Cruwys, T., Steffens, N.K., Haslam, S.A., Haslam, C., Hornsey, M.J., McGarty, C., & Skorich, D.P. (2019). Predictors of social identification in group therapy. Psychotherapy Research. Advance online publication. http://dx.doi.org/10.1080/10503307.2019.1587193
Previous research has found that group leaders and members overwhelmingly rate group dynamics as a key driver of positive change in group psychotherapy (Burlingame, McClendon and Alonso, 2011). One way to look at group dynamics is through the construct of social identification, or the degree to which a person subjectively feels that a group positively informs their self-definition (Postmes, Haslam and Jans, 2013).
For this research, the authors looked at contextual factors of social identification, specifically how and when people choose to categorize themselves and others in terms of a specific group membership. The authors focused on this degree of fit in two separate studies.
In the first study, the authors used a measure of perceived similarity, the degree to which patients perceived members of their treatment group to be relatively homogeneous at the start of therapy, to predict social identification at the end of therapy. Participants were 103 psychiatric outpatients who completed group cognitive behavior therapy (CBT) for depression or anxiety based on their primary diagnosis. Because most patients were experiencing comorbid symptoms of several mental illnesses, participants varied in their “match” between the patients’ symptom profiles and their assigned therapy group.
Patients completed questionnaires with items measuring social identification, perceived similarity, and depression symptoms on the first day of therapy after group introductions and at the end of the CBT program. Results indicated that participants who felt that members of the group were similar to one another at the beginning of therapy were more likely to identify strongly with the group at the end of therapy. Additionally, participants were more likely to identify with their CBT group to the extent that they perceived the group to be a good fit with the personal circumstances (i.e., level of symptom severity and assignment to a depression focused versus anxiety focused group).
The authors sought to replicate these findings in the second study, using an objective measure of similarity instead of a perceived measure. Participants were 112 young women with body shape or weight concerns who participated in an eating disorder prevention program. Before the first session and after the final session, group members completed outcome measure questionnaires asking about demographics, height and weight, eating disorder symptoms, and thin ideal internalization. Shorter questionnaires were completed after each session that measured social identification.
The results conceptually replicated the findings of the first study. Participants experienced a larger increase in their social identification with the therapy group based on placement in groups with members who were more similar on a salient dimension, such as their body mass index. Additionally, participants identified more strongly with the therapy group when their symptom profiles were closer to the group treatment focus—in this case, having high thin ideal internalization or low eating disorder symptoms.
These findings suggest that practitioners may want to consider patient fit with a therapy group before recruitment starts. For example, deciding what to call the group, how it will be advertised, and how patients will be screened may affect a patient’s perception of whether they will fit within a specific group.
Another factor for psychologists to consider is how similarly patients will believe they are to other group members with respect to symptom-specific features related to the purpose of the group (i.e., weight in an eating disorder prevention group). Shared experiences and goals, rather than demographic characteristics, may make it more likely for patients to identify with other group members.