In this narrative review, the effectiveness of the REACH Forgiveness psychoeducational group intervention is examined. REACH is an acronym to cue memory for steps in emotional forgiveness: R = recall the hurt; E = empathize; A = altruistic gift of forgiveness; C = commit to forgiveness experienced; H = hold onto forgiveness. Overall, 24 studies that reported outcome data on REACH Forgiveness psychoeducational groups were tabulated and examined. Previous meta-analysis had found that effect size was linearly related to time spent in forgiveness intervention; thus, effect size (denoted by d, pre-post difference in means divided by pooled standard deviation) was examined per hour (i.e. d/hr) as an aid to qualitative comparisons. Overall, mean d/hr = 0.089. Those 12 REACH studies in which Worthington was a coauthor (i.e. the allegiance effect) had a d/hr of 0.093 versus 0.065 for the six in which he was not a coauthor. REACH Forgiveness with Christian samples (k = 9; d/hr = 0.107) had slightly better outcomes than did REACH Forgiveness with secular samples (k = 11; d/hr = 0.077). The effects of cultural adaptation (other than religion) were mixed. For clinical samples, only two REACH Forgiveness studies examined psychoeducational groups and two compared psychoeducation with process group therapy for forgiveness. Areas in which group psychoeducation using REACH Forgiveness was not effective (i.e. couple groups, pre-college youth) or less effective than alternatives such as do-it-yourself workbooks were identified. Best-practice standards for conducting group research on REACH Forgiveness were discussed.

Group cohesion is considered a key group therapeutic factor; however, limited knowledge exists on the session-to-session development of group cohesion in the context of training groups or on the factors that may predict such developments. We utilized multilevel growth modeling to examine the longitudinal changes in 44 counselor trainees' ratings of group cohesion in seven experiential growth groups across four semesters. We found significant between-person variability in the growth trajectory of group cohesion and identified trainee self-disclosure and gender as significant predictors of group cohesion. The results indicated the complexity of within- and between-person changes in group cohesion in training groups and the need for further research to identify potential predictors of these changes. We also discussed ways for group facilitators to attend to self-disclosure as an important marker of group cohesion.

The Achieving Success Everyday (ASE) group counseling model is discussed to support homeless students' unique and complex needs. The phenomenology of student homelessness is reviewed, as well as how residential and environmental instability negatively impacts students' academic and psychosocial functioning. Social support for homeless students is also discussed. Next, the ASE group model is described in detail and existing research on its application in school settings is reviewed. Implications for research and practice are provided as they may influence future efforts to support homeless students. Session examples are used to help school personnel apply the ASE model in their respective schools and communities.

Psychoeducation groups are an integral part of eating disorder treatment in community programs, yet research on their efficacy remains limited. This study examines the impact of participating in a 10-week psychoeducation group on changes in quality of life and in readiness and motivation. Seventy-five adults who had eating disorders were included in the study. We administered the Eating Disorder Quality of Life Scale (EDQLS) and Readiness and Motivation Questionnaire (RMQ) before and after the group. After participation, respondents reported an 11-point increase in the EDQLS score and 9-, 8-, and 9-point increases, respectively, in the total action, confidence, and internality components of the RMQ score. In group exit evaluations, participants reported that the psychoeducation group improved their quality of life and their readiness and motivation to recover.

Most people have been harmed by another at some point in their lives. Many of these hurts linger in the lives of those who were hurt, through anger, fear, and rumination. Forgiving others, when it is safe and prudent to do so, can be one route toward healing these past hurts. Group therapy has specific strengths that might help people to effectively forgive others. One of those strengths is the creation of therapeutic factors. In the current paper we discuss how group forgiveness interventions and the development of three specific therapeutic factors (universality, cohesion, and altruism) can help to promote forgiveness. We review prior work on forgiveness interventions in group therapy, focused on effectiveness generally. We then provide an applied case study of a specific group that used Worthington's REACH Forgiveness model. In this case study we highlight the themes of universality, cohesion, and altruism to illustrate the benefit of forgiveness interventions in group therapy.

There is limited research on group cohesion as a potential outcome facilitator in group-based cognitive-behavioral treatment (GCBT) for youth. We examined if group cohesion mediated the relation between the temperamental trait behavioral inhibition and posttreatment outcomes following GCBT for youth with anxiety disorders. The sample comprised 88 youth (M age = 11.2 years) from a randomized controlled effectiveness trial. The outcomes were posttreatment clinical severity and treatment satisfaction. Group cohesion fully mediated the relation between behavioral inhibition and posttreatment severity. Higher group cohesion was associated with lower posttreatment clinical severity. There was no significant association between behavioral inhibition and treatment satisfaction, hence no mediation. We conclude that group cohesion is a factor that can be targeted by clinicians to potentially enhance GCBT outcomes.

Six hundred and fifty-four inpatients who participated in a spiritual group therapy intervention provided qualitative feedback regarding what helped them and what could be improved. Patients revealed that enjoying a sense of connection with other people and a sense of openness in the groups and simply talking about spirituality with other people was helpful to them. Many group members requested that groups go on for a longer amount of time than 12 sessions, to have longer sessions, and to have more frequent meetings. In addition, members described improvements that could be made to the group, including members' being better screened, leaders preventing individual members from dominating discussions or from being quiet or leaving the group early, and members' wanting more structure as well as more open discussion. The findings highlight the importance of connection, openness, and spirituality when implementing spiritual group interventions in hospital settings. Implications for future research, training, and clinical interventions are discussed.

First responders (e.g. firefighters, law enforcement, paramedics, corrections officers) experience high rates of comorbid posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD). Despite the relevance of both spirituality and forgiveness to PTSD and AUD among first responders, spiritually integrated group interventions for this population are rare. This article discusses a forgiveness session of a spiritually integrated group psychotherapy protocol for first responders (SPIRIT-FR) in acute psychiatric care. This brief group psychotherapy intervention includes (a) psychoeducation about the intersection of PTSD, AUD, and forgiveness (b) discussion of the relevance of forgiveness to PTSD and AUD, and (c) the integration of spiritual beliefs and behaviors to move toward forgiveness. We discuss relevant clinical theory as well as the potential clinical application of this protocol.

This study assessed changes in therapeutic alliance and group cohesion among parents/primary caregivers enrolled in Connecting and Reflecting Experience (CARE), a short-term, group-based, mentalizing-focused parenting program designed to support a diverse community facing socioeconomic and health disparities. Caregivers (N = 44) experiencing parenting stress or parent-child relational challenges were recruited from their children's outpatient psychiatry clinic to participate in one of nine 12-session telehealth CARE groups. Caregivers completed the Working Alliance Inventory-Short Revised and the Therapeutic Factors Inventory Cohesiveness subscale after CARE Sessions 1 and 12. Ratings of group cohesion and therapeutic bond with facilitators increased significantly across treatment. Findings indicate that caregivers from underserved families with high levels of parenting stress experienced an increase in group cohesion and therapeutic alliance throughout a telehealth adaptation of CARE.

This feasibility study reports on the development and initial evaluation of a novel online intervention for helping professionals (HPs; i.e. mental health professionals, chaplains, clergy) designed to (a) address occupational hazards, such as burnout and vicarious traumatization, and (b) promote well-being and flourishing at work. In contrast with competency and self-care focused models, the CHRYSALIS (Catalyzing Helping Professionals' Resilience, VitalitY, Spirituality, Authentic Living, and Inner Strength) intervention centers the self of the provider, explores cultural and spiritual contexts, and attends to systemic challenges. As part of a larger randomized controlled trial evaluating two program formats, the group format entails eight online sessions exploring strengths that can promote well-being, including processing, relational, vitalizing, orienting, and agentic capacities. To pilot test this framework and establish proof of concept, this study analyzed data from 41 HPs who had been randomly assigned to the group condition and completed surveys at four time points. Quantitative results indicated significant reductions in vicarious traumatization and burnout as well as increased well-being and meaning in work. Qualitative results suggest the intervention fostered relational support, cultivated new perspectives, and increased engagement with strengths, positively impacting participants' work and navigation of caregiving systems. Feedback about cohesion and group dynamic challenges in an online format informed further program development. This study provides initial support for the feasibility and efficacy of the group format of the CHRYSALIS intervention as a creative means to address HPs' risk for occupational hazards and promote holistic formation in a relational context.

We are surrounded by trauma, grief, pandemics, health care inequality, poverty, climate change, and social injustice, not to mention increases in suicide, depression, and loneliness. How can group therapists address these issues and thrive? The current special edition focuses on how groups foster compassion, provide spiritual healing, and address human suffering in effective and innovative ways. Instead of focusing on symptom reduction alone, group therapists and researchers are exploring ways that group therapy can provide healing and resources to people including health care providers, and those who are on the front lines. The current special edition will highlight how spiritual interventions, compassion and attachment-focused interventions, and group interventions can engender positive outcomes for diverse group members that include parents of inner-city children to first responders. If there ever was a time for us to focus on compassion, faith, and forgiveness, it is now.

This qualitative research refers to the patients' perspective on the therapeutic factors operating in long-term group therapy of an integrated systemic orientation (ISO). Semi-structured interviews of members of two long-term ISO psychotherapy groups were conducted in three phases: the first, second, and third year of their group psychotherapy. The research sample consisted of 13 participants. The data was analyzed through an interpretative phenomenological analysis. The results confirmed the classification of Yalom's therapeutic factors. However, an additional therapeutic factor emerged, the "development of pluralistic perspectives" that appears more clearly from the second year of therapy onward. Moreover, from the second year onward, the categories "existential factors" and "interpersonal learning" get strengthened. Limitations and future directions are discussed.

This paper offers a brief overview of the historically predominant form of psychotherapy research both for individual and group psychotherapies, the randomized control trial (RCT), and its surrounding controversies and critiques as the backdrop from which new directions in both clinical theory building and research are being pursued, including efforts at building integrative models of treatment. The paper explores one promising integrative model, namely the incorporation of process and dynamic orientations into the province of group cognitive behavioral therapy (CBT) and identifies challenges in implementing this model.

The article focuses on a male-only therapy group that has been functioning for the last nine years in the Middle East, in Iran. The group has a permanent main female therapist and temporary, mostly female trainee cotherapists. We explore culturally specific factors that we believe impact expressions of aggression in the group. These factors include the Iranian gender segregation culture, the ideal of masculinity relating to the concept of "Gheirat" (moral vigilance), the legal acceptance of multiple wives in Iran (which often leads to family instability), and the cultural belief about the uncontrollability of sexual desires in men. We also comment on the role of a common dynamic in Iranian families, in which the relationships between mothers and sons are usually overwhelming while the emotional relationships between parents are somehow restrained. We close by discussing future directions for this area of study as well as by proposing interventions therapists may consider when encountering related group dynamics.

The current paper was an invited keynote given at the 2023 Connect Conference of the American Group Psychotherapy Association. The paper addresses the current struggles with love and hate in society and in therapy groups. The author elaborates on how our society has been living through collective traumas, and she focuses on how the pandemic and traumatic social currents have been undermining our collective sense of well-being. They have also been a source of important creative changes in our society and in process and therapy groups. The author examines malignant hate in society, the development of the self, her personal experiences with hate, her experiences conducting "Love and Hate Institutes" at AGPA conferences, and it concludes with a commentary on how developing yourself in a therapy/process group can help you live more fully and contribute to society.

Utilizing the work of Wilfred Bion, Harry Stack Sullivan, and other theorists and practitioners, as well as philosophers and students of race in America, this article argues that racism/white supremacy sabotages our work, and yet is fundamental to our way of doing, being, and thinking in our society. As a result of the centrality of racism/white supremacy, the author lays out four challenges which, if met, will aid in overcoming racism/white supremacy: (a) the first challenge of denial, (b) the second challenge of impaired empathy (and the failure to think), (c) the experience of shame, and (d) the denial of death. The article discusses each of these and concludes with a word on the possibility of passion-if we are able to overcome racism/white supremacy.

The current paper is an invited keynote from the 2023 Connect conference of the American Group Psychotherapy Association. The author describes the large group identity and how it develops alongside the individual self. Barriers to coexistence among groups is explored as well as ways of fostering peace.

This paper describes the decade-long, successful experience of developing a group therapy training program for mental health professionals in China. The perspectives of two Western group therapy instructors/supervisors and of a Chinese colleague who participated broadly in the program are described. We explore our understanding of Western ideas about group therapy and how these were experienced in the Chinese context. We address the opportunities that emerged at the interface of two very different cultures, and the challenges of translating and integrating Western group therapy principles and practices within a culture with a very different history and worldview.