossRefGoogle Scholar
Yalom, I. D. (1995). Theory and practice of group psychotherapy, 4th ed.New York: Basic Books.Google Scholar