Ryum Truls, Hagen Roger, Nordahl Hans M, Vogel Patrick A, Stiles Tore C
Norwegian University of Science and Technology, Norway.
Behav Cogn Psychother. 2009 Oct;37(5):497-510. doi: 10.1017/S1352465809990208. Epub 2009 Aug 11.
Research on group therapy indicates that various dimensions of the helpful relationship qualities (cohesion, climate, empathy, alliance) are associated with outcome. However, the use of a wide variety of empirical scales makes comparisons between studies as well as generalizations somewhat difficult. Although a generic, trans-theoretical measure such as the Group Climate Questionnaire-Short Form (GCQ-S; MacKenzie, 1983) is available and applicable to most treatment conditions, it has never been tested with cognitive-behavioural group therapy.
To investigate perceived dimensions of group climate (engagement, avoidance and conflict) as predictors of long-term (1 year) follow-up in a manualized, structured time-limited cognitive-behavioural group therapy (CBGT) for out-patients with comorbid psychiatric disorders.
Data from 27 patients were analysed using hierarchical multiple regression analyses. Outcome measures used were general symptomatic complaints (SCL-90-R), interpersonal problems (IIP-64), specific mood- and anxiety symptoms (BDI; BAI) and early maladaptive schemas (YSQ). After controlling for scores on the relevant dependent variables at both intake and treatment termination, dimensions of group climate measured close to termination were entered as predictors in separate analyses.
Higher ratings of engagement were associated with reduced scores on all outcome measures at follow-up, except for anxiety symptoms (BAI). Higher ratings of avoidance were associated with lower anxiety symptoms at follow up, whereas ratings of conflict were unrelated to all follow-up scores.
The results provide partial support for the use of the GCQ-S as a predictor of long-term follow-up in CBGT, and highlights perceived engagement as the most important dimension. Clinical implications are discussed.
团体治疗的研究表明，助人关系品质的各个维度（凝聚力、氛围、同理心、联盟）与治疗结果相关。然而，使用各种各样的实证量表使得不同研究之间的比较以及归纳总结有些困难。尽管有通用的、跨理论的测量工具，如团体氛围问卷简版（GCQ-S；麦肯齐，1983），可用于大多数治疗情况，但它从未在认知行为团体治疗中进行过测试。
在针对患有共病精神障碍的门诊患者的手册化、结构化限时认知行为团体治疗（CBGT）中，调查团体氛围的感知维度（参与、回避和冲突）作为长期（1年）随访预测指标的情况。
使用分层多元回归分析对27名患者的数据进行分析。使用的结果测量指标包括一般症状主诉（SCL-90-R）、人际问题（IIP-64）、特定的情绪和焦虑症状（BDI；BAI）以及早期适应不良图式（YSQ）。在控制了入组时和治疗结束时相关因变量的得分后，将接近治疗结束时测量的团体氛围维度作为预测指标分别进行分析。
除焦虑症状（BAI）外，更高的参与度评分与随访时所有结果测量指标的得分降低相关。更高的回避度评分与随访时较低的焦虑症状相关，而冲突评分与所有随访得分均无关。
结果为将GCQ-S用作CBGT长期随访的预测指标提供了部分支持，并突出了感知到的参与度是最重要的维度。讨论了临床意义。
