Therapeutic change in group therapy for interpersonal trauma: a relational framework for research and clinical practice

Zoë Chouliara*, Thanos Karatzias, Angela Gullone, Sandra Ferguson, Katie Cosgrove, Claire Burke Draucker

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)


Our understanding of therapeutic change processes in group therapy for complex interpersonal trauma has been limited. The present study aimed at addressing this gap by developing a framework of therapeutic change in this field from a survivor and therapist perspective. This is a qualitative study, which utilized semistructured individual interviews. Transcripts were analyzed using interpretative phenomenological analysis (IPA) to identify recurrent themes. A final sample of n = 16 patients and n = 5 facilitators completed the interview. Main change processes identified by survivors were as follows: self versus others, trust versus threat, confrontation versus avoidance, and “patching up” versus true healing. Therapeutic processes identified by therapist facilitators included managing group dynamics, unpredictability and uncertainty, and process versus content. The proposed framework explains therapeutic change in group therapy in relational terms, that is, therapeutic dissonance, the dynamic interaction of self and experience as well as building empathic trusting relations. The importance of managing dissonance to aid personally meaningful recovery was highlighted. These findings have implications for the usefulness of relational and person-centered approaches to clinical practice in the area of interpersonal and complex trauma, especially in the early identification, prevention, and management of dropouts.

Original languageEnglish
Pages (from-to)2897-2916
Number of pages20
JournalJournal of Interpersonal Violence
Issue number15-16
Early online date24 Apr 2017
Publication statusPublished - 1 Aug 2020
Externally publishedYes


  • Complex trauma
  • Recovery
  • Group therapy
  • Qualitative
  • Clinical framework


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