Chapter 3: Cohesiveness The Theory and Practice of Group Psychotherapy Irvin Yalom, Ph.D

Cohesiveness Cohesiveness in group therapy corresponds with therapeutic relationship in individual therapy. Therapeutic alliance is the most valuable variable in individual psychotherapy research. In group, it also includes the relationship the pt has with others and with the group as a whole (i.e. that is two more dimensions).

Cohesiveness Cohesiveness in group represents the “we-ness” or amount of “groupness”. This provides the group with a better defense against any external / internal threats. Extremely difficult cohesiveness in order to research it appropriately. Yalom defines it as a member’s desire to remain in the group. The experience of warmth, acceptance and being valued.

Cohesiveness It is fixed and can change as the group changes among the stages, composition, etc… Of all aspects of cohesiveness, it is the aspect of sharing one’s inner world while being accepted by others, that directly influences self esteem. One theory of group effectiveness is that some patients have a poor group history in their life. Therefore, internalizing the atmosphere of cohesive group, augmenting a process of self acceptance or self cohesion.

Cohesiveness In a study of 139 subjects (described on p 52), the subjects state that the most positive aspect of the group was the feeling of security and acceptance. In fact, in this study the two predicting variables of positive outcomes were : group cohesiveness and general popularity. Greater cohesiveness = increased disclosure, attendance, influenceability, intimacy and social risk taking.

Cohesiveness However, this acceptance of others may be challenged by how participants accept themselves. As such, two challenges are inherently posed in group. A person’s ability to establish and maintain meaningful interpersonal relationship. A person’ ability to maintain self worth/ self esteem among others.

Cohesiveness Self Esteem vs public esteem Childhood evaluations from others contributed to an internal reservoir of self worth. However, people to some degree continue to be concerned for the current evaluation of others.

Cohesiveness Public esteem - a group’s evaluation of someone. This depends on how important group is to person, the frequency of contact, and the relevance of the feedback to person’s traits. A discrepancy between self and public esteem leads to dissonance. If discrepancy is negative pt can: Misperceive / deny Devalue group Rise to the occassion

Cohesiveness These esteem issues were influenced by person’s popularity in group. 3 variables that did not correlate with outcome but did with popularity are: P60 previous self disclosure interpersonal compatibility chosen as leisure companions.

Cohesiveness Group Cohesiveness can also = Hostility Other variables associated with cohesiveness: try harder to influence other more receptive to being influenced receptive others and accepting greater security and relief from tension more participation self disclosure protect group norms group is less disrupted with member leaves.