Group cohesion in online and in-person psychotherapy in a randomized control trial for cancer survivors

Abstract

Objective: To explore the role of group cohesion (GC) in-person positive group psychotherapy (PPPC) and online positive group psychotherapy (OPPC). Method: A sample of 126 female cancer survivors experiencing emotional distress following primary oncological treatment was randomized to PPPC or OPPC. Measures of emotional distress, post-traumatic stress, and post-traumatic growth were taken at pre-treatment, post-treatment (after 12 weeks), and 3-month follow-up (from post-treatment), with GC assessed at post-treatment for this secondary analysis. Results: There were no significant differences in GC levels between the PPPC and OPPC groups. Higher GC was associated with greater reductions in depressive symptoms (b= -0.80, CI(95 %)= -1.18 – -0.42, p< 0.001) and post-traumatic stress (b= -1.38, CI(95 %)= -2.42 – -0.34, p< 0.010) in both modalities. Participants with higher GC reported immediate post-traumatic growth at post-treatment, while those with lower GC achieved similar growth levels by 3-month follow-up. No specific sociodemographic or clinical variables were associated with higher GC. Conclusions: In group psychotherapy for cancer survivors, GC is associated with a more pronounced reduction of depressive symptoms and post-traumatic stress, and with earlier post-traumatic growth in both OPPC and PPPC. Findings suggest that all cancer survivors have equal potential to develop GC, regardless of clinical or sociodemographic characteristics.