When Group Spirit Meets Personal Journeys: Exploring Motivational Dynamics and Design Opportunities in Group Therapy

TL;DR

This paper explores the motivational dynamics and communication challenges in group therapy, specifically in a CBT program, highlighting opportunities for HCI to improve stakeholder engagement and reduce attrition.

Contribution

It provides an in-depth case study of stakeholder interactions in group CBT, revealing motivational conflicts and proposing design opportunities for technology to enhance engagement.

Findings

Identified conflicts between intrapersonal and interpersonal motivation.

Highlighted communication barriers among facilitators and clients.

Suggested design opportunities for HCI to mediate motivational tension.

Abstract

Psychotherapy, such as cognitive-behavioral therapy (CBT), is effective in treating various mental disorders. Technology-facilitated mental health therapy improves client engagement through methods like digitization or gamification. However, these innovations largely cater to individual therapy, ignoring the potential of group therapy-a treatment for multiple clients concurrently, which enables individual clients to receive various perspectives in the treatment process and also addresses the scarcity of healthcare practitioners to reduce costs. Notwithstanding its cost-effectiveness and unique social dynamics that foster peer learning and community support, group therapy, such as group CBT, faces the issue of attrition. While existing medical work has developed guidelines for therapists, such as establishing leadership and empathy to facilitate group therapy, understanding about the interactions between each stakeholder is still missing. To bridge this gap, this study examined a group CBT program called the Serigaya Methamphetamine Relapse Prevention Program (SMARPP) as a case study to understand stakeholder coordination and communication, along with factors promoting and hindering continuous engagement in group therapy. In-depth interviews with eight facilitators and six former clients from SMARPP revealed the motivators and demotivators for facilitator-facilitator, client-client, and facilitator-client communications. Our investigation uncovers the presence of discernible conflicts between clients' intrapersonal motivation as well as interpersonal motivation in the context of group therapy through the lens of self-determination theory. We discuss insights and research opportunities for the HCI community to mediate such tension and enhance stakeholder communication in future technology-assisted group therapy settings.