Evaluation of Group Psychotherapy

¹ Consultant Psychiatrist, All Saints' Hospital, Birmingham, 18
² Medical Director, Uffculme Clinic, Birmingham, 13

The main aims of this work were to develop a method of evaluating group psychotherapy, and to use it in evaluating a group psychotherapy programme. The patients studied were the 53 in-patients or day-patients who were discharged on completion of their treatment, over a period of seven months, from one of seven psychotherapeutic groups. Over the same period 37 patients left without completing their treatment, and they are the subject of a separate study.

The method used consisted of giving all patients, just before their discharge, a standardized interview by an independent interviewer specially trained in questionnaire and rating methods. In the interview the patients were asked about their improvement, their understanding of the process of group psychotherapy, and their valuation of the various aspects of the therapeutic regime and the other therapies such as drugs that they might have received. These findings were then correlated with the opinions of the group therapists and the observations of the researchers.

Two concepts which were considered essential for evaluation of group psychotherapy were those of patients' `suitability' and `sophistication' in group psychotherapy. The patients' `suitability' was rated at the start of the treatment, and the attributes considered were the patient's age, intelligence, anxiety level, motivation, secondary gain, ego strength, and reality difficulties.

By `sophistication' in group psychotherapy was meant the patient's understanding of the psychotherapeutic process brought about by active participation in group psychotherapy. Sophistication scores were obtained by asking patients in the standardized interview 14 questions dealing with the various group phenomena and processes.

The effectiveness of group psychotherapy was investigated by studying how the patients rated their improvement and how they compared it with their expectations, and how the therapists rated their patients' improvement.

Using suitability ratings and sophistication scores it was shown that patients considered more suitable achieved significantly greater sophistication in group psychotherapy than patients considered less suitable, and that the more sophisticated patients experienced significantly greater improvement than the patients considered less sophisticated. This shows that suitability ratings were of value in predicting the outcome of treatment.

The concept of patients' suitability was also found to be of value in many other respects. Patients considered more suitable were treated longer, less often given physical treatment, and found to prefer group psychotherapy more than the other items of the therapeutic regime.

One would have expected that the therapist and the group to which the patient belonged would play an important part in determining patients' sophistication; but it was found on the contrary that it was the patients' suitability which played a greater part.

Eighteen patients given physical treatments along with group psychotherapy were compared with the 35 patients treated with group therapy only. It was found that patients who were given physical treatments were older, had lower suitability ratings, and achieved greater improvement in a shorter period of time. In spite of these findings we did not, for various reasons that we have given, think that combining physical treatment with group therapy either shortened the period of treatment or led to greater improvement.

Many other aspects of evaluative research have been discussed; such as the various methods used for evaluating group psychotherapy and the different concepts of what constitutes improvement or recovery.

In this study the results of group psychotherapy were modest but worth while, and could have been improved with more experienced therapists.

This article has been cited by other articles:

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