Wechselseitige Effekte von Gruppenkohäsion und Symptomen: Eine Studie mit depressiven Patienten in tagesklinischer und stationärer Psychotherapie

Cohesion is an important aspect of group therapeutic relationships. It represents a potential curative factor and can explain subsequent improvements in symptoms. Although the association between experienced cohesion and severity of symptoms has often been confirmed, longitudinal studies are missing which account for the correct temporal sequence of cohesion and change in symptoms and which also differentiate the average level of cohesion of individual participants (between-person effect) from individual variation in cohesion over the course of therapy (within-person effect). The current study examined the cohesion experience to patient groups in an inpatient psychotherapy unit with an integrated day clinic. In this study 40 depressive patients were recruited for a randomized controlled study comparing day clinic and inpatient psychotherapy. All patients answered questionnaires on therapeutic relationships (including cohesion) and current symptoms at the end of each week. The statistical analysis of the multilevel data applied an autoregressive cross-lagged model. The results indicated a reciprocal influence. An individual increase of cohesion was a significant predictor for improved symptoms, even when controlling for previous symptom burden. Conversely, an improvement in symptoms was predictive for a subsequent increase in cohesion. The study demonstrated the importance of relationship quality to the patient group and suggested a reciprocal influence of cohesion and symptoms; however, due to the small sample, the results should be interpreted with caution.