In slow-open groups as well as therapies of less than ten sessions, each group session holds importance. Patients, therapists and co-therapists have different perspectives and may gain different experiences from a group session. This study investigates the perspectives of patients, therapists and co-therapists on alliance, new insights and therapist techniques in the same group session. Do the three actors perceive these group aspects similarly or differently? Which group aspects are related with the outcome coping? One hundred and forty-nine sessions of a cognitive behaviour therapy group have been investigated. Patients, therapists and co-therapists gave ratings on their perceived alliance, group topics and insights as well as therapists’ technique competency. Concerning new insights, there was concordance between patients and co-therapists (r = .211, p < .05). Concerning alliance, there was a concordance between patients and therapists (r = .327, p < .01). Therapists focusing on alliance building was associated with lower patient outcomes in terms of work coping (β = –.391). The quality of therapeutic techniques was the same in groups with higher and lower outcomes. Patients’ perception of whether they felt good in the group session was explanative for session outcome, while therapists’ perceptions and context conditions (supervision, number of participants) was not. Patients, therapists and co-therapists have different perspectives on the same group therapy session. Patients’ perceptions are associated with session outcomes. A lower session outcome must not be associated with a poor technique performance of the therapist. Therapists should not only be aware of alliance building and correct technical performance, but they must also be aware of patients’ perceptions of the group process and outcome.
Key learning aims
The present research is the first evaluation of group session aspects and session outcomes in rehabilitation patients with work anxieties in slow-open groups. We will learn:
(1) Whether patients’, therapists’ and co-therapists’ perceptions of the same group session are similar or different;
(2) Whether group sessions that result in worse outcomes are different from group sessions resulting in a better outcome;
(3) Which aspects of the group session are predictive for a better outcome.