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

**Authors:** Alejandra Arizu-Onassis, Joan C. Medina, María Lleras de Frutos, Aida Flix-Valle, Maria Serra-Blasco, Laura Ciria-Suarez, Cristian Ochoa-Arnedo

PMC · DOI: 10.1016/j.ijchp.2025.100635 · International Journal of Clinical and Health Psychology : IJCHP · 2025-10-15

## TL;DR

This study found that group cohesion in both online and in-person therapy for cancer survivors helps reduce depression and stress, and promotes faster emotional growth.

## Contribution

The study demonstrates that group cohesion equally benefits both online and in-person therapy for cancer survivors.

## Key findings

- Higher group cohesion was linked to greater reductions in depressive symptoms and post-traumatic stress in both therapy modalities.
- Participants with higher group cohesion experienced immediate post-traumatic growth, while others caught up by 3 months.
- No sociodemographic or clinical factors were associated with higher group cohesion.

## Abstract

To explore the role of group cohesion (GC) in-person positive group psychotherapy (PPPC) and online positive group psychotherapy (OPPC).

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.

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.

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.

## Linked entities

- **Diseases:** cancer (MONDO:0004992)

## Full-text entities

- **Diseases:** depressive symptoms (MESH:D003866), cancer (MESH:D009369)

## Full text

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## Figures

4 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12550287/full.md

## References

40 references — full list in the complete paper: https://tomesphere.com/paper/PMC12550287/full.md

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Source: https://tomesphere.com/paper/PMC12550287