Alliance Across Group Treatment for Veterans With Posttraumatic Stress Disorder: The Role of Interpersonal Trauma and Treatment Type

The authors examined initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. One hundred and 78 male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive-behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or noninterpersonal) impacted initial levels of alliance or change in alliance over time. Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a noninterpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p > .05) but did not have significantly different initial alliance ratings. The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance.