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Does Group Alliance Improve Treatment Outcomes for Eating Issues?

According to a new study, conducted by Giorgio A. Tasca of the Department of Psychology at the University of Ottawa, individuals who feel more connected to other members of their treatment group have fewer eating issues than those who feel less aligned. “Therapeutic alliance” is a term used to describe the bond between a client and his or her therapist. Alliance has been shown to be a core element in predicting treatment outcomes for a variety of psychological issues. In group therapy settings, clients develop a therapeutic bond with their therapists, but also forge alliances with the other members of the group. This group alliance also is a crucial part of the overall therapeutic process. Tasca chose to study the dynamic of group alliance and how it affected treatment gains in a sample of 238 individuals who had received mixed diagnoses for eating and food problems. The participants recorded their level of alliance each week for nine weeks. They also kept track of their desire to restrict food after every meal.

Tasca found that there was a strong association between group alliance and food restriction. The participants who had the highest levels of alliance had the lowest restriction urges. Additionally, the level of intensity to restrict was predictive of group alliance ratings. However, the findings must be considered in light of some limitations. First, all of the participants had mixed diagnoses. This means that the alliance-outcome findings could be different for each individual eating problem. Also, the alliance levels were gauged using self-reports. Future research might utilize more subjective measures to assess alliance for group members. Regardless of these factors, the results underscore the importance of alliance for every individual in the group—not just to the therapists, but to other members of the group as well. “Clinicians may improve group treatment by assessing alliance to the group and outcomes repeatedly, being aware of their interplay, and structuring interventions based on the mutual causal effects of change in each,” Tasca said.

Tasca, G. A., Lampard, A. M. (2012). Reciprocal influence of alliance to the group and outcome in day treatment for eating disorders. Journal of Counseling Psychology. Advance online publication. doi: 10.1037/a0029947

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  • Cody

    September 27th, 2012 at 9:09 PM

    It always works well to have someone with you when you are into something.I think the togetherness factor and the encouragement that is available in such a group is always better than going it alone and small set backs are easier to overcome when you have inspiration!

  • paula

    September 27th, 2012 at 11:28 PM

    well I can see how this can be beneficial to a lot o people in therapy. but at the same time we should not forget those that can be at a disadvantage due to this. there are always those who will take others’ improvements unfavorably when they are not making progress themselves. such people could really feel the pinch in a group setting, but that is regardless of the alliance.

  • kayleigh

    September 28th, 2012 at 3:54 AM

    When you have this sort of alliance with others, that can be nice, no matter your addiction. There is someone else in the group that not only knows how you feel and the things in life that could be driving this copulsion, but who is also going to be there to hold you accountable for your actions. It is a whole lot easier to lie to those from whom you feel disengaged. But if you have created a friendship and an alliance within your therapy group, then it is a lot more difficult to look a friend in the eye and confess that you are not adhering to the treatment plan. This is the situational ideal I suppose, and there is no guarantee that you will find this. But of you do then that could definitely make healing a whole lot less difficult and more of a challenge that you wish to embrace, not let beat you.

  • Bertha

    September 28th, 2012 at 5:14 AM

    While this is news to cheer,I am interested in knowing just why this happens.Why is it that we make a connection with those in the same boat quite easily and then their success pushes us ahead too?Why does this happen?

  • Sally

    September 28th, 2012 at 11:55 AM

    Given that so many girls with eating disorders tend to judge not only themselves but also their peers, I wonder if this closeness stems in part from wanting to keep an eye on what the others are doing and how they could be secretly be holding onto their disordered eating patterns. I know that this is pretty cynical to think like this, but I was once one of those girls so I know what it’s like to not one person to get something over on me and make me think that it’s okay to be eating and gaining while secretly they are not changing.

  • daphne

    September 28th, 2012 at 1:21 PM

    I can see how this works – I started running every morning a few months ago but didn’t really stick to it and kept skipping it almost every alternate day. Then my husband joined me and we push each other to make sure we run every morning now. If I am the one who is too lazy on a particular day, he will encourage and push me. And on some other days it is me who is encouraging him. This sort of team work can definitely help us in working towards our common goal and also brings in that breath of fresh air as it is more interesting and energetic instead of going it alone.


    September 29th, 2012 at 5:13 AM

    self reporting gets a little too tricky to trust all the time
    why not reports form the group mediators?
    that’s the sort of data that i would eish to see

  • al

    September 29th, 2012 at 1:54 PM

    How about men with eating disorders? Same results?

  • giles

    September 29th, 2012 at 2:31 PM

    this may work for those with team player attributes but not so much for someone like me who wants to make his own choices and is hardly influenced by what others suggest,be it negative or positive!

  • Ken

    September 29th, 2012 at 5:56 PM

    The strength of a group is always greater than the sum of strength of each member.Be it physical strength or mental.And it is clearly demonstrated by this study.I can certainly work better and restrict myself from something,if need be,if I have more people with me doing the same.Its just the way we are programmed,right?At least most of us :)

  • Gianna

    September 29th, 2012 at 11:19 PM

    Well if you cannot hold out and keep a check on yourself without others constantly having to push you,then how will you manage once you’re out of therapy?This is something to be considered for all those who rely too much on such an alliance. It need not always be a positive thing you know!

  • sullivan

    September 30th, 2012 at 4:56 AM

    I can definitely see the benefits of forging these alliances, with both the therapist and the group as a whole.

    There needs to be the development of this leevl of trust in order for anyone to even hope to heal from their issues. You have to be in a position where you can trust your therapist; but you also have to trust those other people in your group with whom you are working and sharing.

    If that critical piece is missing then there is a good chance that you will either fail to show your true emotions and and feelings within the group setting. Either that or you will no longer attend, and then you will still be stuck spinning yur wheels and making no progress at all on your own.

  • Donald

    September 30th, 2012 at 9:12 AM

    “The participants who had the highest levels of alliance had the lowest restriction urges.”

    this right here proves that although group alliance does matter it depends on the individual as to how he uses it to his advantage and furthers his own could be in a great group but still struggle if he is not putting in individual although there can be a strong influence due to group alliance, one’s own effort are what are the most important aspect!

  • Stella p

    September 30th, 2012 at 12:01 PM

    I would love to see the way that someone, an outsider I guess would report their findings versus the results that have come via self reporting. Those who report on their own individual experiences may try to pait a rosier picture than what reality actually shows.

  • Karen

    September 30th, 2012 at 4:03 PM

    Interesting to see that even the association with others in a group settings can help.I always thought it is the connection with the therapist that matters.

    Is it just pure drive to excel just like your fellow- group members ? any particular reasons for this effect?

  • ingriD

    October 1st, 2012 at 4:14 AM

    Group therapy is very effective for some people but I still think that with something as personal as an eating disorder, it could be so much more effective to do one on one therapy. I think that people for the most part are more reluctant to be open and honest when working within agroup setting. They may also say things that they think will make them look better in the eyes of the group instead of the things that they are actually doing or feeling. I know that groups work for some, but I think that you have to really know the patient and make sure that this will be the best treatment setting for them.

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