Burlingame Gary M, Alldredge Cameron T, Arnold Rachel A
Int J Group Psychother. 2021 Apr;71(2):338-370. doi: 10.1080/00207284.2020.1844010. Epub 2021 Feb 25.
The identification of relationship ruptures in group therapy coupled with repair efforts by the group leader are addressed from a measurement-based care (MBC) perspective. Several MBC systems are now recognized as evidence-based treatments, and these systems typically use self-report assessment of both outcome and relationship measures. After laying a brief foundation of alliance rupture and repair from an individual therapy perspective, the complexity of applying alliance and repair across the multiple therapeutic relationships and constructs found in the group treatment literature is considered. The Group Questionnaire (GQ) is an empirically derived measure designed to capture the multiple relationship structures (member-member, member-leader, and member-group) and constructs (alliance, cohesion, climate, and empathy) in group therapy. Similarities and differences between the GQ and alliance rupture and repair measures are considered, followed by algorithms used to identify rupture and repair in group therapy on the three GQ subscales-positive bond, positive work, and negative relationship. MBC clinical reports are used to illustrate how rupture is identified at both a group and individual member perspective along with information to support repair interventions. Finally, both clinical and empirical reasons for using the MBC approach are considered along with clinical observations.
从基于测量的照护（MBC）角度探讨了团体治疗中关系破裂的识别以及团体领导者的修复努力。如今，几种MBC系统被公认为循证治疗方法，这些系统通常使用自我报告来评估治疗结果和关系指标。在从个体治疗角度简要介绍了联盟破裂与修复的基础之后，我们考虑了在团体治疗文献中发现的跨多种治疗关系和结构应用联盟与修复的复杂性。团体问卷（GQ）是一种基于实证得出的测量工具，旨在捕捉团体治疗中的多种关系结构（成员-成员、成员-领导者和成员-团体）和结构要素（联盟、凝聚力、氛围和同理心）。我们考虑了GQ与联盟破裂及修复测量工具之间的异同，随后介绍了用于在团体治疗中根据GQ的三个子量表——积极联结、积极工作和消极关系——识别破裂与修复的算法。MBC临床报告用于说明如何从团体和个体成员的角度识别破裂，以及支持修复干预的信息。最后，我们结合临床观察，探讨了采用MBC方法的临床和实证原因。
