Group Cohesion Paper Example

Psychosocial Oncology and Palliative Care Department, Princess Margaret Hospital, Toronto, ON, Canada b Department of Psychology, Boston University, Boston, MA, USA c Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON, Canada M5B 2K3 d Anxiety Treatment and Research Centre, St. Joseph’s Healthcare, Hamilton, ON, Canada e Department of Psychiatry and Behavioural Neurosciences, McMaster University f Mood Disorders Program, St. Joseph’s Healthcare, Hamilton Received 6 August 2005; received in revised form 11 June 2006; accepted 16 June 2006

Abstract Cognitive-behavior therapy (CBT) for Social Phobia is effective in both group and individual formats. However, the impact of group processes on treatment efficacy remains relatively unexplored. In this study we examined group cohesion ratings made by individuals at the midpoint and endpoint of CBT groups for social phobia. Symptom measures were also completed at the beginning and end of treatment. We found that cohesion ratings significantly increased over the course of the group and were associated with improvement over time in social anxiety symptoms, as well as improvement on measures of general anxiety, depression, and functional impairment.

In conclusion, findings are consistent with the idea that changes in group cohesion are related to social anxiety symptom reduction and, therefore, speak to the importance of nonspecific therapeutic factors in treatment outcome. r 2006 Elsevier Ltd. All rights reserved. Keywords: Social phobia; Social anxiety disorder; Group cohesion; Cognitive-behavior therapy

Introduction Social phobia is characterized by an excessive fear of social or performance situations, during which a person may be scrutinized, judged, embarrassed, or humiliated by others. Evidence-based psychosocial treatments for social phobia have primarily come from a cognitive-behavioral orientation and include various combinations of four main components: (1) exposure-based strategies, (2) cognitive therapy, (3) social skills training, and (4) applied relaxation (for reviews, see Rodebaugh, Holaway, & Heimberg, 2004; Turk, Coles, & Heimberg, 2002).

Cognitive-behavioral treatment for social phobia has been shown to be effective when ÃCorresponding author. Department of Psychology, Ryerson University, 350 Victoria Street, Toronto, ON M5B 2K3, Canada. Tel.: +416 979 5000×2631; fax: +416 599 5660. E-mail address: [email protected] (M.M. Antony).

0005-7967/$ – see front matter r 2006 Elsevier Ltd. All rights reserved. doi:10.1016/j.brat.2006.06.004

ARTICLE IN PRESS688 M. Taube-Schiff et al. / Behaviour Research and Therapy 45 (2007) 687–698

administered in either individual and group formats (e.g., Heimberg, Salzman, Holt, & Blendell, 1993; Turner, Beidel, Cooley, Woody, & Messer, 1994). However, the mechanisms of change, and effective ingredients of these treatments remain relatively understudied. Researchers have compared group and individual treatments for this condition, although evidence regarding the relative effectiveness of each approach has been inconsistent (see Scholing & Emmelkamp, 1993; Stangier, Heidenreich, Peitz, Lauterbach, & Clark, 2003; Wlazlo, Schroeder-Hartwig, Hand, Kaiser, & Munchau, 1990 for direct comparisons of individual and group cognitive-behavioral treatment for social ¨ phobia). However, for some patients, group treatment may offer a number of advantages over individual treatment.

For example, group treatment provides an opportunity to marshal group processes (e.g., encouragement, support, and modeling from other group members) that may aid in teaching cognitive strategies and facilitating exposure exercises. Further, there may be nonspecific effects that arise as a result of the relationships that form amongst group members that may contribute to therapeutic outcome. We decided to investigate how these group processes, particularly group cohesion, may be related to treatment outcome in cognitive-behavior therapy (CBT) groups for social phobia.