The relationships among working alliance, group cohesion and homework engagement in group cognitive behaviour therapy for social anxiety disorder

ObjectiveFew studies have investigated the role of generic relational factors, such as group cohesion and working alliance, in group cognitive behaviour therapy (CBT) for social anxiety disorder (SAD). The aim of this study was to examine the temporal associations among working alliance, group cohesion, and an index of a CBT-specific factor, homework engagement, as correlates of fear of negative evaluation and symptoms of social anxiety in group CBT for SAD.MethodThere were 105 participants with a diagnosis of social anxiety disorder who were randomly assigned to 12 sessions of group imagery-enhanced or standard CBT. Participants completed measures at various time points during the 12-session interventions, and the relationship among variables was examined through random-intercept cross-lagged panel models.ResultsGroup cohesion was significantly associated with social anxiety symptoms at the end of treatment, however there was no significant relationship with working alliance. Greater homework engagement predicted lower social interaction anxiety, but only during mid-treatment.ConclusionThe results highlight the importance of supporting group cohesion and maximising homework engagement during core components of social anxiety treatment such as behavioural experiments.

Automated summary

The study examines the role of group cohesion, working alliance, and homework engagement in group cognitive behavior therapy for social anxiety disorder. The results show that group cohesion is significantly associated with social anxiety symptoms, while working alliance is not. Greater homework engagement predicts lower social interaction anxiety, but only during mid-treatment.