Mark J. Macgowan, PhD, LCSW Community-Based Intervention

1
A Review of Selected Process Measures for
Group-Based Interventions

• Mark J. Macgowan, PhD, LCSW
• Community-Based Intervention Research Group
  (C-BIRG)
• Florida International University, Miami
• Email Macgowan_at_fiu.edu

SASATE, June 2004 San Juan, Puerto Rico
2
Goals of Presentation

• Establish the need to effectively and efficiently
  measure targeted group factors related to
  outcomes
• Identify selected instruments to measure
  processes in groups for adolescent AOD users

3
Why Look Inside the Black Box?

• Studies have identified particular group-related
  factors that affect outcomes
• Feldman, Caplinger Wodarski (1983) found that
  group factors (e.g., composition, leadership
  behaviors) mediated group outcomes regardless of
  treatment method in their study of antisocial
  boys in groups
• Dishion, Poulin, Burraston (2001) found that
  the group process, more than the individual
  affiliation patterns, contributed to iatrogenic
  growth. This finding suggests that skilled group
  leadership that could orchestrate a dynamic group
  environment that does not provide group attention
  to deviance would reduce or eliminate the
  iatrogenic effect (p. 89)
• Few empirical studies examine both outcomes and
  processes (Hill, Nutt, Jackson, 1994)

4
How Could Measuring Processes be Helpful?

• Illuminate the mechanisms of change in groups to
  allow for explication, replication, or control
• Maximize the dosage of group work
• Such processes could be monitored and
  manipulated, treating processes as active
  ingredients of group

5
Measures for Group and Member Variables

• Criteria for Instrument Selection
• Evidence of relationship to outcomes
• Acceptable psychometrics
• Relatively easy to administer and score
• Suitable for adolescents in groups

6
Measures of Group and Member Variables

• Group cohesion
• Group climate
• Therapeutic alliance
• Group engagement

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Group Cohesion

• The groups attractiveness to the participants
  and a sense of belonging, inclusion, and
  solidarity (Corey, 1990, p. 116).
• Related to positive outcomes in groups (Budman,
  et al., 1989 Burlingame, et al., 2002 Yalom,
  1995).
• Regarded as demonstrably effective, Division 29
  Task Force (Steering Committee, 2002).
• Caveat Cohesion in adolescent groups can be
  problematic.

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Cohesion Group Attitude Scale (Evans, 1982,
1984 Evans Jarvis, 1986)
Description and Psychometrics
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Group Climate

• Definition A property of the group that
  facilitates or impedes the work of an individual
  to reach a goal (MacKenzie, 1981, 1983)
• Three areas
• Engaged - positive working group atmosphere
• Avoiding - avoidance of personal responsibility
• Conflict - anger and tension in the group.
• Empirically associated with positive outcomes
  (Kivlighan Tarrant, 2001 Ogrodniczuk Piper,
  2003).
• Has been used in research involving adolescents
  (Kivlighan Tarrant, 2001)

10
Group Climate Questionnaire (MacKenzie, 1981,
1983)
Description and Psychometrics
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Therapeutic Alliance in Groups

• Perceptions of the therapists attitudes,
  feelings, and behaviors toward the respondent as
  well as toward other group members (Marziali et
  al., 1999, p. 430)
• An important element of empirically supported
  therapy relationships (Steering Committee, 2002
  Horvath Bedi, 2004 Martin, Garske, Davis,
  2000) and of successful groups (Marziali, et al.,
  1997).

12
Group Therapy Alliance Scale (Marziali,
Munroe-Blum, McCleary, 1997)
Description and Psychometrics
13
Engagement Group Engagement Measure (Macgowan,
1997, 2000)

• Leader/observer rating about each member
• Original version 7 factors, 37 items
• Two shorter versions (Macgowan Newman, in
  press)
• 7-factor, 27-item, for clinical groups
• 5-factor, 21-item version for clinical or
  non-clinical groups

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Engagement Dimensions and Description
Not in 5-factor, 21-item GEM
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Group Engagement Measure
Description and Psychometrics
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How Could Process Instruments be Utilized in
Research?

• Description
• Correlation
• Sequential analysis

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Summary and Conclusions

• We should measure particular group factors
  related to outcomes
• Instruments to measure processes in groups for
  adolescent AOD users are available, which are
  relatively easy to administer and score
• The data yielded by such instruments provide
  important quantitative data about group factors
• Needs
• Psychometric testing of instruments with
  adolescents
• Relationships between measures and constructs
  suggests the presence of common
  factors/higher-order factors. Need more effective
  and efficient measurement technologies

18
References

• Budman, S. H., Soldz, S., Demby, A., Davis, M.,
  Merry, J. (1993). What is cohesiveness? An
  empirical examination. Small Group Research,
  24(2), 199-216.
• Burlingame, G. M., Fuhriman, A., Johnson, J. E.
  (2002). Cohesion in group psychotherapy. In J. C.
  Norcross (Ed.), Psychotherapy relationships that
  work Therapist contributions and responsiveness
  to patients. (pp. 71-87). New York Oxford.
• Corey, G. (1990). Theory and practice of group
  counseling (3rd ed.). Pacific Grove, Calif.
  Brooks/Cole.
• Dagley, J. C., Gazda, G. M., Eppinger, S. J.,
  Stewart, E. A. (1994). Group psychotherapy
  research with children, preadolescents, and
  adolescents. In A. Fuhriman G. M. Burlingame
  (Eds.), Handbook of group psychotherapy An
  empirical and clinical synthesis (pp. 340-369).
  New York John Wiley and Sons.
• Dishion, T. J., Poulin, F., Burraston, B.
  (2001). Peer group dynamics associated with
  iatrogenic effects in group interventions with
  high-risk young adolescents. In D. W. Nangle C.
  A. Erdley (Eds.), The role of friendship in
  psychological adjustment (pp. 79-92). San
  Francisco Jossey-Bass.
• Evans, N. J. (1982). The relationship of
  psychological type and attraction to group in a
  growth group setting. Journal for Specialists in
  Group Work, 7(2), 74-79.

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References

• Evans, N. J. (1984). The relationship of
  interpersonal attraction and attraction to group
  in a growth group setting. Journal for
  Specialists in Group Work, 9(4), 172-178.
• Evans, N. J., Jarvis, P. A. (1986). The Group
  Attitude Scale A measure of attraction to group.
  Small Group Behavior, 17(2), 203-216.
• Feldman, R. A., Caplinger, T. E., Wodarski, J.
  S. (1983). The St. Louis conundrum The effective
  treatment of antisocial youths. Englewood Cliffs,
  NJ Prentice-Hall.
• Hill, C. E., Lambert, M. J. (2004).
  Methodological issues in studying psychotherapy
  processes and outcomes. In M. J. Lambert (Ed.),
  Bergin and Garfield's handbook of psychotherapy
  and behavior change (5th ed., pp. 84-135).
  Hoboken, NJ Wiley.
• Hill, C. E., Nutt, E. A., Jackson, S. (1994).
  Trends in psychotherapy process research
  Samples, measures, researchers, and classic
  publications. Journal of Counseling Psychology,
  41(3), 364-377.
• Horvath, A. O., Bedi, R. P. (2004). The
  alliance. In M. J. Lambert (Ed.), Bergin and
  Garfield's handbook of psychotherapy and behavior
  change (5th ed., pp. 37-69). Hoboken, NJ Wiley.

20
References

• Kivlighan, D. M., Tarrant, J. M. (2001). Does
  group climate mediate the group leadership -
  group member outcome relationship? A test of
  Yalom's hypotheses about leadership priorities.
  Group Dynamics, 5(4), 220-234.
• Macgowan, M. J. (1997). A measure of engagement
  for social group work The Groupwork Engagement
  Measure (GEM). Journal of Social Service
  Research, 23(2), 17-37.
• Macgowan, M. J. (2000). Evaluation of a measure
  of engagement for group work. Research on Social
  Work Practice, 10(3), 348-361.
• Macgowan, M. J., Levenson, J. S. (2003).
  Psychometrics of the Group Engagement Measure
  with male sex offenders. Small Group Research,
  34(2), 155-169.
• Macgowan, M. J., Newman, F. L. (in press). The
  factor structure of the Group Engagement Measure.
  Social Work Research.
• MacKenzie, K. R. (1981). Measurement of group
  climate. International Journal of Group
  Psychotherapy, 31(3), 287-295.
• MacKenzie, K. R. (1983). The clinical application
  of a group climate measure. In R. R. Dies K. R.
  MacKenzie (Eds.), Advances in group
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  (pp. 159-170). New York International
  Universities Press.

21
References

• Martin, D. J., Garske, J. P., Davis, M. K.
  (2000). Relation of the therapeutic alliance with
  outcome and other variables a meta-analytic
  review. Journal of Consulting and Clinical
  Psychology, 68(3), 438-450.
• Marziali, E., Munroe-Blum, H., McCleary, L.
  (1997). The contribution of group cohesion and
  group alliance to the outcome of group
  psychotherapy. International Journal of Group
  Psychotherapy, 47(4), 475-497.
• Marziali, E., Munroe-Blum, H., McCleary, L.
  (1999). The effects of the therapeutic alliance
  on the outcomes of individual and group
  psychotherapy with borderline personality
  disorder. Psychotherapy Research, 9(4), 424-436.
• Ogrodniczuk, J. S., Piper, W. E. (2003). The
  effect of group climate on outcome in two forms
  of short-term group therapy. Group Dynamics,
  7(1), 64-76.
• Steering Committee. (2002). Empirically supported
  therapy relationships Conclusions and
  recommendations of the Division 29 Task Force. In
  J. C. Norcross (Ed.), Psychotherapy relationships
  that work Therapist contributions and
  responsivenss to patients (pp. 441-443). New
  York Oxford.
• Yalom, I. D. (1995). The theory and practice of
  group psychotherapy (4th ed.). New York Basic
  Books.