van Andel Peter, Erdman Rudolph A M, Karsdorp Petra A, Appels Ad, Trijsburg Rutger W
Department of Medical Psychology and Psychotherapy, and the Netherlands Institute for Health Sciences, Erasmus MC Rotterdam, Rotterdam, The Netherlands.
Psychother Psychosom. 2003 May-Jun;72(3):141-9. doi: 10.1159/000069733.
Various definitions of both group cohesion and working alliance are used in theories on group psychotherapy, making the study of their relative contribution to the treatment outcome difficult. In this study, two different, nonoverlapping questionnaires were used to explore the relationship between group cohesion, working alliance and treatment outcome in a time-limited, structured cognitive behavioral group psychotherapy aiming at the reduction of coronary risk factors.
After having undergone percutaneous transluminal coronary angioplasty, 42 patients were treated with the aim to reduce exhaustion, anxiety, hostility and depression. The newly developed Group Cohesion Questionnaire (GCQ) and the Helping Alliance Questionnaire (HAQ-II, measuring the bond between individual patients and the group psychotherapist) were administered after the fifth and tenth treatment session. Exhaustion, quality of life, anxiety, blood pressure and heart rate were measured before and after treatment. To test the relationship between the GCQ, the HAQ-II and outcome variables, Pearson Product-Moment correlations and hierarchical regression was applied.
Principal Component Analysis of the GCQ yielded two dimensions, the bond with the group as a whole and the bond with other group members. Hierarchical regression showed that both the bond with other group members and working alliance contributed significantly and independently to the prediction of posttreatment systolic and diastolic blood pressure as well as posttreatment quality of life (confidence).
Conceptually and empirically, group cohesion and the working alliance may be considered to represent different relationships in a psychotherapy group, contributing in different ways to the treatment outcome in cardiac patients receiving cognitive behavioral group psychotherapy.
团体心理治疗理论中对团体凝聚力和工作联盟有多种不同定义，这使得研究它们对治疗结果的相对贡献变得困难。在本研究中，使用了两种不同的、不重叠的问卷，以探讨在旨在降低冠心病危险因素的限时、结构化认知行为团体心理治疗中，团体凝聚力、工作联盟与治疗结果之间的关系。
42例接受经皮腔内冠状动脉成形术的患者接受治疗，目的是减轻疲惫、焦虑、敌意和抑郁。在第五次和第十次治疗 session 后，发放新开发的团体凝聚力问卷（GCQ）和帮助联盟问卷（HAQ-II，测量个体患者与团体心理治疗师之间的联系）。在治疗前后测量疲惫、生活质量、焦虑、血压和心率。为了检验GCQ、HAQ-II与结果变量之间的关系，应用了Pearson积差相关和分层回归。
GCQ的主成分分析产生了两个维度，即与整个团体的联系和与其他团体成员的联系。分层回归显示，与其他团体成员的联系和工作联盟都对治疗后收缩压和舒张压以及治疗后生活质量（信心）的预测有显著且独立的贡献。
从概念和实证角度来看，团体凝聚力和工作联盟在心理治疗团体中可能代表不同的关系，对接受认知行为团体心理治疗的心脏病患者的治疗结果有不同的贡献方式。
