Patients in group therapy often struggle with interpersonal problems and difficulties regulating emotions. Group therapy is an ideal format for many such patients because it exposes them to ample feedback from the group and leader in a safe environment.

However, the specific needs of each member vary. Attachment theory offers an effective framework for determining how best to intervene with each member and the group as a whole.

This book applies attachment theory to group psychotherapy, explaining how group therapists can effectively work with members of different attachment styles. By understanding the needs of each member based on his or her attachment style, the leader can best foster corrective emotional exchanges that challenge members' maladaptive beliefs about themselves and others.

The chapters provide clinical guidance and case examples for numerous aspects of group therapy, including screening and preparing potential members, identifying individuals who are not good candidates for group therapy, and fostering here-and-now emotional experiences that help group members move toward positive change.

Table of Contents



I. Theory and Empirical Research on Attachment and Group Psychotherapy

  1. An Overview of Attachment Theory and Its Application to Group Psychotherapy
  2. Measuring Group and Dyadic Adult Attachment Styles
  3. Attachment in Individual and Group Psychotherapy: Empirical Findings

II. Applications of Attachment to Group Practice

  1. Assembling the Group: Screening, Placing, and Preparing Group Members
  2. Processes That Foster Secure Attachment in Group Psychotherapy
  3. Treating the Preoccupied Group Member
  4. Treating the Dismissing-Avoidant Group Member
  5. Attachment and Special Group Populations: Eating Disorders, Substance Abuse, and Trauma
  6. Diversity in Group Psychotherapy: Attachment, Ethnicity, and Race
  7. Attachment, Loss, and Termination in Group Psychotherapy
  8. In-Depth Clinical Case Studies: Attachment Theory and Group Psychotherapy

Afterword: Closing Reflections on Attachment and Group Psychotherapy

Appendix: Group Therapy Questionnaire–S



About the Authors

Author Bios

Cheri L. Marmarosh, PhD, is a full-time associate professor of professional psychology at the George Washington University and a licensed psychologist.

She has published numerous empirical and theoretical articles that focus on how group and individual therapy facilitate change. She has supervised the research and clinical work of many doctoral students in the DC area. She is also an associate editor of Group Dynamics: Theory, Research, and Practice and on the editorial boards of the International Journal of Group Psychotherapy and Psychotherapy: Theory, Research, Practice, and Training.

Dr. Marmarosh is a faculty member in the Advanced Training Program in the Institute of Contemporary Psychotherapy and Psychoanalysis and on the steering committee of the Couple Program at the Washington Center for Psychoanalysis. She is a Fellow of APA Division 29 (Psychotherapy).

Dr. Marmarosh has a private practice in Washington, DC.

Rayna D. Markin, PhD, is an assistant professor of counseling at Villanova University and a licensed psychologist.

She has published numerous empirical and theoretical articles on the group therapy process and outcome, with special attention on how attachment and transference impact group member relationships and the group therapy process. She is interested in studying relationship-based psychotherapies, in general, and the curative factors in individual and group therapies. She is also interested in designing attachment-based interventions that use a group format for at-risk mothers.

Dr. Markin has practiced in numerous settings, from counseling centers and hospitals to private practice. She is involved in several professional organizations, such as the Society for Psychotherapy Research and APA Division 29. However, she derives the most joy from spending time with her two most precious attachment objects, her husband and young daughter.

Eric B. Spiegel, PhD, is a licensed psychologist in private practice in Philadelphia and Bryn Mawr, Pennsylvania.

He enjoys working across therapeutic modalities, offering individual, couples, and group psychotherapy in his practice.

Dr. Spiegel specializes in anxiety and mood disorders, attachment and relationship issues, clinical hypnosis, mind–body psychology, and trauma.

He is involved in several professional organizations, including the American Society of Clinical Hypnosis (ASCH). In 2012, he was honored by ASCH with the Early Career Achievement Award. He currently serves as the moderator of the Board of Governors and as a member of the Executive Committee for ASCH.

He received his doctorate in counseling psychology from the University of Maryland in 2005.

Reviews & Awards

Marmarosh, Markin, and Spiegel offer an elegant, integrated approach supported by current research to demonstrate that, indeed, attachment theory is a worthwhile conceptualization that will help group therapists work with particularly difficult group members—those with insecure attachment patterns...Given the broad perspective, this book will interest group psychotherapists and organizational consultants as well as therapists who want a deeper understanding of how to think about and apply attachment-based interventions.