The Cohesiveness in Group Counseling

The Cohesiveness in Group Counseling/ Therapy
Literature Review

Uy Minh Ngo
MSCP Program, Assumption University

The use of groups in therapy was started following the First World War, but as far as the development’s history of psychotherapy, “the beneficial effects of groups have been around much longer” (Avery, 1996, p. 86). There is a research indicated that “group therapy is a highly effective form of psychotherapy and that it is at least equal to individual psychotherapy in its power to provide meaningful benefit.” (Yalom, 2005, p. 1)

According to Yalom (2005), there are 11 therapeutic factors playing different roles in group counseling, in which the Group cohesiveness is an important and complex one. The group cohesion factor has been studying for few decades by many psychologists in different areas of psychology such as social psychology, organizational psychology, and clinical/ counseling psychology. The present paper will discuss about the group cohesiveness (also called cohesion): What is the group cohesion? How does it work in the counseling process? What are the outcomes or consequences? How to measure the group cohesiveness

The various definitions of group cohesiveness
Comparing with the individual psychotherapy, the cohesiveness was described is a similar factor of the client-counselor relationship, which is an important factor for a successful therapy in individual counseling (Yalom, 2005). However, the “relationship” in group therapy is a more complex concept, because it includes several relationships such as member to member, member to leader, member to group, and so on.

Burlingame, Fuhriman, and Johnson (2001) stressed on the context in which therapy occurs: “In the group psychotherapy, the context is a system of many individuals and relationships, instead of a single relationship between two individuals as in individual therapy” (p. 373). Thus, they defined the group cohesion as the therapeutic relationships in group therapy, which including all kinds of the relationships: member-to-leader, member-to-member, and member-to-group. Barlow and Burlingame (2006) defined the group cohesion as “member-to-member high positive emotional relatedness, encourages disclosure of meaningful material” (p. 110).

Yalom (2005) refers to the sense of “group-ness” or “we-ness” of the participants in the group counseling to demonstrate the group cohesiveness. Yalom explained that the members of the cohesion group will feel warmth, comfort, and belong with each others. Posthuma (1996) explained the sense of “we-ness” is developed by the group members when they are sharing themselves, trying to understand and to accept others, allowing interest and caring others.

Some other psychologists such as Festinger (1950) and Corey (2004) defined cohesiveness is the resultant of all the forces acting on the members that make them want to remain in the group. Carron et al, (1998, cited on Estabrooks and Carron, 1999) defined group cohesion as “a dynamic process reflected by the tendency of a group to stick together and remain united in the pursuit of its instrumental objectives and/ or for the satisfaction of member affective needs” (p. 577).

For a summary, cohesiveness refers to the group’s atmosphere of the attractiveness, and the belongingness of the members in the group. The members in group feel safety, warmth, and supported by other members.

Multidimensional perspectives of group cohesiveness
As Yalom’s view, the group cohesiveness is a one-dimension perspective and it is quite simple to understand and measure, however some other researchers suggested for studying the cohesiveness as a multiple dimensions perspective. Dion (2000) suggested that all group factors such as belonging, social identity, and attraction in the group should be considered as the dimensions of group cohesiveness. Braaten (1991) described the group cohesiveness as a system of five of pairs: 1) attraction and bonding; 2) support and caring; 3) listening and empathy; 4) self-disclosure and feedback; and 5) process performance and goal attainment.

Some other researchers described the cohesiveness including two different dimensions: task-cohesion (also called task-oriented cohesion), described an attraction to the group because of a liking for or commitment to the group tasks; and social-cohesion (also called social-emotional cohesion or interpersonal cohesion), reflects an attraction to the group because of the satisfactory relationships and friendships with other members of the group. (Festinger et al., 1950, and Hackman, 1976., cited on Zaccaro, 1990; and Rempel and Fisher, 1997)

According to Carron et al. (1998, cited on Estabrooks and Carron, 1999), cohesion can be included four dimensions: (a) Individual Attractions to the Group-Task, describes the individual member’s perceptions of his or her personal involvement with the group task; (b) Individual Attraction to the Group-Social, describes the individual member’s perceptions of his or her personal acceptance and social interaction with the group; (c) Group Integration-Task, describes the individual member’s perceptions of the similarly, closeness, and bonding that exists within the group as a totality around its collective task; and (d) Group Integration-Social, describes the individual member’s perceptions of the similarly, closeness, and bonding that exists within the group as a totality around social concerns. (p. 578).

The cohesiveness as a stage of development of group therapy
Although group psychotherapy is conducted for similarly-problems clients (e.g. schizophrenia, anxiety, conduct problem, etcetera.), these clients may come from different backgrounds such as cultural values, educational level, religions, previous experiences, and so on. It seems people/ client need the time for “observe and judge” his/ her group before open to share or to show their conflicts. Although the group itself may attract its members at the beginning of the therapy, people may not openly talking or sharing their own ideas or problems, especially the personal issues.

After some sessions of the therapy process, the client may feel more safety, acceptance, and ready for “giving and receiving”. At this state, the cohesiveness is developed. Moursund (1993) described: “The group offers the chance to relearn acceptance and closeness. It is a safe place to experiment with trust, with loving and being loved”.

Corey (2004) indicated that the group cohesion factor is a major factor in the later stage (or working stage) of the group counseling process. In this stage, the members feel safety, can openly to talk about their own feelings, can sharing their own deeper experiences, can show their conflicts, etcetera. However, in some circumstances, the group cohesiveness may become a “potentially hinder the group’s development”, because the members may settle for the feeling of security and comfortable rather than openly to confront or taking risks.

As a stage of the development of the therapy, the counselor/ therapist will do some specific steps and with specific techniques to support the clients achieve the sense of belonging, acceptance, and support each other. Burlingame, Fuhriman, and Johnson (2001) introduced the “Empirically Supported Principles Regarding the Therapeutic Relationship in Group Treatment” (p. 375):

Principle 1: Pregroup preparation sets treatment expectations, defines group rules, and instructs members in appropriate roles and skills needed for effective group participation and group cohesion.

Principle 2: The group leader should establish clarity regarding group processes in early sessions since higher levels of structure probably lead to higher levels of disclosure and cohesion.

Principle 3: Leader modeling real-time observations, guiding effective interpersonal feedback, and maintaining a moderate level of control and affiliation may positively impact cohesion.

Principle 4: The timing and delivery of feedback should be pivotal considerations for leaders as they facilitate this relationship-building process.

Principle 5: The group leader’s presence not only affects the relationship with individual members, but all group members as they vicariously experience the leader’s manner of relating, and thus the importance of managing one’s own emotional presence in the service of others.

Principle 6: A primary objective of the group leader should be facilitating group members’ emotional expression, the responsiveness of others to that expression, and the shared meaning derived from such expression.

The important of group cohesiveness
Group cohesiveness is an important factor which effects to the whole group counseling/ therapy process as Yalom (2005) noted: “Cohesiveness is necessary for other group therapeutic factors to operate.” (p. 56). In general, Yalom addressed some major outcomes of the therapy in the cohesion group such as: improved the self-esteem, public esteem, and therapeutic change; maintaining the member’s attendance; facilitate the expression of hostility; and so on.

According Corey (2004), the group cohesiveness occurs and leads these specific factors move beyond: 1) trust and acceptance; 2) empathy and caring; 3) intimacy; 4) hope; 5) freedom and experiment; 6) catharsis; 7) cognitive restructuring; 8) commitment to change; 9) self-disclosure; 10) confrontation; 11) benefiting from feedback; and 12) commentary.

Relate to the absenteeism, Zaccaro (1990) concluded, “group cohesion may facilitate the attendance because it can result in groups establishing strong attendance norms that constrain individual absenteeism.” (p. 390).

Budman, Soldz, Demby, Davis, and Merry (1993) in their study indicated that cohesion can be a strong and productive force which will influent the behaviors and attitudes of group members and the overall group process as well.

There is a group of researchers, who studied the influence of group cohesion on maternal well-being, concluded that “cohesion appears to play a role in improved self-esteem, as it was most consistently and significantly associated in both the regression and correlation analyses” (Lipman, Waymouth, Gammon, Carter, Secord, Leung, Mills, and Hicks, 2007). Another study on group cohesiveness and the collective self-esteem (CSE) also found that the group cohesiveness facilitates members’ CSE, and CSE related to the group members’ well-being. There was a significant relationship between group therapy CSE and the cohesiveness (Marmarosh, Holtz, and Schottenbauer, 2005).

Not only support for the outcomes of the therapy, the cohesiveness itself is a “technique” for treatment as Moursund (1993) indicated, “people become a group, the group becomes my group, our group. We belong together. We support each other. We care, and in caring we cure” (p. 138)

Measure the group cohesiveness
Schutz Cohesiveness Questionnaire. This questionnaire was original developed by Schutz in 1966 and then was modified by Lieberman et al. in 1973 for group therapy, included 13 items used Likert scale to measure the attractiveness of the group members and the degree of perceived belongingness or acceptance by other members in the group. (See Marmarosh, Holtz, and Schottenbauer, 2005).

Group Atmosphere Scale (GAS). This scale was developed to systematically measure the psychological environment of outpatient therapy group by Silbergeld et al. in 1975. GAS contains 12 sub-scale, each of which has ten true-false items was ranged from 0 to 10 (negative to positive attitude) to measure specific aspects of the group environment. There are 7 of 12 sub-scales are used to measure the cohesion: spontaneity, support, affiliation, involvement, insight, clarity, and autonomy. (See Lipman, et al., 2007)

Group Environment Questionnaire (GEQ), which was developed by Carron et al. (1985, cited on Fraser, and Spink, 2002). GEQ based on a conceptual model that portrays cohesion as a multidimensional construct focusing on individual and group considerations, both containing the task and social aspects.

Conclusions and Recommendations
As Yalom (2005) stressed on his book, the cohesiveness is an important and complex therapeutic factor. Studying group cohesiveness helps counselors/ psychotherapists understand how to build up, maintaining, and measure the state of cohesiveness in group processes. It’s also important to learn how to use the cohesiveness of the group as a “special technique” to help the clients express their own feelings and personal experiences.

There are several studies was conducted to research about the group cohesiveness in counseling/ psychotherapy, but according to Burlingame, Fulriman, and Johnson (2001), the majority of studies have emphasized a single relationship dimension, in specific the member-to-group relationship. So the further researches can pay more attention to the other relationships such as: member-to-member, leader-to-group, and leader-to-leader.

References
Avery, B. (1996). Principles of psychotherapy. CA: Thorsons.

Barlow, H. S., Burlingame, M. G. (2006). Essential theory, processes, and procedures for successful group psychotherapy: Group cohesion as exemplar. Journal of Contemporary Psychotherapy, 36, 107-112.

Braaten, L. J. (1991). Group cohesion: A new multidimensional model. Group, 15, 39-55.

Budman, S. H., Soldz, S., Demby, A., Davis, M., and Merry, J. (1993). What is cohesiveness: An empirical examination. Small Group Research, 24, 199-215.

Burlingame, M. G., Fuhriman, A., Johnson, E. J. (2001). Cohesion in group psychotherapy. Psychotherapy, 38(4), 373-379

Carron, A. V., and Spink, K. S. (1995). The group size/ cohesion relationship in minimal groups. Small Group Research, 26, 86-105

Corey, G. (2004). Theory and practice of group counseling, (6th ed.) CA: Brooks/Cole.

Dion, K. L. (2000). Group cohesion from ‘field of forces” to multidimensional construct. Group Dynamics: Theory, Research, and Practice, 4, 7-26.

Estabrooks, A. P., and Carron, A. V. (1999). Group cohesion in older adult exercisers: Prediction and intervention effects. Journal of Behavioral Medicine, 22(6), 575-588

Festinger, L. (1950). Informal social communication. Psychological review, 57(5), 271-282.

Fraser, N. S., and Spink, S. K. (2002). Examining the role of social support and group cohesion in exercise compliance. Journal of Behavioral Medicine, 25(3), 233-249.

Lipman, L. E., Waymouth, M., Gammon, T., Carter, P., Secord, M., Leung, O., Mills, B., and Hicks, F. (2007). Influence of group cohesion on maternal well-being among participants in a support/ education group program for single mothers. American Journal of Orthopsychiatry, 77(4), 543-549.

Marmarosh, C., Holtz, A., and Schottenbauer, M. (2005). Group cohesiveness, group-derived collective self-esteem, group-derived hope, and the well-being of group therapy members. Group Dynamics: Theory, Research, and Practice, 9(1), 32-44

Moursund, J. (1993). The process of counseling and therapy (3rd ed.). Chapter 8, Groups and group therapy. NJ: Prentice Hall.

Posthuma, B. W. (1996). Small groups in counseling and therapy: Process and leadership, (2nd ed.). Massachusetts: Allyn & Bacon.

Rempel, M. W., Fisher, J. R. (1997). Perceived threat, cohesion, and group problem solving in intergroup conflict. International Journal of Conflict Management, 8(3), 216-234.

Yalom, D. I. (2005). The theory and practice of group therapy, (5th ed.). NY: Basic Books.

Zaccaro, J. S. (1990). Nonequivalent associations between forms of cohesiveness and group-related outcomes: Evidence for multidimensionality. The Journal of Social Psychology, 131(3), 387-399.