| Decades after the heyday of the encounter group movement, it appears that group treatment may be dying a slow death of attrition. There is reason to suspect that some clinicians have a bias against group treatment that may account for a dearth of new group referrals. This bias can be measured indirectly using an instrument being developed in support of Attachment Theory (Bowlby, 1988). It is called the Social Group Attachment Scale (SGAS) (Smith et al., 1999) and scores on this instrument have been shown to be associated with a measure of clinicians' attitudes towards group treatment (Marmarosh et al., 2006). While most measures of attachment focus on dyadic attachment (mother-child attachment, romantic attachment), the SGAS has been shown to measure social group attachment as distinct from dyadic attachment. This dissertation seeks to determine whether scores on the SGAS are associated with differences in clinicians' own feelings about group therapy and/or their beliefs about their patients' feelings about group therapy as measured by the Group Psychotherapy Survey -- Revised (Carter et al., 2001). Additionally, it seeks to determine whether differences in social group attachment can predict actual clinical referral decisions (as measured by percentage of referrals to group treatment as opposed to other forms of treatment). Finally, this dissertation seeks to determine whether other factors might predict referral decisions. A step-wise multiple regression analysis was performed on the data and the results did not support the hypothesis that group attachment scores predict referral decisions. A somewhat surprising result was that referral decisions can be predicted by the length of time a clinician has been practicing. Clinicians who have been practicing for a longer period of time, most of whom work in private practice, refer fewer patients to group than newer clinicians, most of whom work in mental health agencies. Other results suggested that differences in social group attachment were associated with differences in clinicians' attitudes and beliefs towards group treatment and that clinicians generally believe that their patients hold more positive views of group treatment than they themselves do. Implications and limitations of the study are discussed and directions for future research are proposed. |
