title: Dynamic relationships of therapist alliance and group cohesion in transdiagnostic group CBT for anxiety disorders.
abstract: OBJECTIVE
  Little is known about the temporal variability of the alliance-symptom change and cohesion-symptom change relationships over the course of group therapy. These questions were examined in a sample of 373 clients receiving a transdiagnostic cognitive behavior therapy (tCBT), which culled the principle research-supported mechanisms of change for anxiety disorders.
  
  
  METHODS
  The authors examined relationships between the client versions of the Working Alliance Inventory and Group Cohesion Scale in predicting subsequent symptom change, as assessed by the state scale of the State-Trait Anxiety Inventory.
  
  
  RESULTS
  Alliance and cohesion were significant predictors of next session anxiety scores. The alliance was consistently associated with anxiety symptoms (rs = -.152 to -.198, ps < .05), but cohesion only showed significant relationships with anxiety symptoms at Sessions 8 and 10 (Session 8, r = -.233, p = .020, and 10, r = -.236, p = .027). Alliance-anxiety relations remained constant, whereas cohesion-anxiety relations substantially increased from earlier to later sessions.
  
  
  CONCLUSIONS
  Differences that were obtained in the relation of alliance and cohesion with anxiety symptoms suggests that these processes have different roles within group tCBT. If replicated, the present findings would suggest that the dynamic relationships between alliance and cohesion and symptoms within group CBT for anxiety disorders have been an important omission in process-outcome studies.
authors.affiliation: School of Psychological Sciences, Monash University.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Norton
authors.affiliation: Cognitive Behavior Therapy Research Unit, Monash University.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Kazantzis
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D006126:Group Processes; D006801:Humans; D010043:Outcome and Process Assessment, Health Care; D011369:Professional-Patient Relations; D011615:Psychotherapy, Group / Q000379:methods*