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Updated: Aug 14, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
It's complicated: Using group member process-feedback to improve group therapist effectiveness
Paul B Gold1, Dennis M Kivlighan1
1Department of Counseling, Higher Education and Special Education, University of Maryland, College Park.
Abstract:
Experienced leaders of psychotherapy groups are surprisingly inaccurate in their judgments about their members' perceptions of positive bonding relationships with the leader and other group members. The practical implication is worrisome: the lower the leader's degree of accuracy, the worse the member therapeutic outcomes tend to be. A promising approach to improving leaders' appraisals of their members' perceptions of positive bonding relationships is to provide them, after each session, feedback about their own and their members' bonding relationship perceptions. Profiling trajectories of leaders' and members' perceptions over time yields rich "stories" of relationship development, that if strategically packaged into brief, concise, and vivid reports, and delivered as a formal "group member feedback" intervention, would direct leaders' attention to those emerging, but easily overlooked, countertherapeutic relationships, requiring immediate, well-informed targeted interventions. To increase the utility of such reports, training leaders use intuitively appealing, but structured heuristics ("interpersonal-fit-with-the-group" and "intrapersonal-split-relationships"), accelerate leaders' recognition of patterns in perceptions as they change over time, and free up their cognitive resources for determining whether to intervene into the group process at the appropriate level: intraindividual, interpersonal, or group-as-a-whole. To illustrate the use of these heuristics, we present two hypothetical cases, with visual displays of congruent and discrepant perceptions of bonding relationship perceptions between members over time, and make tentative recommendations about where and when leaders might intervene to achieve optimal impact. (PsycINFO Database Record
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