凝聚力團體對高孤寂感青少年心理健康之研究

Group Cohesion Intervention and Mental Health Outcomes among Adolescents with High Loneliness

本研究旨在瞭解高孤寂感青少年的心理健康狀態，透過第一階段的凝聚力團體方案的建構，並於第二階段實證檢驗團體效果。在第一階段，本研究透過5位學術領域、5位實務場域專家組成的修正式專家德懷術小組，形成具有團體凝聚力理論基礎的團體方案，第二階段則透過實際招募四個團體、30位青少年參與團體方案，並進一步分析團體歷程數據和成效。研究發現：（1）高孤寂感青少年在與人際關係滿意度低於低孤寂感青少年；（2）高孤寂感青少年在情緒困擾、網路成癮等面向存在較高風險；（3）高孤寂感青少年在參與凝聚力團體之後在孤寂感受降低、與人際關係滿意度提升；（4）高孤寂感青少年在凝聚力團體感受到的凝聚感受是陡升持平狀態，代表凝聚力團體在高孤寂感青少年存在一定團體效果。最後，本研究提出高孤寂感青少年心理健康、凝聚力團體方案和未來研究之建議。

In recent years, numerous international studies (Antunes et al., 2022; Liu et al., 2015; Twenge et al., 2021) have focused on adolescent loneliness, and related studies have also been conducted in Taiwan (Lin & Hsing, 2022). These studies have all found that adolescent loneliness is an issue that warrants serious attention. According to the literature, the impact of loneliness on adolescents is multifaceted. On the emotional level, it has been associated with depressive symptoms (Allen et al., 2014; Caputi et al., 2017), suicidal behaviors (He & Xiang, 2022), and family and school interpersonal relationships (Allen et al., 2014; Antunes et al., 2022; Engels et al., 2001; Liu et al., 2015; Marini et al., 2006; Mattanah et al., 2004; Wei et al., 2005). On the behavioral level, loneliness has been linked to internet addiction or internet gaming disorder (Ho & Kao, 2021; Konan et al., 2018; Primack et al., 2017; Sarıalioğlu et al., 2022; Song et al., 2014; Twenge & Spitzberg, 2020; Twenge et al., 2019; Yu et al., 2022), weight control (Qualter et al., 2018), and shy behaviors (Bowker et al., 2019). Adolescent loneliness has thus emerged as a pressing global issue that requires collective attention. The present study aims to focus on adolescent loneliness in Taiwan and explore possible coping strategies.
In response to adolescent loneliness, this study attempts to adopt the concept of group therapy as an intervention approach. Zhang et al. (2023) and Mahon (2024) indicated that social support and emotional companionship within group therapy are effective methods for addressing loneliness. This study posits that if loneliness reflects a desire for relationships but is accompanied by either the loss of most relationships or the inability to attain satisfaction within them, then“group cohesion”may serve as its opposite. Group cohesion be significantly associated with the effectiveness of group therapy (Burlingame et al., 2011; Burlingame et al., 2018; Christensen et al., 2021; Gully et al., 2012; Naeli et al., 2022; Norcross & Wampold, 2011). Furthermore, empirical evidence suggests that group cohesion plays a role in reducing interpersonal difficulties. For example, Fjermestad et al. (2025) investigated adolescents with anxiety disorders, noting that such disorders may lead to social anxiety or interpersonal withdrawal. Their study emphasized the effectiveness of cultivating peer relationships and social skills in group therapy. Results showed that. They shifted from initially placing more trust in the group leader as the group progressed to increasingly valuing emotional support and interactions among group members. It demonstrated that adolescents’sense of belonging and connectedness to other members and the group increased. Moreover, the study found that group cohesion not only serves as an effective factor in reducing adolescent anxiety and promoting mental health but also becomes increasingly important over time. Similarly, A significant association was found between group cohesion and social anxiety symptoms at the conclusion of group therapy, suggesting that higher group cohesion may be linked to lower levels of social anxiety symptoms (McEvoy et al., 2024). Their findings highlighted group cohesion as one of the core factors in treating social anxiety disorder.
Overall, of loneliness, which primarily involves the quantity of interpersonal interactions (loss of most relationships) and quality (inability to achieve satisfaction within relationships). For example, O’Shea et al. (2015) drawing from an interpersonal process orientation, demonstrated that both group therapy and individual therapy can effectively improve adolescents’depression, anxiety, related internalizing problems, and overall functioning, with treatment effects persisting up to 12 months after completion. Their findings also confirmed that group therapy enables adolescents to recognize that they are not alone in facing depressive emotions, fosters mutual support among members, and provides opportunities to practice interpersonal interactions and problem-solving skills within the group. In other words, group therapy may serve as an intervention model for adolescents with interpersonal needs, with effects comparable to individual therapy treatment. researchers have emphasized“group cohesion,”as it is considered a necessary condition for other therapeutic factors in group treatment (Yalom, 2005). For instance, Caputi et al. (2017) found that interventions enhancing classroom group cohesion effectively reduced adolescent loneliness and regulated emotional states. Therefore, assistance for adolescents experiencing loneliness should not be limited to individual behavioral treatments but must also consider the role of group factors. Accordingly, the purposes of this study are: (1) to establish a semi-structured group program for adolescents that fosters group cohesion, adhering to the spirit of empirical research, and (2) to explore the key activities and essential facilitation techniques that promote group cohesion during adolescents’participation in the semi-structured group, while evaluating its effectiveness. The findings are intended to for subsequent adolescent counseling practices or treatment approaches for mental health professionals assisting adolescents experiencing high levels of loneliness.
This study was conducted in two stages. The first stage involved the construction of a group program focused on cohesion, and the second stage examined the program’s effectiveness through empirical testing. In the first stage, a modified Delphi panel, consisting of five academic experts and five field practitioners, was formed to develop a group program grounded in the theoretical basis of group cohesion. In the second stage, four groups were recruited, with 30 adolescents participating in the program. Among them, 12 were biologically male and 18 were biologically female. Five participants were junior high school students (four in seventh grade and one in eighth grade; mean age = 12.60 years), and 25 were senior high school students (one in tenth grade, 18 in eleventh grade, and six in twelfth grade; mean age = 17.16 years). Data on group processes and outcomes were subsequently analyzed.
The primary aim of this study was to examine the effectiveness of the cohesion-focused group program for adolescents with high loneliness (defined as scoring > 8 on the Taiwan Adolescent Loneliness Scale). Twenty adolescents with high loneliness were selected, along with an additional 10 adolescents with low loneliness. Significant differences were found between the two groups in interpersonal relationship satisfaction (t = 3.62), BSRS-5 total score (t = -3.38), Taiwan Adolescent Loneliness Scale score (t = -5.83), and the Chinese Internet Addiction Scale (t = -2.16). These results indicated that adolescents with high loneliness reported significantly lower interpersonal satisfaction, while their emotional distress and internet addiction scores were higher compared to adolescents with low loneliness. The study further found that after participating in the cohesion-focused group program, adolescents with high loneliness showed significant improvements in interpersonal relationship satisfaction (t = 8.43) and significant reductions in loneliness scores (t = -5.40). This indicates that their interpersonal satisfaction increased, while their sense of loneliness decreased significantly following participation in the group. Additionally, data were collected from adolescents with high loneliness regarding their perceptions of group cohesion after each session. The results showed a progressive increase in group cohesion scores, supporting the view that group cohesion is a dynamic process. Further analysis of group cohesion scores across different sessions revealed significant statistical differences: The first session’s cohesion score was significantly lower compared to sessions two through six; the second session’s score did not significantly differ from the third, but was significantly lower than the fourth, fifth, and sixth sessions; and the third session’s cohesion score was significantly lower compared to the sixth.
The findings of this study provide an empirical foundation demonstrating that group cohesion can offer significant benefits for adolescents experiencing high levels of loneliness. This carries profound implications, as relevant institutions may consider adopting group cohesion–enhancing strategies within group therapy or classroom settings to address mental health issues among adolescents with high loneliness, thereby promoting their overall well-being. Finally, this study offers recommendations concerning the mental health of adolescents with high loneliness, the development of cohesion-focused group programs for this population, and directions for future research.