Examining between-group and within-group cultural concealment effects in group therapy

There is new evidence that cultural concealment can limit the effectiveness of therapy for some clients. The degree of cultural concealment, or the amount that clients feel obligated to suppress, or conversely, comfortable to share their own cultural experiences in therapy, can affect treatment processes and outcome. While the first study on cultural concealment was conducted with individual therapy clients, theoretically cultural concealment may have the same negative impact on group therapy processes and outcome. This study explored the association between cultural concealment and members’ perceptions of group therapy processes and improvement. To do this, we administered surveys to participants at the end of their group therapy treatment to assess their perception of their own cultural concealment over the course of treatment as well as their estimate of improvement and perceptions of group cohesion and a global therapeutic factor within their therapy group. Analyses were conducted to examine the effect of cultural concealment at the individual- and group-level by calculating within-group and between-group cultural concealment components. Results indicated that cultural concealment at the individual-level was negatively associated with clients’ perceptions of improvement, group cohesion, and a global therapeutic factor (i.e., within-group effect). Additionally, cultural concealment at the group-level was negatively associated with clients’ perceptions of a global therapeutic factor (i.e., between-group effect).