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Alliance and Cohesion Predicting Outcome in Group Psychotherapy: A Structural Equation Model Meta-Analysis
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Within group psychotherapy, previous meta-analyses have shown that the client-therapist relationship (alliance) and group relationships (cohesion) both predict client improvement. Accounting for the inherent connection between alliance and cohesion, we meta-analyzed studies (k = 14) that individually measured alliance, cohesion, and an outcome among group therapy participants. A random-effects, two-stage structural equation model found that alliance (b = .12) and cohesion (b = .12) uniquely predicted outcome and were statistically indistinguishable. Findings replicate past meta-analyses. Alliance and cohesion are highly related, and both uniquely predict outcome. Minimal studies and large heterogeneity limit generalizability, but we encourage clinicians to foster all therapeutic relationships and we provide researchers with suggestions for future work.
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