Attachment in Group Therapy

In group therapy, individuals immediately rely on their prior attachment experiences to understand group processes and cope with the feelings the group elicits. Internal representations of self and others, as well as emotion-regulating strategies, are all automatically triggered in the group.

To help clients work effectively with these automatic thoughts and feelings the group leader tries to create a safe environment where individuals can explore these implicit attachment-based processes as they are activated. Regardless of the issues group members present with, the format of the group, or the theory supporting the group interventions, leading a group is often challenging because there are many internal and interpersonal dynamics influencing the process at any one point in time.

In this video, Dr. Cheri L. Marmarosh conducts a brief pre-session screening with an individual client, then shows how she applies attachment theory in the group's first interaction, demonstrating how individuals with different attachment histories may navigate their initial experience in a group.

This approach to group therapy applies attachment theory to the beginning of a group interaction, and it demonstrates how individuals with different attachment histories may navigate their initial experience in a group.

In group therapy, individuals use prior attachment experiences to understand group processes and cope with any feelings the group elicits. Their internal representations of self and others and emotion-regulating strategies are automatically triggered in the group.

Despite these automatic thoughts and feelings, the group leader tries to create a safe environment where individuals can explore these implicit attachment-based processes as they are activated in the group.

Even though the video depicts one session and not an on-going group therapy process, we can see how attachments influence the members and how the group leader works to develop a safe group climate for all members to explore their reactions in the group, regardless of their different interpersonal histories and needs.

Cheri L. Marmarosh, PhD, is an associate professor of professional psychology at the George Washington University, a fellow of APA Division 29 (Society for the Advancement of Psychotherapy) and APA Division 49 (Society of Group Psychology and Group Psychotherapy), and a licensed psychologist in private practice in Washington, DC.

She has taught group psychotherapy for more than 20 years, taught a course applying attachment to psychotherapy for 10 years, and has published more than 40 empirical and theoretical articles that focus on how group and individual psychotherapy facilitate change. She is currently an associate editor of Psychotherapy and the past associate editor of Group Dynamics: Theory, Research, and Practice. She is currently on the editorial boards of the International Journal of Group Psychotherapy and The Journal of Counseling Psychology.

Dr. Marmarosh is the lead author of two books, Attachment in Group Psychotherapy (2013, American Psychological Association) and Groups: Fostering a Culture of Change (2013, Sage Publications).

• Bowlby, J. (1988). A secure base: Clinical applications of attachment theory. London: Routledge.
• Hammond, E., & Marmarosh, C. (2011). The influence of individual attachment styles on group members' experience of therapist transitions. International Journal of Group Psychotherapy, 61, 595–618.
• Kilmann, P., Urbaniak, & Parnell (2006). Effects of attachment focused versus relationship skills-focused group interventions for college students with insecure attachment patterns. Attachment and Human Development, 8, 47–62.
• Markin, R. D. & Marmarosh, C. (2010). Application of adult attachment theory to group member transference and the group therapy process. Psychotherapy Theory, Research, Practice and Training, 47(1), 111–121.
• Marmarosh, C. L. (2009). Multiple attachments and group psychotherapy: Implications for college counseling centers. International Journal of Group Psychotherapy, 59(4), 461–489.
• Marmarosh, C., Bieri, K., Fauchi-Schutt, J., Barrone, C., & Choi, J. (2011). The secure psychotherapy base: Using client and therapist adult attachment styles to predict changes in alliance and therapy outcome, Poster at the American Psychological Association, Division 39, Washington, D.C.
• Marmarosh, C., Franz, V. A., Koloi, M., Majors, R., Rahimi, A., Ronquillo, J., Somberg, R., Swope, J., & Zimmer, K. (2006). Therapists' group attachments and their expectations of patients' attitudes about group therapy. International Journal of Group Psychotherapy, 56, 325–338.
• Mikulincer, M. & and Shaver, P. R. (2007). Attachment in adulthood: Structure, dynamics, and change. New York: Guilford Press.

APA Videos

• Attachment-Based Family Therapy
  Guy S. Diamond
• Attachment-Based Psychotherapy in Practice
  Peter C. Costello
• Family Therapy With Patients Having Physical Health Problems
  Susan H. McDaniel
• Intimate Partner Violence
  Casey T. Taft
• The Therapy Relationship
  Charles G. Gelso
• Using Client Feedback in Therapy
  Barry L. Duncan

APA Books

• Attachment in Group Psychotherapy
  Cheri L. Marmarosh, Rayna D. Markin, and Eric B. Spiegel
• Attachment-Based Family Therapy for Depressed Adolescents
  Guy S. Diamond, Gary M. Diamond, and Suzanne A. Levy
• Attachment-Based Psychotherapy: Helping Patients Develop Adaptive Capacities
  Peter C. Costello
• Grief in Childhood: Fundamentals of Treatment in Clinical Practice
  Michelle Y. Pearlman, Karen D'Angelo Schwalbe, and Marylène Cloitre
• Inside the Session: What Really Happens in Psychotherapy
  Paul L. Wachtel
• Insight in Psychotherapy
  Edited by Louis G. Castonguay and Clara E. Hill
• The Real Relationship in Psychotherapy: The Hidden Foundation of Change
  Charles J. Gelso