Purpose: Research on group dynamics has suggested that group-related factors such as engagement and cohesion play a substantial role in facilitating outcomes. As established models such as psychoeducation are disseminated into less-controlled community settings, understanding the impact of these group-related factors will play an increasingly important role in maintaining effectiveness.

Methods: Participants in this analysis were part of the intervention condition of a randomized clinical trial testing PERF (PsychoEducation Responsive to Families) a year-long educational multi-family model, conducted in partnership with the National Alliance for the Mentally Ill of St. Louis (n=183). Each PERF group determined its own unique curriculum, drawing resources from a standardized manual. Families were eligible for participation regardless of the psychiatric diagnosis of their member with the illness (FMI). Families were assessed at intake, 12- and 24- months on scales for family burden, impact, positive change, knowledge/mastery, social support, and attitudes towards caregiving. Additionally, group engagement and cohesiveness were measured for group completers only (n=44) using a four-item scale during the first 6 months of the intervention. Group engagement and cohesiveness were used to predict change scores between baseline and each follow-up using Hierarchical Linear Modeling controlling for specific group membership, relationship of family member to FMI, and FMI illness.

Results: Greater group cohesiveness was associated with increased social support, positive family impact, and decreased burden. Greater group engagement was associated with positive family outcomes.

Discussion/Implications: Despite selection bias, results suggest the contribution of group processes to achieving outcomes among program participants. Greater group engagement and cohesion were associated with more favorable outcomes. Findings affirm previous group dynamics research: group specific factors such as engagement and cohesion are significant when translating clinical group interventions into less-controlled community settings.