The differential effectiveness of group psychotherapy: A meta-analytic perspective.

The differential effectiveness of group psychotherapy was estimated in a meta-analysis of 111 experimental and quasi-experimental studies published over the past 20 years. A number of client, therapist, group, and methodological variables were examined in an attempt to determine specific as well as generic effectiveness. Three different effect sizes were computed: active versus wait list, active versus alternative treatment, and pre- to posttreatment improvement rates. The active versus wait list overall effect size (0.58) indicated that the average recipient of group treatment is better off than 72% of untreated controls. Improvement was related to group composition, setting, and diagnosis. Findings are discussed within the context of what the authors have learned about group treatment, meta-analytic studies of the extant group literature, and what remains for future research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A controlled study of quantitative feedback in married-couples brief group psychotherapy.

Investigated the impact of delayed, written feedback on the process and outcome of brief group psychotherapy for married couples using a 2-group, 2-stage design. 12 18–36 yr old heterosexual couples participated. Results show that (1) feedback variables showed more significant changes in expected directions than did the nonfeedback variables; (2) therapy plus feedback, in contrast to therapy alone, led to the assessment of greater behavioral change; (3) therapy plus feedback was a more effective tool than therapy alone for increasing the degree of congruence between self and peer ratings, and between self and therapist ratings. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A meta-analytic review of the effectiveness of inpatient group psychotherapy.

The effectiveness of inpatient group therapy was estimated in a meta-analysis of 24 controlled and 46 studies with pre-post-measures published between 1980 and 2004. Diagnosis, theoretical orientation and the role of the group in the particular treatment setting were used to examine differential effectiveness. Beneficial effects were found for inpatient group therapy in controlled studies (d = 0.31) as well as in the studies with pre-post-data (d = 0.59). Differences in the homogeneity of patient improvement effect sizes were found across different diagnostic categories. Furthermore, greater improvement was exhibited in mood disorder patients when compared to mixed, psychosomatic, post traumatic stress disorder (PTSD), and schizophrenic patients replicating recent findings from meta-analyses of outpatient group treatment. A comparison between controlled studies and pre-post-measure studies indicated no improvement for waitlist patients which contradicts previous reports. Implications for therapy and future research are discussed within the context of methodical considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of psychotherapy: The Consumer Reports study.

Consumer Reports (1995, November) published an article which concluded that patients benefitted very substantially from psychotherapy, that long-term treatment did considerably better than short-term treatment, and that psychotherapy alone did not differ in effectiveness from medication plus psychotherapy. Furthermore, no specific modality of psychotherapy did better than any other for any disorder; psychologists, psychiatrists, and social workers did not differ in their effectiveness as treaters; and all did better than marriage counselors and long-term family doctoring. Patients whose length of therapy or choice of therapist was limited by insurance or managed care did worse. The methodological virtues and drawbacks of this large-scale survey are examined and contrasted with the more traditional efficacy study, in which patients are randomized into a manualized, fixed duration treatment or into control groups. I conclude that the Consumer Reports survey complements the efficacy method, and that the best features of these two methods can be combined into a more ideal method that will best provide empirical validation of psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A survey of group psychotherapy training during predoctoral psychology internship.

Do psychologists receive sufficient training in group psychotherapy? Existing literature indicates that comprehensive training standards have not been universally or rigorously followed within the field of psychology. Results of this study indicate that, much like graduate school programs, predoctoral clinical psychology internships also do not routinely provide adequate group therapy training. This deficit in training undermines the proficiency and competency of psychologists who will increasingly be called upon to lead psychotherapy groups in clinical practice. Specific recommendations are provided to training directors who are interested in expanding their group therapy training opportunities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The effectiveness of traditional child psychotherapy.

This study used a randomized design to evaluate the effectiveness of child psychotherapy as typically delivered in outpatient settings. Overall, results were similar to the results of nonrandomized studies of traditional child psychotherapy: Little support was found for its effectiveness, with treatment producing an overall effect size of –.08. Despite the lack of significant differences between treatment and control groups in regard to changes in child functioning, parents of children who received treatment reported higher levels of satisfaction with services than control group parents whose children received academic tutoring. Overall, the findings highlight the importance of developing, validating, and transporting effective treatments to clinical settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Comparative effectiveness of there-and-then versus here-and-now therapist interpretations in group psychotherapy.

Compared the effectiveness of 4 methods of group psychotherapy: interpretive there and then, interpretive here and now, these treatments in combination, and problem discussion (attention placebo). Validation checks ascertained that the therapist carried out his role as prescribed for each condition. To maximize the potential for gain in the 2 groups to be characterized by a higher level of there-and-then clinical inferences, 28 undergraduate clients and an insight-oriented therapist were employed. Outcome measures included the Rotter Internal-External Control Scale, a questionnaire on S's expectations of goal attainment, and the State-Trait Anxiety Inventory. No clear evidence for the superiority of the insight-production groups was found. However, clients' experiences were less consistently positive in the here-and-now group and tended to be more consistently positive in the combined group than in the others. Theoretical implications of the findings are discussed. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A randomized controlled outcome and follow-up study of Mann's time-limited psychotherapy.

Thirty-three patients were assessed for suitability for time-limited psychotherapy (TLP). A battery of outcome measures was composed of Ss self-report measurements and objective judgments by external ("masked") raters. Ss were randomly assigned to either the experimental group, which received TLP immediately, or the control group, whose TLP was delayed for 3 months. Ss were evaluated on outcome measures at TLP termination and again at 6 and 12 months after termination. Significant improvement was observed in the experimental group after TLP, but the control Ss did not show any systematic changes after waiting. However, after TLP, the control Ss improved significantly. The gains achieved after therapy were stable in both groups after 6- and 12-month follow-ups. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of ovarian cell proliferation in rats during the embryonic period and the first three weeks postpartum

The purpose of this study was to characterize the patterns of ovarian cell proliferation during the earliest stages of folliculogenesis, which occur in the embryonic period and the first weeks postpartum in rats. Rats were given continuous infusions of [3H]thymidine (3H-TdR) or bromodeoxyuridine (BrdU), and cells that were synthesizing DNA were visualized by autoradiography or immunohistochemistry. There were dramatic changes in the patterns of cell proliferation during the period studied. Mesenchymal cells proliferated extensively in the embryonic and neonatal ovary, but their growth fraction declined precipitously as follicles formed. Epithelial cells in the medulla of the ovary left the cell cycle at about embryonic Day 12, then resumed proliferation as soon as they were incorporated into follicles just after birth. Epithelial cells towards the cortex of the organ continued to proliferate until late in the embryonic period; they apparently became quiescent around the time of birth, and incorporation into follicles did not release them from their quiescent state. After the follicles had formed, patterns of cell proliferation continued to change. At 5 days postpartum, approximately 36% of the smallest follicles (1-8 granulosa cells in cross section) had at least 1 granulosa cell that was labeled following a 24-h infusion of 3H-TdR; by Day 20 only 14% of these follicles were labeled, and by Day 30 only 4.4% were labeled.     

Group cognitive-behavioral therapy and group interpersonal psychotherapy for the nonpurging bulimic individual: A controlled comparison.

Evaluated the effectiveness of group cognitive-behavioral treatment (CBT) and group interpersonal psychotherapy (IPT) for binge eating. 56 women with nonpurging bulimia were randomly assigned to 1 of 3 groups: CBT, IPT, or a wait-list control (WLC). Treatment was administered in small groups that met for 16 weekly sessions. At posttreatment, both group CBT and group IPT treatment conditions showed significant improvement in reducing binge eating, whereas the WLC condition did not. Binge eating remained significantly below baseline levels for both treatment conditions at 6-mo and 1-yr follow-ups. These data support the central role of both eating behavior and interpersonal factors in the understanding and treatment of bulimia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effects of brief psychotherapy during the hospitalization period on the recovery process in heart attacks.

70 patients with a first heart attack were randomized into a treatment or a control group. Treated patients were seen almost every day during hospitalization for psychotherapy to facilitate coping and to unearth psychological resources and hidden strengths. Data collected on all Ss showed significant differences in favor of the treated on the following variables: days in intensive care and in the hospital; development of supraventricular arrhythmias and congestive heart failure; nurses' observations of weakness; physician report of depression; self-report of surgency; social affection and vigor; presence of either extreme anxiety or extreme lack of anxiety; and, at a 4-mo follow-up, residual fears as well as inability to return to normal activity. Mechanisms to explain these results are offered, including action of catecholamines, mobilization of psychological energy and active coping to counteract the "sick role," and feedback of information to provide a more accurate and wide-angled cognitive map. Recommendations are made for systematic application of this treatment with hospital patients. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A 2-year follow-up of the effectiveness of traditional child psychotherapy.

This study examined outcomes at a 2-year follow-up assessment for child psychotherapy as it typically is delivered in outpatient settings. The treatment condition (53 children, mean age?=?10.5 years) and control condition (53 children, mean age?=?10.0 years) were compared with regard to rates of linear and curvilinear change for psychopathology, adaptive functioning, and consumer satisfaction. Although both conditions showed curvilinear as well as linear improvement in behavioral and emotional problems, relatively little support was found for the effectiveness of traditional child psychotherapy or for the presence of a psychotherapy "sleeper effect." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy and effectiveness of psychotherapy relative to medications.

A recent survey by Consumer Reports (1994) found that people who receive psychotherapy were generally pleased with their experience and that their satisfaction was unrelated to the type of treatment or the addition of medications. M. E. P. Seligman (1995) argued that these findings demonstrate the value of psychotherapy and suggested that such survey methodologies may be superior to randomized clinical trials in this regard because they study what occurs in actual clinical practice. Although such approaches provide important information, they are no substitute for controlled clinical trials when it comes to drawing causal inferences. However, the study does highlight the importance of defining outcome in the broadest possible fashion and of addressing the external validity of the findings obtained. Attention to such considerations has implications for the relative value of drugs and psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The dynamics of attachment and systems-centered group psychotherapy.

In this article, links are made between 2 theoretical paradigms, 1 that primarily describes the dynamics of dyads (attachment theory) and another that primarily although not exclusively describes the dynamics of groups (the theory of living human systems). The ideas presented are based on research into empathic attunement in adult psychotherapy, clinical material from a group psychotherapy session, and research in the field of attachment. It is suggested that systems-centered group psychotherapy provides the environment for changing members' attachment status through its attention to emotional resonance, authentic affect, and empathic attunement. These ideas are presented with a view toward encouraging research into the links between attachment theory, affect attunement, and group psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The social relations model: A tool for group psychotherapy research.

The social relations model presented in this article provides a solution to some of the problems that plague group psychotherapy research. The model was designed to analyze nonindependent data and can be used to study the ways in which group members interrelate and influence one another. The components of the social relations model are the constant (i.e., group effect), the perceiver effect, the target effect, the relationship effect, and error. By providing estimates of the magnitude of these 5 factors and by examining the relationships among these factors, the social relations model allows investigators to examine a host of research questions that have been inaccessible. Examples of applications of the social relations model to issues of group leadership, interpersonal feedback, and process and outcome research are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A delay discounting measure of great expectations and the effectiveness of psychotherapy.

Many clients prematurely terminate therapy before they have recovered. One possible explanation for treatment dropout is unmet expectations. Although the effects of unmet role expectations have received much attention in the literature, little is known about unmet outcome expectations. Two studies were designed to look at duration and effectiveness outcome expectations held by individuals within a primary referral base for a training clinic setting--a setting with a slower rate of recovery than other outpatient settings. Study 1 (N = 110) used a delay discounting method to find rate-of-recovery expectations associated with differing treatment lengths. Results indicated expectations much higher than the demonstrated effectiveness of therapy associated with training clinics. Study 2 (N = 307) replicated Study 1 and examined the possibility of altering outcome expectations through education. Study 2 results indicated that outcome expectations may be altered through client education. Both studies' results are discussed in terms of reducing premature termination and overall treatment outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Co-therapists and the creation of a functional psychotherapy group: A group dynamics perspective.

This article supports Dugo and Beck's (1997) proposal that co-therapy teams should move through the early phases of their own development as a team before meeting with a therapy group. Effective leaders facilitate group development by meeting the needs of the group at various stages. To do this, co-therapists must agree on the nature of those needs. Co-therapists need to develop a united front, a shared purpose, and a shared action plan. If these are lacking, the chances of successful outcomes are diminished. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The efficacy of group psychotherapy for older adult clients: A meta-analysis.

This review examined the effectiveness of group psychotherapy for older (55+) adults. Results from 44 studies with pre-post designs and 27 controlled studies indicated that group psychotherapy benefits older adults, with average rs of .42 and .24 for pre-post and controlled designs, respectively. The type of therapy provided and the age of the clients were associated with pretreatment to posttreatment improvement. Clients in cognitive-behavioral group therapy improved more than those receiving reminiscence therapy. The older the average age of the group members, the less they benefited from therapy. Number of sessions attended, length of therapy sessions, the percentage of women in the group, and client living situation were not significant moderators of outcome. Overall, group interventions for older adults appear to be effective and the average effect size for pre-post studies was quite similar to those yielded by meta-analyses of group therapy with younger adults and adolescents. However, the average effect size for controlled studies of group therapy with older adults appears to be somewhat smaller than the values reported in meta-analyses with younger clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The first trial of the P technique in psychotherapy research: A still-lively legacy.

A 49-year-old study of P technique applied to a psychotherapy patient with a recurrent physical symptom is dusted off and re-presented, together with examples of other studies with similar methods conducted since then. The specific aims were to understand the main dimensions of psychotherapeutic change as well as the context for the recurrent symptom. The general aims were to illustrate the contributions from applying the P technique to psychotherapy research, to psychosomatic medicine, and to personality research. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Task group structure, communication, and effectiveness in three organizations.

Examined the importance of interpersonal communication as a mediating variable between group structure and perceptions of group effectiveness. 407 respondents from 3 similar US Navy organizations were identified sociometrically as comprising 43 task groups. Six of 7 measures of group structure were significantly associated with measures of information accuracy and communication openness within groups, but not with a measure of perceived group effectiveness. The measures of communication, however, were significantly related to effectiveness. It is concluded that group structure may act, in part, to affect the ability of groups to transmit information necessary to coordinate activities and make effective decisions. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)