Relational challenges often associated with interpersonal trauma may hinder survivors’ abilities to fully benefit from group therapy. This quasi-experimental study compared clinical outcomes of a 16-week version of the Trauma Recovery and Empowerment Model (TREM) for women and an attachment-informed adaptation (ATREM). Prior findings of TREM are extended by demonstrating that both group conditions can facilitate comparable clinical outcomes, creating options for group facilitators. Only ATREM resulted in statistically significant improvement in individual attachment avoidance, and it trended toward a slightly higher completion rate. This study provides insight into the emerging concept of group attachment.
AfifiT. O.MacMillanH. L. (2011). Resilience following child maltreatment: A review of protective factors. Canadian Journal of Psychiatry, 56, 266-272.
2.
AllenJ. (2013). Treating attachment trauma with plain old therapy. Journal of Trauma & Dissociation, 14, 367-374.
3.
AmaroH.ChernoffM.BrownV.ArévaloS.GatzM. (2007). Does integrated trauma-informed substance abuse treatment increase treatment retention?Journal of Community Psychology, 35, 845-862.
4.
AmaroH.DaiJ.ArévaloS.AcevedoA.MatsumotoA.NievesR.PradoG. (2007). Effects of integrated trauma treatment on outcomes in a racially/ethnically diverse sample of women in urban community-based substance abuse treatment. Journal of Urban Health, 84, 508-522.
BoccatoG.CapozzaD. (2011). Attachment styles and social groups: Review of a decade. Testing, Psychometrics, Methodology in Applied Psychology, 18, 19-30.
7.
BowlbyJ. (1982). Attachment and loss: Attachment (2nd ed., vol. 1). New York: Basic Books.
8.
BowlbyJ. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books.
9.
BreidingM. J. (2015). Prevalence and characteristics of sexual violence, stalking, and intimate partner violence victimization-national intimate partner and sexual violence survey, United States, 2011. American Journal of Public Health, 105(4), e11-e12.
10.
BurtonM. S.CooperA. A.FeenyN. C.ZoellnerL. A. (2015). The enhancement of natural resilience in trauma interventions. Journal of Contemporary Psychotherapy, 45, 193-204.
11.
ChouliaraZ.KaratziasT.GulloneA.FergusonS.CosgroveK.DrauckerC. B. (2017). Therapeutic change in group therapy for interpersonal trauma: A relational framework for research and clinical practice. Journal of Interpersonal Violence. Advance online publication. doi:10.1177/0886260517696860
12.
CihlarB. E. (2014). The trauma recovery and empowerment model: A trauma-informed treatment program for female offenders in the community (Doctoral dissertation). Available from ProQuest Dissertations and Theses database. (3608215). Retrieved from https://pqdtopen.proquest.com/pubnum/3608215.html
13.
CocozzaJ. J.JacksonE. W.HenniganK.MorrisseyJ. P.ReedB. G.FallotR.BanksS. (2005). Outcomes for women with co-occurring disorders and trauma: Program-level effects. Journal of Substance Abuse Treatment, 28, 109-119.doi:10.1016/j.jsat.2004.08.010
14.
CutronaC. E.RussellD. W. (1987). The provisions of social relationships and adaptation to stress. Advances in Personal Relationships, 1, 37-67.
15.
DegnanA.Seymour-HydeA.HarrisA.BerryK. (2016). The role of therapist attachment in alliance and outcome: A systematic literature review. Clinical Psychology & Psychotherapy, 23, 47-65.
16.
DerogatisL. R. (2001). BSI 18, brief symptom inventory 18: Administration, scoring and procedures manual. Minneapolis, MN: NCS Pearson.
17.
DevriesK. M.MakJ. Y.BacchusL. J.ChildJ. C.FalderG.PetzoldM., et al. (2013). Intimate partner violence and incident depressive symptoms and suicide attempts: A systematic review of longitudinal studies. PLoS Medicine, 10(5), e1001439. doi:10.1371/journal.pmed.1001439
18.
FallotR. D.McHugoG. J.HarrisM.XieH. (2011). The trauma recovery and empowerment model: A quasi-experimental effectiveness study. Journal of Dual Diagnosis, 7, 74-89.
19.
FieldT. A. (2014). Integrating left-brain and right-brain: The neuroscience of effective counseling. The Professional Counselor, 4, 19-27.
FloresP. J. (2010). Group psychotherapy and neuro-plasticity: An attachment theory perspective. International Journal of Group Psychotherapy, 60, 546-570.
22.
FoaE. B.RiggsD. S.DancuC. V.RothbaumB. O. (1993). Reliability and validity of a brief instrument for assessing post-traumatic stress disorder. Journal of Traumatic Stress, 6, 459-473.
23.
FonagyP.BatemanA. W. (2006). Mechanisms of change in mentalization-based treatment of BPD. Journal of Clinical Psychology, 62, 411-430. doi:10.1002/jclp.20241
24.
FonagyP.LeighT.SteeleM.SteeleH.KennedyR.MattoonG., et al. (1996). The relation of attachment status, psychiatric classification, and response to psychotherapy. Journal of Consulting and Clinical Psychology, 64, 22-31. doi:10.1037/0022-006X.64.1.22
25.
FowlerJ. C.CharakR.ElhaiJ. D.AllenJ. G.FruehB. C.OldhamJ. M. (2014). Construct validity and factor structure of the difficulties in emotion regulation scale among adults with severe mental illness. Journal of Psychiatric Research, 58, 175-180.
26.
FraleyR. C.RoismanG. I.Booth-LaForceC.OwenM. T.HollandA. S. (2013). Interpersonal and genetic origins of adult attachment styles: A longitudinal study from infancy to early adulthood. Journal of Personality and Social Psychology, 104, 817-838. doi:10.1037/a0031435
27.
GallagherM. E.TascaG. A.RitchieK.BalfourL.MaxwellH.BissadaH. (2014). Interpersonal learning is associated with improved self-esteem in group psychotherapy for women with binge eating disorder. Psychotherapy, 51, 66-77. doi:10.1037/a0031098
28.
GottliebB. H.BergenA. E. (2010). Social support concepts and measures. Journal of Psychosomatic Research, 69, 511-520. doi:10.1016/j.jpsychores.2009.10.001
29.
GratzK. L.RoemerL. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 41-54.
30.
GriffinD. W.BartholomewK. (1994). The metaphysics of measurement: The case of adult attachment. In BartholomewK.PerlmanD. (Eds.), Advances in personal relationships: Attachment processes in adulthood (pp. 17-52, vol. 5). London, England: Jessica Kingsley.
31.
HarrisM.AnglinJ. (1998). Trauma recovery and empowerment: A clinician’s guide for working with women in groups. New York: Simon and Schuster.
32.
HermanJ. L. (1997). Trauma and recovery. New York: Basic books.
33.
HillbergT.Hamilton-GiachritsisC.DixonL. (2011). Review of meta-analyses on the association between child sexual abuse and adult mental health difficulties: A systematic approach. Trauma, Violence, & Abuse, 12, 38-49. doi:10.1177/1524838010386812
34.
KaratziasT.FergusonS.GulloneA.CosgroveK. (2016). Group psychotherapy for female adult survivors of interpersonal psychological trauma: A preliminary study in Scotland. Journal of Mental Health, 25, 512-519.
35.
KeatingL.TascaG. A.GickM.RitchieK.BalfourL.BissadaH. (2014). Change in attachment to the therapy group generalizes to change in individual attachment among women with binge eating disorder. Psychotherapy, 51, 78-87. doi:10.1037/a0031099
36.
KilmannP. R.LaughlinJ. E.CarranzaL. V.DownerJ. T.MajorS.ParnellM. M. (1999). Effects of an attachment-focused group preventive intervention on insecure women. Group Dynamics: Theory, Research, and Practice, 3, 138-147. doi:10.1037/1089-2699.3.2.138
37.
KimH.WildemanC.Jonson-ReidM.DrakeB. (2017). Lifetime prevalence of investigating child maltreatment among US children. American Journal of Public Health, 107, 274-280. doi:10.2105/AJPH.2016.303545
38.
KinleyJ. L.ReynoS. M. (2013). Attachment style changes following intensive short-term group psychotherapy. International Journal of Group Psychotherapy, 63, 53-75.
39.
KirchmannH.SteyerR.MayerA.JoraschkyP.Schreiber-WillnowK.StraussB. (2012). Effects of adult inpatient group psychotherapy on attachment characteristics: An observational study comparing routine care to an untreated comparison group. Psychotherapy Research, 22, 95-114.
40.
KnightC. (2006). Groups for individuals with traumatic histories: Practice considerations for social workers. Social Work, 51, 20-30.
41.
KurdekL. A. (2002). On being insecure about the assessment of attachment styles. Journal of Social and Personal Relationships, 19, 811-834.
42.
LambertM. J.BarleyD. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy, 38, 357-361. doi:10.1037/0033-3204.38.4.357
43.
LevyK. N.EllisonW. D.ScottL. N.BerneckerS. L. (2011). Attachment style. Journal of Clinical Psychology, 67, 193-203.
44.
LundqvistG.HanssonK.SvedinC. G. (2009). Group therapy for women sexually abused as children: Social interaction, adjustment, and relationships before and after group therapy. Psychoanalytic Social Work, 16, 158-175. doi:10.1080/15228870903200335
45.
MagnavitaJ. J.AnchinJ. C. (2013). Unifying psychotherapy: Principles, methods, and evidence from clinical science. New York: Springer.
46.
MarkinR. D.MarmaroshC. (2010). Application of adult attachment theory to group member transference and the group therapy process. Psychotherapy, 47, 111-121. doi:10.1037/a0018840
47.
MarmaroshC. L. (2015). Emphasizing the complexity of the relationship: The next decade of attachment-based psychotherapy research. Psychotherapy, 52, 12-18. doi:10.1037/a0036504
48.
MarmaroshC. L.MarkinR. D.SpeigelE. B. (2013). Attachment in group psychotherapy. Washington, DC: American Psychological Association.
49.
McHugoG. J.CaspiY.KammererN.MazelisR.JacksonE.RussellL., et al. (2005). The assessment of trauma history in women with co-occurring substance abuse and mental disorders and a history of interpersonal violence. Journal of Behavioral Health Services & Research, 32, 113-127.
50.
McHugoG. J.KammererN.JacksonE. W.MarkoffL. S.GatzM.LarsonM. J., et al. (2005). Women, co-occurring disorders, and violence study: Evaluation design and study population. Journal of Substance Abuse Treatment, 28, 91-107. doi:10.1016/j.jsat.2004.08.009
51.
McLellanA. T.LuborskyL.WoodyG. E.O’BrienC. P. (1980). An improved diagnostic evaluation instrument for substance abuse patients: The Addiction Severity Index. Journal of Nervous and Mental Disease, 168, 26-33.
52.
MikulincerM.ShaverP. R. (2010). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press.
53.
MorrisseyJ. P.EllisA. R.GatzM.AmaroH.ReedB. G.SavageA., et al. (2005). Outcomes for women with co-occurring disorders and trauma: Program and person-level effects. Journal of Substance Abuse Treatment, 28, 121-133.
54.
MullerR. T. (2009). Trauma and dismissing (avoidant)attachment: Intervention strategies in individual psychotherapy. Psychotherapy, 46, 68-81. doi:10.1037/a0015135
55.
MullerR. T.GragtmansK.BakerR. (2008). Childhood physical abuse, attachment, and adult social support: Test of a mediational model. Canadian Journal of Behavioural Science / Revue anadienne des sciences du comportement, 40, 80-89. doi:10.1037/0008-400X.40.2.80
56.
PaquinJ. D.KivlighanD. M.DrogoszL. M. (2013). Person-group fit, group climate, and outcomes in a sample of incarcerated women participating in trauma recovery groups. Group Dynamics: Theory, Research, and Practice, 17, 95-109. doi:10.1037/a0032702
57.
PearlmanL. A.CourtoisC. A. (2005). Clinical applications of the attachment framework: Relational treatment of complex trauma. Journal of Traumatic Stress, 18, 449-459.
58.
PowersM. B.GillihanS. J.RosenfieldD.JerudA. B.FoaE. B. (2012). Reliability and validity of the PDS and PSS-I among participants with PTSD and alcohol dependence. Journal of Anxiety Disorders, 26, 617-623. doi:10.1016/j.janxdis.2012.02.013
59.
RehanW.AntfolkJ.JohanssonA.SanttilaP. (2017). Do single experiences of childhood abuse increase psychopathology symptoms in adulthood?Journal of Interpersonal Violence, 34, 1021-1038.
60.
SaundersE. A.EdelsonJ. A. (1999). Attachment style, traumatic bonding, and developing relational capacities in a long-term trauma group for women. International Journal of Group Psychotherapy, 49, 465-485.
61.
ScharfeE.ColeV. (2006). Stability and change of attachment representations during emerging adulthood: An examination of mediators and moderators of change. Personal Relationships, 13, 363-374.
62.
ShulmanL. (2015). The skills of helping individuals, families, groups, and communities (8th ed.). Boston, MA: Cengage Learning.
63.
SmithE. R.MurphyJ.CoatsS. (1999). Attachment to groups: Theory and management. Journal of Personality and Social Psychology, 77, 94-110. doi:10.1037/0022-3514.77.1.94
64.
SpohnR.WrightE. M.PetersonJ. C. (2017). Rape and mental health outcomes among women: Examining the moderating effects of "healthy" fear levels. Violence Against Women, 23, 1055-1075. doi:10.1177/1077801216655625
65.
StraussB. M.MestelR.KirchmannH. A. (2011). Changes of attachment status among women with personality disorders undergoing inpatient treatment. Counselling and Psychotherapy Research, 11, 275-283.
TascaG. A.BalfourL.RitchieK.BissadaH. (2006). Developmental changes in group climate in two types of group therapy for binge-eating disorder: A growth curve analysis. Psychotherapy Research, 16, 499-514.
68.
TascaG. A.RitchieK.BalfourL. (2011). Implications of attachment theory and research for the assessment and treatment of eating disorders. Psychotherapy, 48, 249-259. doi:10.1037/a0022423
69.
TaylorP.RietzschelJ.DanquahA.BerryK. (2015). Changes in attachment representations during psychological therapy. Psychotherapy Research, 25, 222-238.
70.
ToussaintD. W.VanDeMarkN. R.BornemannA.GraeberC. J. (2007). Modifications to the Trauma Recovery and Empowerment Model (TREM) for substance-abusing women with histories of violence: Outcomes and lessons learned at a Colorado substance abuse treatment center. Journal of Community Psychology, 35, 879-894.
71.
WalkerH. E.FreudJ. S.EllisR. A.FraineS. M.WilsonL. C. (2019). The prevalence of sexual revictimization: A meta-analytic review. Trauma, Violence, & Abuse, 20, 67-80. doi:10.1177/1524838017692364
72.
WallinD. J. (2015). Attachment in psychotherapy. New York: Guilford Press.
73.
WangJ.KellyB. C.BoothB. M.FalckR. S.LeukefeldC.CarlsonR. G. (2010). Examining factorial structure and measurement invariance of the Brief Symptom Inventory (BSI)-18 among drug users. Addictive Behaviors, 35, 23-29. doi:10.1016/j.addbeh.2009.08.003
74.
WolfeJ.KimerlingR.WilsonJ.KeaneT. M. (1997). Assessing psychological trauma and PTSD. In KeaneIJWTM (Ed.), Gender issues in the assessment of Posttraumatic Stress Disorder (pp. 192-238). New York: Guilford.
75.
YalomI. D.LeszczM. (2005). The theory and practice of group psychotherapy (5th ed.). New York: Basic Books.
76.
ZinzowH. M.AmstadterA. B.McCauleyJ. L.RuggieroK. J.ResnickH. S.KilpatrickD. G. (2011). Self-rated health in relation to rape and mental health disorders in a national sample of college women. Journal of American College Health, 59, 588-594.
