ALL BONDS ARE NOT THE SAME: DIFFERENT STRUCTURAL LEVELS OF POSITIVE BONDING RELATIONSHIPS IN THERAPY GROUPS

Intrapersonal split alliances were defined as discrepancies in how group members perceived their positive bonding relationships with the group leader, the other group members and the group-as-a-whole, and were related to group members’ outcome. Participants were 168 patients (116 women and 52 men) diagnosed as overweight or obese who participated in one of twenty, 12-session, therapy groups for weight management. Group members completed the Outcome Questionnaire-45 (OQ-45, Lambert et al., 2004) pre-and post-treatment and the Group Questionnaire (Krogel, et al., 2013) at an early, middle and late group session. Early, middle and late ratings were aggregated because bond scores were consistent across time. Two-level (members within groups), polynomial, multi-level regressions and response surface analyses were used to examine congruencies and discrepancies in ratings of positive bonding to the leader, group members and group-as-awhole. When positive bonds with the leader and bonds with the group members were congruent and when positive bonds with the group members and bonds with the group-as-a-whole were also congruent, there was greater symptom improvement. The findings show that, like interpersonal split alliances, intrapersonal alliances are harmful for treatment progress and need to be recognized and addressed by the group leader.