Research & Group Analysis

It has become very clear over the past three decades that group analytic research is needed to evidence the effectiveness of group analysis. This means that quantitative studies must be carried out. Ideally, RCTS, because in the hierarchy of evidence, randomised controlled trials are high up on the pyramid of evidence. 

Not everybody is convinced that quantitative research is the way forward. Some might even argue that it cannot capture the intricacies of human interaction. Others might counter that quantitative methods are the only ones that can prove that group analysis is an effective treatment. Qualitative researchers may regard group analysis as an evidence-based psychotherapy anyway, because they include qualitative studies in their evaluation of group analysis. 

Opponents of any kind of research might say that it does not matter whether its effectiveness is demonstrated. They have witnessed that most group members improved in their groups and don’t require ‘hard’ evidence.

Then there is another group of people, who lump all analytic treatments together. If individual analytic therapy is effective, then group analytic psychotherapy is as well, because it includes several similar elements. Studies have also demonstrated the effectiveness of focused group analytic therapy for various client groups, such as borderline personality disorders. 

Does this evidence suffice? Can one generalise and conclude that the effectiveness of group analysis has been proven? Or is it about wording? If group analysis would be baptised ‘dynamic group therapy’, would it be considered to be more effective then? 

Pure Foulkesians might like the term ‘group analysis’. They could also argue that is differs from other group therapies, for example, mentalisation group therapy. Mentalisation refers to a person’s ability to think about how others might be thinking, feeling and/or behaving. It entails putting oneself into the mind of another person, metaphorically speaking. During therapy sessions, clients focus on difficulties in their current life in order to improve their understanding of themselves and others. Clients focus on what is going on in their minds and think about what might be happening in other peoples’ minds. Particularly in situations, which may cause strong emotional reactions and problematic behaviour.  

Perhaps I am getting too pedantic when differentiating between group analysis and other group analytic therapies. However, it begs the question: one group analysis or many?  Which of the different group analytic models are effective for which mental health conditions or disturbances? 

All this is tricky. Unless a manualised treatment is used, such as short-term group analytic psychotherapy, to which the therapist adheres to exactly, how do we actually know that every group analyst practises in the same way? 

In my personal experience, group psychotherapists have different styles. While some are quite humorous, others are rather serious. Some offered individual interpreted, one group member after the other got an interpretation. Others provide whole-group interpretations. 

Then there is the therapeutic relationship. It is crucial. Some therapists seem to be naturals, their clients improve regardless of what model they use. There is some anecdotal evidence for this. Would their group members improve more (have less symptoms, less conflicts in relationships, be happier and achieve what they would like to achieve in life)? In other words, is the therapist the most crucial ingredient? 

It boils down to what counts as evidence to some extent, and what is regarded as improvement, or as effective. Of course, I know the research definition of effectiveness. But does it really capture everything there is to capture about a person? I don’t think so. 

Then there is this thorny issue of DSM/ICD. While some agree that the evidence-base of group analysis should be strengthened, others believe that operationalising, RCTs, and other quantitative methods and techniques can’t capture all the aspects that people experience as beneficial. 

Even if all group analysts agreed that more quantitative research should be carried out, then we would need a research strategy. Once this has been agreed upon, who would actually carry out the research? Unfortunately, research is often a university affair, not the loving kind, but the money and power-oriented affair. Research must be funded. 

Universities carry weight and researchers, who hold a university post are more likely to know the grant application procedure, can complete forms, and know the right people, who would support applications. You scratch my back, I scratch yours. Doesn’t sound too altruistic or group analytic, does it? 

I’d be very interested in what you think. Drop me an email and I will include your views in the next column.