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The Psychology of the COVID-19 Pandemic: A Group-Level Perspective

September 2020
Group Dynamics Theory Research and Practice 24(3):122-138

September 2020
24(3):122-138

DOI:10.1037/gdn0000142

Authors:

Cheri L Marmarosh

George Washington University

Donelson R. Forsyth

University of Richmond

Bernhard M. Strauss

Friedrich Schiller University Jena

Gary Michael Burlingame

Brigham Young University - Provo Main Campus

Objective: The coronavirus disease (COVID-19) threatened not only people’s physical health but also every aspect of their psychological well-being: from their struggle to avoid contracting the disease, to their coping with the disruption of the normal course of their lives, to the trauma they endured when the virus took the lives of those they loved. The objective of this article is to consider the group-level processes that sustain people’s physical and psychological well-being during COVID-19. Method: Applying group dynamic and group therapy theory and research, we explore why COVID-19 spread so rapidly. We also explore how people cope with prolonged social isolation, distress, and social inequities, as well as how people deal with the psychological trauma of the disease, which includes heightened levels of depression, anxiety, substance abuse, and complicated bereavement. Results: Researchers and theorists suggest that human beings are fundamentally social, and the need to gather with others is extremely important, especially during times of distress. The need to belong as well as the importance of reducing loneliness during uncertain times often encourages people to connect, despite recommendations to remain socially distant. Conclusions: Group treatment options developed by group psychotherapists are effective at reducing depression, anxiety, complicated grief, and stress. We conclude by examining the growing impact of online groups and the many ways that these groups help people improve their psychological well-being during the COVID-19 crisis.

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The Psychology of the COVID-19 Pandemic:

A Group-Level Perspective

Cheri L. Marmarosh

The George Washington University

Donelson R. Forsyth

University of Richmond

Bernhard Strauss

University Hospital, Jena, Germany

Gary M. Burlingame

Brigham Young University

Objective: The coronavirus disease (COVID-19) threatened not only people’s physical

health but also every aspect of their psychological well-being: from their struggle to

avoid contracting the disease, to their coping with the disruption of the normal course

of their lives, to the trauma they endured when the virus took the lives of those they

loved. The objective of this article is to consider the group-level processes that sustain

people’s physical and psychological well-being during COVID-19. Method: Applying

group dynamic and group therapy theory and research, we explore why COVID-19

spread so rapidly. We also explore how people cope with prolonged social isolation,

distress, and social inequities, as well as how people deal with the psychological trauma

of the disease, which includes heightened levels of depression, anxiety, substance

abuse, and complicated bereavement. Results: Researchers and theorists suggest that

human beings are fundamentally social, and the need to gather with others is extremely

important, especially during times of distress. The need to belong as well as the

importance of reducing loneliness during uncertain times often encourages people to

connect, despite recommendations to remain socially distant. Conclusions: Group

treatment options developed by group psychotherapists are effective at reducing de-

pression, anxiety, complicated grief, and stress. We conclude by examining the grow-

ing impact of online groups and the many ways that these groups help people improve

their psychological well-being during the COVID-19 crisis.

Highlights and Implications

• Group dynamic theorists and researchers provide important contributions to the

understanding of the prevention of COVID-19. Group dynamics explain why

some people perceive less of a threat and why some people refuse to wear face

masks or social distance.

• Group psychotherapy researchers and practitioners describe the importance of

group leadership, group cohesion, and the effects of loneliness and social

isolation on people coping with COVID-19.

XCheri L. Marmarosh, Department of Psychology,

The George Washington University; XDonelson R.

Forsyth, Jepson School of Leadership Studies, Univer-

sity of Richmond; Bernhard Strauss, Institute of Psycho-

social Medicine, Psychotherapy and Psycho oncology,

University Hospital, Jena, Germany; XGary M. Bur-

lingame, Department of Psychology, Brigham Young

University.

Correspondence concerning this article should be addressed to

Cheri L. Marmarosh, Department of Psychology, The

George Washington University, 1922 F Street, Wash-

ington, DC 20008. E-mail: cmarmarosh@gmail.com

This document is copyrighted by the American Psychological Association or one of its allied publishers.

This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

Group Dynamics:

Theory, Research, and Practice

ISSN: 1089-2699 http://dx.doi.org/10.1037/gdn0000142

122

• Given the mental and physical health challenges we face with COVID-19, online

group and group therapy interventions are becoming more prevalent. The

importance of future studies examining the effectiveness of online groups (both

support and therapy) are necessary. We also need studies that examine what

individual difference variables inﬂuence the effectiveness of online group inter-

ventions, such as age, race, class, ethnicity, culture, attachment style, and level

of isolation.

• One of the main implications of this article is that it is critical to examine the

group-level factors that inﬂuence how we navigate a pandemic. Groups inﬂu-

ence how we prevent the transmission of COVID-19, how we sustain ourselves

during periods of social isolation, and how we address the effects of complicated

bereavement, trauma, illness, social inequities, unemployment, anxiety, and

depression.

Keywords: group therapy, COVID-19, pandemic, group dynamics

On March 11, 2020, the World Health Orga-

nization (WHO) declared the severe respiratory

syndrome coronavirus COVID-19 a pandemic.

A devastating disease, the virus caused respira-

tory collapse, inﬂammation, and organ failure,

resulting in the death of over half a million

people in the ﬁrst 6 months of the pandemic.

With no known cure or vaccine available, the

threat seemed dire but also unavoidable. Peo-

ple’s lives were substantially disrupted as ev-

eryday interactions were replaced by prolonged

periods of isolation and loneliness. Most social

activities, such as school and work, were sus-

pended, as were many sources of general life

satisfaction and happiness, such as leisure and

recreational activities. As the disease intensi-

ﬁed, researchers documented elevated levels of

depression and anxiety, increases in intrusive

thoughts and sleep disturbances, substantial and

negative changes in feelings and emotional re-

sponsiveness, and substance abuse (e.g., Wang

et al., 2020). It is difﬁcult to identify any aspect

of people’s psychological experiences that was

not signiﬁcantly inﬂuenced by the disease.

Understanding and responding effectively to

the psychological impact of the pandemic re-

quires recognizing and intervening to undo the

chaos it wrought on individuals’ adjustment, but

here we focus on the group-level processes per-

taining to the prevention, maintenance, and res-

toration (after loss) of psychological well-being

before, during, and after the pandemic. The

pandemic attacked not just individuals but also

their relationships and the groups that sustain

those relationships, including their families,

work groups, and friendship circles. To cope,

social isolation was mandated, but that mandate

separated people from the groups that sustain

them. As sheltering in place wore on, the isola-

tion strained the resources of people’s remain-

ing alliances, including their families and clos-

est friendships. The illness was also, in many

cases, a fatal one and so permanently changed

the nature and structure of many people’s

groups and relationships. Speciﬁcally, we draw

on the psychology of groups and their dynamics

to (a) explain how people reacted to the threat of

the virus (e.g., coping with health threats, in-

creasing compliance with health mandates); (b)

suggest ways to counter the negative psycho-

logical side effects people may experience dur-

ing the pandemic (e.g., dealing with social iso-

lation, reducing stress in quarantined groups);

and (c) help individuals deal with the psycho-

logical consequences of the pandemic experi-

ence, including the loss of friends and loved

ones to the disease (e.g., coping with grief).

This focus on group-level processes does not

assume individual-level processes need not be

considered but instead only seeks to redress the

tendency to stress individual approaches rather

than interpersonal ones. All too often, analyses

focus on individual prevention strategies such

as wearing a mask, individual factors that inﬂu-

ence health risks such as age, and individual

interventions to cope with distress such as one-

on-one counseling. The current analysis, in con-

trast, serves as a reminder that people are sub-

stantially inﬂuenced by group interactions and

of how extremely important groups can be when

123GROUP AND COVID-19

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preventing and treating people who are suffer-

ing during COVID-19. In 2018, the American

Psychological Association’s Commission for

the Recognition of Specialties and Proﬁciencies

in Professional Psychology recognized group

therapy as a specialty. This recognition empha-

sized the importance of group dynamics and the

beneﬁts of group interventions that are critical

to mental health and relevant to coping with

COVID-19. Although there may not be research

that has studied the group factors directly re-

lated to prevention or intervention and COVID-

19, we can apply the knowledge we have from

years of group theory and research to this pan-

demic. Group theory, research, and practice has

important implications for how we try to control

the spread of COVID-19, facilitate coping with

the virus, and intervene when the public strug-

gles with job loss, mental illness, health dispar-

ities, and complicated grief.

Prevention: Minimizing the Risk of

Contracting COVID-19

COVID-19, a highly communicable disease,

has spread worldwide. Authorities, recognizing

the magnitude of the threat, warned citizens of

the infection and proposed a series of nonphar-

maceutical interventions (NPIs) to limit conta-

gion (e.g., stock sufﬁcient food and water, se-

cure medical supplies, and avoid travel to

destinations where the virus was emerging).

These NPIs were crucially important for con-

trolling the spread of the disease, and the num-

ber of cases was lower in places where people

prepared diligently (e.g., Brauner et al., 2020).

However, many people failed to accurately as-

sess the magnitude of the threat and heed re-

peated reminders to minimize that threat. Al-

though studies of how people prepare for

impending crises have identiﬁed a number of

psychological processes that can work to inter-

fere with proactive responses, including unreal-

istic optimism, diminished self-efﬁcacy, and

avoidance of information pertaining to the

threat (Shepperd, Klein, Waters, & Weinstein,

2013;Stewart, 2015;Sweeny, Melnyk, Miller,

& Shepperd, 2010), these psychological pro-

cesses were ampliﬁed by group-level processes

that caused individuals to misjudge the magni-

tude of the threat and join together with others

when they should have practiced social distanc-

ing.

Reassurance or Accuracy

People encountering a threat usually respond

to minimize that threat, particularly if they be-

lieve the threat to be highly probable and the

outcome to be severely negative and if the steps

to take to reduce the threat are considered efﬁ-

cacious (e.g., Floyd, Prentice-Dunn, & Rogers,

2000). Their estimates of likelihood, severity,

and response efﬁcacy are determined by the

objective, factual claims of authorities—such as

warnings from the Centers for Disease Control

and Prevention (CDC)— but also by the actions

and reactions of those around them. For exam-

ple, even though the CDC may warn that

COVID-19 poses a great risk to health, individ-

uals may reject that information if it is incon-

sistent with the estimates of those they associate

with on a regular basis (e.g., family members,

coworkers, social network connections). Stud-

ies of social comparison processes suggest in-

dividuals strive for accuracy but that they also

show a preference for reassuring, comforting

information. In the case of COVID-19, associ-

ating with people who suggested that the virus

was only as threatening as the ﬂu or even a hoax

resulted in an incautious response to the virus

(e.g., Erceg, Ružojcˇic´, & Galic, 2020).

Individuals’ miscalibrated estimates of threat

potential could have been adjusted as they dis-

cussed their estimates with other people, but

error checking is often overlooked as groups

share information. Groups can manifest ratio-

nality as they pool information to reach the best

decision possible (e.g., Larson, 2010), but too

often people overshare ideas that are common

within the group. If many individuals in the

group are aware of some fact, datum, or case,

the group will spend an inordinate amount of

time discussing those inputs and fail to consider

ideas and information held by only a few indi-

viduals in the group. In consequence, groups too

often fail to make the best choice— one that is

fully informed by all the available information.

In the case of COVID-19, even if some mem-

bers of the group are aware of data that accu-

rately signal the magnitude of the threat, their

voices will not be heard as the group discusses

the crisis (Stasser & Abele, 2020).

Unfortunately, people do not recognize the

extent to which their opinions, beliefs, and be-

haviors are inﬂuenced by those around them

(Cialdini, 2005). They often assume that they

124 MARMAROSH, FORSYTH, STRAUSS, AND BURLINGAME

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have objectively reviewed the facts and have

based their response on this rational analysis,

when in actuality, their responses are deter-

mined by social comparison biases, overreli-

ance on shared information, and conformity to

group norms. For example, the data that they

themselves gather locally—from those they in-

teract with—tend to inﬂuence people even more

than they realize. As Zell and Alicke (2010)

discovered in their studies of the local domi-

nance effect, people’s judgments are more in-

ﬂuenced by their close social contacts rather

than the more diffuse data based on the re-

sponses of thousands of people. Yet when asked

to describe their metacognitive processing of

the information, people were certain that they

were relying on the data from the highly repre-

sentative sample rather than the anecdotal case

data provided to them by their associates.

Socializing or Quarantining

Because there was no known cure for the

disease, nor a vaccine that would prevent infec-

tion, public health authorities relied on NPIs to

limit the spread of the disease within the popu-

lation. In particular, the CDC advised individu-

als to maintain social distance (www.cdc.gov/

coronavirus/), and state ofﬁcials included this

requirement in the health mandates.

NPIs were medically necessary, but limiting

individuals’ contact with other people blocked

them from the primary means of coping with the

stress of traumatic events: their groups. Those

who study mental health— clinical, counseling,

community, and health psychologists, social

workers, and psychiatrists— have long recog-

nized the relationship between groups and

members’ psychological well-being. Theory

and research suggest that people need to be

connected to other people and that, if these

connections are severed, they experience signif-

icant psychological distress. As Baumeister and

Leary (1995) suggested, humans have a power-

ful need to belong: “a pervasive drive to form

and maintain at least a minimum quantity of

lasting, positive, and impactful interpersonal re-

lationships” (p. 497). They likened the need to

belong to other basic needs, such as hunger or

thirst. Individuals therefore, under most circum-

stances, resist isolation and seclusion; they

choose to afﬁliate with others rather than be

alone.

This need to belong is strongest when people

face a stressful, uncertain future. In times of

trouble, such as illness, catastrophe, natural di-

saster, or ﬁnancial upheaval, they seek out com-

fort and support by joining with other people

(Rofé, 1984). Decades of research on coping

conﬁrms the stress-afﬁliation effect: People

seek out others as a coping mechanism to ac-

quire reassuring information germane to the

threat, secure emotional support, and acquire

tangible aid (Aspinwall & Taylor, 1997;Cohen

& Wills, 1985;Hill, 1987). This reaction is, in

most cases, an adaptive one, for afﬁliating with

others reduces morbidity and mortality, modu-

lates key neural and biological responses to

stress, and reduces the negative effects of major

stressful life events (see Taylor, 2011 for a

review). However, in the case of a threat of a

contagious disease, the need to belong compels

individuals to seek out association with others

even though that association is unhealthy.

In consequence, despite warnings to avoid

groups, many people continued to join them,

even though that risky socializing provided the

disease the opportunity to spread from the in-

fected to the uninfected. When surveyed after

the CDC released its guidelines of social dis-

tancing (March 17–20, 2020), many people re-

ported actions that were inconsistent with the

mandate: They were continuing to join with

others in face-to-face social groups, sit side by

side in public settings, and take part in large

social gatherings without face coverings (R.

Forsyth, 2020). These individuals, in general,

were not the people in the sample who felt they

were unlikely to contract the illness or those

who believed they would survive the illness. In

fact, recognition that the virus was a signiﬁcant

health threat and that they would likely contract

it were associated with more, rather than less,

risky socializing. Disregarding the mandate to

socially distance was also associated with dis-

positional differences in respondents’ prefer-

ence to join with others when stressed (Hill,

1987). Those who engaged in risky socializing

were also people who were more likely to agree

with statements such as “If I feel unhappy or

kind of depressed (stressed), I usually try to be

around other people to make me feel better” and

“One of my greatest sources of comfort when

things get rough is being with other people”

(Hill, 1987, p. 1011).

125GROUP AND COVID-19

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Compliance or Resistance

As the number of COVID-19 cases increased,

the CDC urged individuals to continue taking

precautions to minimize the spread of the virus,

including maintaining social distance, avoiding

groups, and wearing face coverings. However,

many people resisted this mandate. Churches

continued to hold services, people congregated

in parks, beaches, and clubs, and travel re-

sumed. The CDC’s requirement to wear face-

covering became, over time, a contentious, po-

litically charged issue, and the media reported

multiple incidents of confrontations between

the masked and unmasked (McKelvey, 2020).

In some cases, large groups of people gathered

publicly to protest the mandates, displaying a

marked consistency in their actions and atti-

tudes.

No one factor distinguishes those who ad-

opted the mandated NPIs and those who re-

sisted. Some who refused to comply did not

think the disease was a signiﬁcant threat to

them, personally (e.g., Harper, Satchell, Fido, &

Latzman, 2020). Individuals with certain

traits—such as elevated levels of narcissism and

psychopathy— complied less than people

whose personalities did not include these dark

triad characteristics (Nowa et al., 2020). How-

ever, group-level processes likely also gener-

ated this marked variance in response to the

CDC’s NPIs. The pandemic restricted people’s

contact with other people, and so reduced the

density and heterogeneity of their social net-

works. This isolation, combined with the ten-

dency to maximize cohesion during periods of

stress, likely resulted in both polarization and an

increased identiﬁcation with the group and its

norms. Those norms, in some cases, stressed

compliance: that taking steps to minimize the

spread of the virus was the socially approved

course of action, and that not complying would

be considered unusual and inappropriate. But in

some social groups, noncompliance became the

norm. These groups maintained that govern-

ment authorities had no right to curtail people’s

freedom to assemble, travel, and work, and so

wearing a mask in public or quarantining was

considered socially indefensible by the mem-

bers of these groups. In consequence, noncom-

pliance came to be associated with group iden-

tity. As social identity theory suggests, when

people categorize themselves as members of a

particular group they subsequently strive to act,

think, and feel in ways that they believe are

prototypical for a member of that group (Hogg,

Hains, & Mason, 1998). Sustained, psycholog-

ically, but this collectively shared social iden-

tity, those who resisted compliance acted in

ways that spread rather than controlled a deadly

disease (D. Forsyth, 2020).

Protection: Coping During the

COVID-19 Crisis

How do we endure when forced to cope with

the long-term effects of a pandemic like COVID-

19? We have addressed the challenges to prevent

the spread of the disease, but there are other strug-

gles caused by COVID-19. There is the stress of

isolation on groups of people, such as families

who are sequestered from the outside world.

There is also ongoing risk of getting sick, job loss

and ﬁnancial insecurity, and the death of loved

ones. Not to mention the stress of racial and

economic inequities and an overwhelmed

health care system. Psychologists have stud-

ied the impact of each of these on well-being,

and they provide important guidance as we

navigate the ways social groups and group

therapy can help people cope.

Experiences in Isolated Groups: The Value

of Cohesion

During COVID-19, many families were iso-

lated from the outside world. How did people

cope when their social networks shrink from

many to very few? Did they seize this time of

enforced togetherness to strengthen their attach-

ments to one another—to share, support, and

appreciate each other? Or did boredom, tension,

and conﬂict grow with each passing day?

Studies of groups that have spent long peri-

ods of time in isolation, such as teams stationed

in Antarctica and explorers living for months on

end in a conﬁned space, suggest that some

groups will prosper, but others will falter under

the strain. During the International Geophysical

Year (1957–1958), for example, several coun-

tries sent small groups of military and civilian

personnel to outposts in Antarctica. These

groups were responsible for collecting data

about that largely unknown continent, but the

violent weather forced the staff to remain in-

doors most of the time. As months went by with

126 MARMAROSH, FORSYTH, STRAUSS, AND BURLINGAME

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little change in their situation, morale declined

and group members’ initial friendliness, good

humor, and sensitivity were replaced with leth-

argy, low morale, grouchiness, and boredom.

Other groups, however, manage to prosper

when cut off from the outside world. Some of

the isolated groups studied by researchers at the

Naval Medical Research Institute in Bethesda,

Maryland, for example, responded quite posi-

tively when sequestered. These researchers con-

ﬁned pairs of volunteers to a 12-by-12-foot

room with no means of interacting with anyone

outside of that space—no computer, no Internet,

no media. Some of these groups imploded—

they insisted they be released from the study

after only a few days. Others, however, thrived.

Over the course of the isolation, their reliance

on one another strengthened, as did their satis-

faction with their circumstances. They shared

concerns and worries about how they were deal-

ing with the isolation and made adjustments

whenever conﬂicts and tensions arose. They set

up schedules of activities, even agreeing on a

plan of action for meals, exercise, and recre-

ation. Cooperation, then, was critical. As one

person who spent considerable time in an iso-

lated group in an underwater habitat, SEALAB,

explained, “If we hadn’t had a real compatible

group there might have been a lot of hard feel-

ings. Everybody was cooperative. They all

worked and helped each other as much as pos-

sible. I think it was a real good group” (Radloff

& Helmreich, 1968, p. 82). The successful

groups also avoided one of the symptoms of

maladaptive responding displayed by the less

successful groups: withdrawal. The members of

groups that did not cope well with isolation,

over time, tended to stop interacting with each

other—they cocooned instead of communicat-

ing, collaborating, cooperating, and caring for

one another (Radloff & Helmreich, 1968).

What we can learn from this study of groups

in isolation is that group cohesion is one of the

factors that helps groups survive during times of

distress. It is the glue that keeps people together

when things are challenging in the group, such

as conﬂict within the group. During this pan-

demic, many people have been in groups such

as health care workers helping patients with

COVID-19, employees engaging in online

zoom meetings, or families socially isolating

together. It is important for us to understand

how to facilitate cohesion within these groups

and to tolerate conﬂict when it surfaces. Group

researchers and therapists have long recognized

the importance of group cohesion and studied

how it facilitates safety and the ability to toler-

ate tensions in the group (Yalom & Leszcz,

2005).

The bonds between the members of cohesive

groups are strong and not easily broken, and

these bonds sustain members’ sense of well-

being. Several studies have indicated that cohe-

sion positively correlates with an elevation in

members’ self-esteem, reduced symptoms, and

higher rates of goal attainment (Braaten, 1989;

Budman et al., 1989;Tschuschke & Dies,

1994). In families, cohesion is negatively re-

lated to loneliness, and family cohesion also can

decrease loneliness for family members (Fuji-

mori, Hayashi, Fujiwara, & Matsusaka, 2017).

A meta-analysis examining the relationship be-

tween cohesion and group therapy treatment

outcome in 40 studies indicated that cohesion

signiﬁcantly related to outcome in both inpa-

tient and outpatient settings (Burlingame, Mc-

Clendon, & Yang, 2018).

How do we foster cohesion in groups? This is

an important question, and group dynamic re-

searchers and group therapists have focused on

the impact of empathy in the group. Johnson,

Burlingame, Olsen, Davies, and Gleave (2005)

found that empathy by leaders and/or members

related to perceived positive relationships

within the group. Researchers also have shown

that leaders who promote interpersonal interac-

tion and prioritize the cultivation of cohesion

also facilitate a greater bond between members

(Burlingame et al., 2018).

One of the most inhibiting leadership factors

is the leader’s inability to tolerate emotional

reactions (Mikulincer & Shaver, 2016). Failure

to be able to express or accept caring, to address

conﬂict, or to explore members’ avoidant be-

haviors (e.g., missed sessions/tardy behavior)

negatively inﬂuences the development of cohe-

sion within a group (Yalom & Leszcz, 2005).

Social psychologists found that the more a

leader engaged in avoidant behaviors, such as

dismissing vulnerability/avoiding members’

needs, the less group members rated group co-

hesion (Davidovitz, Mikulincer, Shaver, Izsak,

& Popper, 2007). Similarly, Smokowski, Rose,

Todar, and Reardon (1999) found that dropout

from the group increased when group members

127GROUP AND COVID-19

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experienced group leaders as not adequately

supporting or protecting them.

During COVID-19, people are often interact-

ing in groups. Many are cloistered with family

for long periods of time in isolation, medical

teams are working together in high-stress situ-

ations, and government groups are negotiating

supplies to protect health care workers. It is

helpful to recognize how the research on cohe-

sion can inﬂuence these groups. To increase

cohesion within these groups, one needs to have

leaders who invite open conversations among

members that encourage differences and dis-

agreements (Burlingame, Fuhriman, & Johnson,

2002;Yalom & Leszcz, 2005). In medical

teams, cohesion is critical. Brindley, Mosier,

and Hicks (2020) studied how clear tasks and

preparation enhanced cohesion, which is neces-

sary when establishing an airway for patients

sick with COVID-19. In all groups, there needs

to be an awareness of the impact of race, eth-

nicity, and culture (DeLlucia-Waack, 2011).

Leaders who are not able to help the group

examine and resolve conﬂicts around diversity

will have members experience discrimination

and prejudice in the group that is likely to erode

group cohesion.

Loneliness and the Beneﬁt of Groups

When the public is required to social distance

to protect others and oneself from exposure to a

virus, there is a likelihood that some people will

experience more isolation and loneliness, while

others can social distance and remain socially

connected. We know that being socially con-

nected positively inﬂuences psychological and

emotional well-being, physical health (Uchino,

2006), and life expectancy (Holt-Lunstad,

Smith, Baker, Harris, & Stephenson, 2015;

Shor, Roelfs, & Yogev, 2013). Unfortunately,

many people may not be as fortunate and will

experience disconnection and isolation that

causes depression, anxiety, and stress (Bai et al.,

2004;Mihashi et al., 2009). Brooks et al. (2020)

reviewed the effects of quarantine and found

that there were long-lasting effects of being

quarantined that exist years later, especially for

health care workers, and these effects included

avoiding people who could be sick and avoiding

work.

Researchers have shown that loneliness can

have long-term deleterious effects, and it is a

subjective experience. People can feel alone

even when with their families or in groups.

Holt-Lunstad et al. (2015) found, even after

accounting for multiple factors, that increased

likelihood of death was 26% for reported lone-

liness, 29% for social isolation, and 32% for

living alone. The results indicated no difference

between objective and subjective measures of

social isolation when predicting mortality. It

seems as though any kind of loneliness can be a

health risk. This is especially important during

COVID-19 when people are distancing and

feeling more isolated.

We know that joining groups is one way

individuals can cope with loneliness and isola-

tion (Forsyth, 2018). When people struggle with

these feelings, they often seek out support

groups to feel less alone (Forsyth & Elliott,

1999). In addition to support groups, people

seek out group psychotherapy to help them feel

less alone and to address important issues.

Yalom and Leszcz (2005) describe how being

with others in the group who experience similar

feelings is one of the most curative aspects of

groups.

One subset of the population that has been hit

particularly hard is the elderly. The elderly are

required to socially isolate more to prevent se-

rious illness and are more likely to feel more

isolated. Researchers have applied a psychoso-

cial group intervention for lonely older people,

and it has been effective at increasing social

activation, new friendships, and remaining in

the group, as well as improved well-being and

subjective health and decreasing need for health

services (Supiano & Luptak, 2014).

Unemployment, Financial Loss,

and Group Support

One of the major stressors for individuals

during a pandemic is job loss, the requirement

to stay home, and the rise in unemployment.

According to Brooks et al. (2020), ﬁnancial loss

during quarantine related to psychological dis-

orders, anger, and anxiety. They also found that

delays in receiving government funding and

having a lower income in general before the

quarantine had a negative impact.

Groups provide support for those during

times of layoff, and spending time with fellow

coworkers can facilitate coping (Cooper, 1981).

Social support also has been shown to moderate

128 MARMAROSH, FORSYTH, STRAUSS, AND BURLINGAME

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the effects of involuntary job loss (Caravan,

Gallo, & Marshall, 2020), but this was related to

race, education, and prior social support before

the loss of employment. In essence, White, ed-

ucated individuals with prior social support

beneﬁted the most from social support after

involuntary job loss to reduce depression. The

ﬁndings expose the different experience of job

loss during a pandemic and the importance of

examining how job loss and unemployment due

to COVID-19 affect people differently depend-

ing on economic status and race.

Social Inequality and Groups

to Promote Change

As we started to see who was impacted most

by COVID-19, we learned that not everyone

was affected the same way. Minorities, espe-

cially Black minorities, had the highest rate of

mortality in major cities that were hit hard by

the virus. According to Yancy (2020), 50 –70%

of COVID deaths were Black individuals even

when they represented 14 –30% of the total pop-

ulation of a city. A similar pattern is found

globally with predominantly Black countries

having the greatest infection and death rate

compared to predominantly White countries. Is-

sues of racism, discrimination, and health care

inequities add incredible stress to individuals

and relate to mental (Carter & Forsyth, 2010;

Murali & Oyebode, 2004;Schwartz, 2017) and

physical health (Sacker, Head, Gimeno, & Bar-

tley, 2009). They also relate to coping with the

additional trauma of COVID-19.

Although discrimination by groups has a neg-

ative impact on health (Pascoe & Smart Rich-

man, 2009), groups also can provide a resource

for minorities and marginalized populations.

Belonging to groups with others who have sim-

ilar experiences increases a sense of belonging

and provides support. Groups that invite people

of different backgrounds and identities also pro-

mote social justice and change. Frantell, Miles,

and Ruwe (2019) reviewed the importance of

intergroup dialogues and that bringing people

with different identities together fosters inter-

group relationships, develops self-awareness,

and promotes social justice. These types of

group conversations are critical during COVID-

19, when we are also facing a time when we are

seeing higher mortality of minorities, health

care inequalities, and increased racism.

Complicated Bereavement and Group

Intervention

During COVID-19, many people lost loved

ones suddenly from the virus and were not able

to comfort their dying family members or en-

gage in funerals with family and friends. The

lack of support, religious rituals, and physical

proximity to family has led some to experience

complicated bereavement (Burke & Neimeyer,

2013). Complicated bereavement occurs when

individuals have an intense grief response that

lasts longer and eventually inﬂuences one’s

daily functioning. Mayland, Harding, Preston,

and Payne (2020) reviewed studies of prior pan-

demics and found that the multiplicity of the

losses, inability to say “goodbye,” and disrup-

tions in the social connections all contributed to

complicated bereavement during pandemics.

They suggested that providing group connec-

tions and increasing support would help people

during COVID-19.

Groups have been used effectively to help

people cope with grief and loss (Maass, Hof-

mann, Perlinger, & Wagner, 2020;Piper,

Ogrodniczuk, Joyce, & Weideman, 2011). They

provide emotional support and hope and reduce

depression caused by isolation. Supiano,

Haynes, and Pond (2017) did a qualitative study

of members in a short-term grief group and

found they were able to help facilitate meaning

out of catastrophic grief experiences. During

COVID-19, online groups have been used to

provide support to health care providers (Wal-

lace, Wladkowski, Gibson, & White, 2020) and

individuals struggling with the loss of a loved

one (Sun, Bao, & Lu, 2020). Wallace et al.

(2020) recommend online support groups for

those individuals providing palliative care for

those who are dying of COVID-19. Knowles,

Stelzer, Jovel, and O’Connor (2017) examined

the effectiveness of a virtual support group for

the elderly experiencing the loss of a spouse and

found that the members had better sleep, less

depression, less ruminations of the spouse, and

less loneliness after the group intervention.

Mayland et al. (2020) suggests that providing

technologically assisted social support during

illness, prior to death, and after the loss could

decrease complicated mourning. They recom-

mend online group-related support during

COVID-19 that includes family gatherings and

religious rituals involving the community.

129GROUP AND COVID-19

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Restoration: Group Therapy Intervention

During COVID-19

When people are suffering, groups provide

healing. They bring hope, decrease isolation,

and connect us to something bigger than our

own pain and loneliness (Yalom & Leszcz,

2005). That is why it is not surprising that group

therapy is one of the most effective treatments

to restore us during and after COVID-19.

General Evidence of Group Therapy

Group therapy has been recently described as

a “triple E treatment” (Burlingame & Strauss, in

press;Yalom & Leszcz, 2005). It is effective,

equivalent, and efﬁcient. Randomized clinical

trials (RCTs) have shown it to be effective when

contrasted with no-treatment controls. A recent

meta-analysis of nearly 50 RCTs that contrasted

individual and group therapy formats using

identical patients, treatments, and dose pro-

duced equivalent outcomes compared to indi-

vidual treatment (Burlingame, Seebeck, Janis,

et al., 2016). Furthermore, equivalence also has

been found when group therapy is contrasted

with other bona ﬁde treatments for common

anxiety and mood disorders (Burlingame &

Strauss, in press). Finally, when one considers

therapist time and treatment cost, group therapy

is a more efﬁcient treatment when compared to

individual therapy (Burlingame et al., 2016).

COVID-19: Evidence Base for

Group Therapy

Global (WHO) and national health care agen-

cies (CDC) have reported an increased preva-

lence of mental problems related to COVID-19

(Qiu et al. (2020);Zhang et al., 2020). Group

interventions may be an important option to

prevent and restore mental health problems re-

lated to this pandemic. A recent review (e.g.,

Burlingame & Strauss, in press) provides ample

evidence for the efﬁcacy of group treatment

with respect to speciﬁc psychological disorders

that may be triggered by the pandemic. In gen-

eral, ﬁndings from 329 randomized controlled

studies that treated 27,000 patients showed

large effects favoring group treatment over

waitlist controls and no differences to active

controls. What follows is a brief summary of

major conclusions regarding the efﬁcacy of

group therapy for anxiety, trauma, mood, and

substance abuse disorders.

Obsessive– compulsive disorder (OCD).

Individuals suffering from OCD report aggra-

vations of their symptoms, especially fear of

contamination and excessive washing of hands

during COVID-19 (Kumar & Somani, 2020).

The lack of inhibitory control as a result of the

pandemic and its consequences is seen as one of

the roots for the increase of symptoms needing

additional treatment options. As far as group

treatment is concerned, Schwartze, Barkowski,

Burlingame, Strauss, and Rosendahl (2016)

summarized three most commonly administered

group treatment comparisons in a meta-analysis

of 12 studies and 832 adult patients: complex

cognitive– behavioral group treatment (CBGT;

13), exposure with response prevention alone

(two), and cognitive therapy (one). No signiﬁ-

cant differences were found between group psy-

chotherapy and active treatments (e.g., individ-

ual psychotherapy, pharmacotherapy, or

common factors), and a similar pattern of ﬁnd-

ings was evident on secondary outcomes (de-

pression, anxiety).

Posttraumatic stress disorder (PTSD).

China indicated that PTSD is one of the mental

health consequences of COVID-19 (Tang et al.,

2020). For example, they reported the incidence

of traumatic stress in medical staff was 27% in

a sample of 230 nurses and doctors. The entire

sample, on average, scored high in the PTSD

self-rating scale (Huang & Zhao, 2020). In a

recent meta-analysis studying PTSD (Schwar-

tze, Barkowski, Strauss, Knaevelsrud, & Rosen-

dahl, 2019), 20 group treatment studies com-

prising 2,244 individuals diagnosed with PTSD

were summarized. As expected, the clinical

characteristics (e.g., trauma type, comorbidity,

severity of PTSD, personal background of par-

ticipants) varied across studies. Nevertheless,

those receiving group treatment experienced

improvement in PTSD, anxiety, and depression

symptoms compared to no treatment (g⫽0.70).

Based on these studies, group psychotherapy

appears to be an efﬁcacious treatment for

PTSD, although there are insufﬁcient trials to

test for equivalence between group and individ-

ual treatment.

Anxiety disorders. Reports so far indicate

an increase of anxiety and panic symptoms and

anxiety disorders as an immediate consequence

of the COVID-19 pandemic (Huang & Zhao,

130 MARMAROSH, FORSYTH, STRAUSS, AND BURLINGAME

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2020;Rajkumar, 2020), raising the question of

how effective treatments for patients suffering

from panic and combined anxiety disorders can

beneﬁt from group treatments. The effects of

CBGT were assessed in a recent meta-analysis

comprising RCTs of group treatments for panic

disorder (Schwartze et al., 2017). A large effect

for CBGT was found on panic and agoraphobia

symptoms when compared to no-treatment con-

trols (g⫽1.08), and no differences were found

when CBGT was compared to treatments (g⫽

0.18) including individual therapy. Over three

fourths (78%) of patients were panic-free after

group psychotherapy compared to 33% in the

waitlist control condition. Thus, CBGT appears

to be a robust treatment for panic disorder.

Major depressive disorder (MDD). As

with the other psychological disorders, an in-

crease of depressive symptoms and depressive

disorders is expected and described following

the outbreak of COVID-19 (Huang & Zhao,

2020;Rajkumar, 2020;Tang et al., 2020). It is

assumed that the feeling of a lack of control

paired with the consequences of social and

physical distancing directly affects the mood of

individuals especially in countries and regions

with high rates of cases and deaths due to the

virus. Janis, Svien, Jensen, and Burlingame (in

press) pooled the ﬁndings from 35 studies (47

comparisons) and 2,918 individuals diagnosed

with MDD who were treated with group treat-

ment, treatment as usual (TAU), medication, or

no treatment. The most frequent treatment was

CBGT (14), followed by mindfulness-based

cognitive therapy (MBCT; six) and psycho-

educational groups (PEGs; six). The combined

effect of group treatment on depression symp-

toms was large (g⫽.86) when compared to no

treatment, with patients being nearly 7 times

more likely to have improved by the end of

treatment. There was strong support for CBGT

and promising evidence supporting both MBCT

and PEGs when compared to no-treatment con-

trols.

Substance abuse disorders (SUDs). An

increase of substance abuse, especially alcohol,

has been assumed to be a consequence of

COVID-19 (Clay & Parker, 2020;Galea, Mer-

chant, & Lurie, 2020). Ornell et al. (2020) ad-

vocate a reinforcement of addiction care for

several reasons: Individuals with SUD are con-

sidered to be a population at risk for contami-

nation (e.g., due to their clinical and psychoso-

cial condition), and these individuals are also

expected to have problems with treatment ac-

cess as well as adherence due to the changes in

social life and economy caused by the pan-

demic.

Recently, a meta-analysis of RCTs focusing

on SUDs in adults (Lo Coco et al., 2019) sum-

marized 33 studies comprising 34 comparisons

with nine studies comparing group to no-

treatment controls, seven comparing group to

individual therapy, and 18 comparing group

treatment to other treatments (e.g., twelve-steps,

TAU). The group treatments included cognitive

behavioral therapy, behavioral, mindfulness, di-

alectical behavior therapy, and integrated treat-

ments. Group treatment outperformed individ-

ual therapy with moderate effects.

Groups and facilitating immune fun-

ctioning. Moreover, there may be added ben-

eﬁt beyond the traditional psychological out-

comes given recent evidence on the impact of

group treatments on the immune system

(Shields, Spahr, & Slavich, 2020). An under-

standable consequence of the pandemic is an

increase of general and speciﬁc stress for indi-

viduals in countries with a high prevalence of

COVID-19 infections. During stress, the sym-

pathetic nervous system suppresses antiviral

processes and up-regulates proinﬂammatory

processes via the neurotransmitter norepineph-

rine (Slavich & Irwin, 2014). Stress responses

keep us in a constant state of ﬁght or ﬂight

(Sapolsky, 2004). Further, there is evidence for

psychosocial stress suppressing cellular and hu-

moral immunity and increasing nonspeciﬁc in-

ﬂammation (Segerstrom & Miller, 2004;Slav-

ich & Irwin, 2014).

Psychosocial interventions appear to exert a

positive effect on immunity (Kim & Su, 2020).

A recent meta-analysis by Shields et al. (2020)

documents psychosocial intervention’s impact

on the immune system, which is causally in-

volved in ⬃50% of deaths worldwide (Furman

et al., 2019). Shields et al. also demonstrated

that group interventions were equally if not

more effective than individual therapy. The so-

cial milieu that groups provide may be a “mo-

tivator” to encourage attendance, which in turn

adds a supportive social environment linked to

health-related biomarkers. This social milieu

creates an opportunity to interact with affected

peers and experience therapeutic factors such as

the instillation of hope, universality, altruism,

131GROUP AND COVID-19

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interpersonal feedback, and cohesion that have

been empirically linked to better outcomes.

Online Group Therapy: Adjusting to

COVID-19

Although the online modes of group therapy

have existed, it has grown exponentially with

COVID-19 (Aafjes-van Doorn, Békès, & Prout,

2020;APA, 2020;Burlingame, Strauss, &

Joyce, 2013). As therapists shift to telehealth

during COVID-19, it is important to examine

the current group research, beneﬁts, and limits

to online group interventions (Weinberg, 2020).

Synchronous groups. Synchronous online

groups consist of chat rooms as well as live

group conferences where participants meet with

each other and the therapist. The efﬁcacy of

these interventions has been tested in several

RCTs with larger samples made up of different

clinical problems (eating disorders, depression,

attention-deﬁcit/hyperactivity disorder, cancer,

social anxiety disorder, and being a victim of

family violence). Some studies support their

efﬁcacy when compared to waitlist or TAU

conditions (e.g., Crisp, Grifﬁths, Mackinnon,

Bennett, & Christensen, 2014;van der Zanden,

Kramer, Gerrits, Cuijpers, 2012), while others

indicate format equivalence when compared to

asynchronous group treatments (Burlingame &

Strauss, in press). Users commonly report a

high degree of satisfaction and indicate that the

online group was an important source to in-

crease coping (Hopf, Grange, Moessner, &

Bauer, 2013;Stephen et al., 2013). These are

the types of groups being used now during

COVID-19.

Beneﬁts and limitations of online groups.

Internet-based (group) treatments can be less

stigmatizing, especially for young people and

those with limited access to psychosocial sup-

port. Moreover, the average amount of therapist

weekly time per participant can be signiﬁcantly

reduced (up to 71%) when compared to tradi-

tional CBGT (Schulz et al., 2016) and equally

effective (Tate et al., 2017). These beneﬁts are

balanced by other ethical challenges regarding

conﬁdentiality. Weinberg and Rolnick (2019)

described evidence that screen relations may

reduce interpersonal connections (e.g., Russell,

2015) and highlighted obstacles when one shifts

from traditional group practice to the screen.

These include (a) loss of control, (b) limited

bodily interactions, (c) inability to read and

respond to verbal and nonverbal signals, and (d)

the meaning of a member’s background—if it

should be considered or ignored. In short, we

are still building what good practice means and

for whom these groups even might be adverse

or harmful (Weinberg & Rolnick, 2019).

Despite the limitations, video conferences in

times of COVID-19 seem to be accepted and

perceived as helpful by patients and providers

(e.g., Liu et al., 2020). There is evidence to

suggest that online support groups help those

who are quarantined during disease outbreaks.

Pan, Chang, and Yu (2005) found that having an

online support group and feeling connected to

others who had been through the same situation

was validating, and it provided people with the

support they needed. Indeed, the scientiﬁc liter-

ature on videoconferencing is more plentiful on

individual (Backhaus et al., 2012;Rees & Ma-

claine, 2015) rather than group treatment. The

pandemic already has begun to produce more

publications on online group treatment (Deh-

kordi, Sakhi, Gholamzad, Azizpor, & Shahini,

2020), and the sustainability of an online group

treatment using different theoretical orienta-

tions is an open question.

Implications

It is critical that we examine the group-level

processes pertaining to the prevention, mainte-

nance, and restoration during COVID-19. Al-

though we often are aware of the individual

factors that are emphasized as we navigate this

pandemic, the social factors are equally impor-

tant. Group dynamics inﬂuence the tension we

see when people are ambivalent about wearing

masks or social distancing, the ways people

cope with social isolation, and the ways groups

can provide relief from depression, anxiety,

substance abuse, and loss.

Working Together to Cope With

COVID-19

Groups also bring together different disci-

plines to understand the diverse challenges

ahead of us as we endure COVID-19 (Holmes et

al., 2020). According to O’Connor et al. (2020),

it requires a group of researchers and clinicians

across professions to address the impact of

COVID-19. No single disciple can tackle this

132 MARMAROSH, FORSYTH, STRAUSS, AND BURLINGAME

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issue in isolation. It requires psychology, psy-

chiatry, neuroscience, epidemiology, and infec-

tious disease specialists to work together. They

also argue that there needs to be collaboration

between the public, patients, health care provid-

ers, and policymakers and a cohesive focused

research agenda that can inﬂuence policy and

practice. Group is indeed a specialty within

psychology that will help us navigate people’s

psychological and physical well-being, increase

successful health care delivery, ﬁght systemic

injustices, develop public policy, and work to-

gether to develop a vaccination for COVID-19.

Group Leadership During COVID-19

One of the most valuable lessons we learned

from the research on cohesion is the role of the

leader in facilitating successful group dynamics.

Burlingame et al. (2002) described the many

things leaders can do to facilitate successful

group process and outcome such as modeling

interpersonal feedback, helping members toler-

ate conﬂict, embracing vulnerability, and dis-

cussing clear goals for the group. Research ﬁnd-

ings suggest that it is also important to

empathize with members (Johnson et al., 2005)

and be supportive when members are distressed

(Davidovitz et al., 2007). It is important for

political leaders and health care leaders to be

aware that the public is needing support, direc-

tion, and empathy during the pandemic.

Group Psychotherapy and Online Groups

One of the most important messages is that

group psychotherapy is an effective treatment,

as effective as individual psychotherapy (Bur-

lingame, Seebeck, Janis, et al., 2016), and that it

is an important treatment for those suffering

during COVID-19. Individuals with anxiety,

depression, grief, loneliness, and substance

abuse can get help during the pandemic with

online therapy group interventions. Although

we are only beginning to understand the differ-

ences between online group therapy and face-

to-face treatment, we are seeing the beneﬁts of

being able to reach out to diverse populations

while ensuring the safety of people who are

isolating to prevent the spread of the virus. Our

ability to engage socially while also protecting

ourselves from illness makes online groups one

of the most important resources during the

COVID-19 pandemic.

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Full-text available

Apr 2024

In deze thematische overzichtsstudie presenteren we de resultaten van een brede analyse van het beschikbare onderzoek rond het welzijn van docenten in het hoger onderwijs gedurende en na de coronapandemie. Docentenwelzijn is hierbij, in lijn met de conceptualisatie van Viac & Fraser (2020), onderverdeeld in vier dimensies: cognitief, subjectief, fysiek en mentaal, en sociaal welzijn. De centrale onderzoeksvraag was: Wat is er bekend over de veranderingen op de vier dimensies van het welzijn van docenten in het hoger onderwijs als gevolg van online en hybride werken en lesgeven gedurende de coronapandemie? Met behulp van een scoping literatuurstudie aan de hand van vier selectiecriteria1 vonden we 48 relevante artikelen; 37 artikelen verschenen in wetenschappelijke tijdschriften en 11 publicaties maakten deel uit van ‘grijze’ literatuur. Uit deze publicaties blijkt dat de verandering naar online of hybride werken een aanzienlijke impact had op het welzijn van docenten in het hoger onderwijs. Hierbij kunnen vier grotere thema’s onderscheiden worden: de impact van thuiswerken op productiviteit, op de verbinding en het contact met collega’s en studenten, de ervaren werkdruk en een veranderende werk-privé balans. Hoewel de negatieve impact van de nieuwe manier van werken op het docentenwelzijn overheerst, werden in meerdere studies ook positieve effecten op docentenwelzijn gerapporteerd. Hiermee lijkt het thuis en op afstand werken een ‘double edged sword’ voor docentenwelzijn te zijn geweest tijdens de coronapandemie. Op basis van deze uitkomsten worden een aantal aandachtspunten voor het Nederlands hoger onderwijs en aanbevelingen voor vervolgonderzoek gegeven.

Online early supportive psychological intervention for bereaved families during COVID-19: Lessons Learned and Implementation Challenges

Preprint

Full-text available

Feb 2024

As the COVID-19 pandemic has created complex conditions and the horrific loss of numerous lives, grieving the loss of loved ones in close families can be extremely difficult. To reduce the suffering of the loss and prevent the development of complicated grief, it is necessary to provide bereavement care as soon as possible. Therefore, we quickly developed a complete online program that included supportive psycho-therapeutic interventions and psychiatric counseling. The structure of all services is the main emphasis of the study, which also emphasizes the quantitative components and the unique characteristics of the interventions. Based on the lesson learned, we discussed the difficulties experienced in putting into practice an internet-based preventive service.

The Expressive Arts in Intimacy Groups with Parents: Processes and Outcomes

Article

Full-text available

Dec 2023

Zipora Shechtman

In light of the growing needs of people for mental health services and the limited resources available, the literature calls for moving from individual therapy to group therapy. Parents of challenging children may be considered one such vulnerable population for whom the lack of professional assistance not only affects parents’ mental health and functioning but also that of their children. Group psychotherapy is an efficient and effective solution for parents: Research has concluded that group therapy is equally or more effective compared to individual therapy. Yet, group therapy is not frequently used with parents, mainly because psychologists are not trained to conduct such groups. Parent groups require therapists who understand parent-child relationship and who are trained in special methods and techniques that help parents engage in the group process. The aim of this paper is two–fold: 1. Present a group therapy modality to increase intimacy in parent-child relationships that relies on the creative arts; 2. Provide outcome and process research based on four large studies, to support the validity of the intervention.

Promoting our Colleagues’ Wellbeing: Group Work during the Covid Pandemic

Article

Full-text available

Aug 2023

Molyn Leszcz

As a Canadian, I want to make special note and express appreciation today that right now in Canada, Pope Francis is on a mission of reconciliation and repair with the Canadian indigenous communities, who have been harmed and traumatized by the Canadian residential school system. His visit is the opportunity for great healing.

Cognitive Attack

Chapter

Full-text available

Apr 2024

David A. Hughes

Menticide attacks the cognitive faculties of victims to break down their mental integrity and render them susceptible to indoctrination. During “Covid-19,” confusion was weaponised in various ways, including a proliferation of nonsensical and ever-changing “rules,” last-minute U-turns on key Government decisions, unpredictability of restrictions easing or tightening, and a fundamental irrationality in Government behaviour. Verbal confusion was deployed against the public through constant mixed messaging. A strategy of continuous questioning by the media caused bewilderment. Words and phrases were twisted to mean their opposites, or were used in an esoteric fashion. The public was made to question its own sanity via means used to make social reality seem surreal. The past was rewritten to deny events that actually took place. The public was gaslighted to think that anything but the “vaccines” were to blame for injuries/deaths to young people. A Soviet-style abuse of psychiatry was used to pathologise dissent.

Cross-Cultural Comparison of Mood Perception During Initial Pandemic Response

Article

Apr 2024

The novel coronavirus (COVID-19) pandemic has been a major global event. Countless restrictions and recommendations have revealed novel insights into the everyday lives of people, which are far from uniform across cultures. In this explorative study, the mood perception of people from “individualistic” (Finland) and “collectivistic” (Japan and South Korea) cultures were studied via self-administered questionnaires at the time of major social restrictions (spring–summer of 2020) when the sociocultural effect of the pandemic was at its strongest. A simple measure of “recent mood perception” forms the core of the analysis, against which various factors were analyzed. Such coarse measures fit well with cross-cultural research, for more specific experiences typically do not translate very well between cultures. Somewhat surprisingly, almost no “constant” measures (e.g., occupation, household structure) proved to be significantly correlated with recent mood, whereas the degree of “changes” in personal situation (time spent home, number of people met, and so on, before and after the outbreak) proved to be significant factors, highlighting contextuality and mindset. Further, difference between “individualistic” and “collectivistic” cultures was also observed. These results highlight the vital importance of not only observing consistent phenomena but also recognizing changes and understanding the unique perspectives and experiences individuals have of them. Depending on the context, an objectively same thing can evoke vastly different perceptions.

Internet-based micro-identities as a driver of societal disintegration

Article

Full-text available

Dec 2023

The article discusses the role of digital media use in societal transformations, with a specific focus on the emergence of micro-identities. It also explores the extent to which such transformations entail increasing the risk of societal disintegration—defined as the erosion of established social structures, values, and norms. Our contention is that the distinctive attributes of digital media, coupled with the myriad expanding opportunities of use they afford, harbor the potential to fragment and polarize public discourse. Such tendencies jeopardize public trust in democratic institutions and undermine social cohesion. The intricate interplay between media usage and polarization synergistically contributes to the formation of micro-identities, characterized by their narrow and emergent nature. These micro-identities, in turn, manifest themselves through in-group self-determination often to the detriment of the broader social fabric. Thus, various micro-identities may actively contribute to the actual atrophy of the implicit rules and procedures hitherto deemed the norm within society. By addressing these multifaceted issues, typically confined within distinct disciplinary silos, this analysis adopts a multidisciplinary approach. Drawing from perspectives in political science, sociology, psychology, and media and communication, this paper offers in-depth analyses of the interactions between social processes and media usage. In doing so, it contributes substantively to the ongoing discourse surrounding the factors driving societal disintegration.

The impact of word-of-mouth (WOM) on attitudes, behavioural intentions, and actual usage of non-pharmaceutical interventions (NPIs) among early and late adopters

Article

Dec 2023
Int J Pharmaceut Healthc Market

Purpose This study aims to examine how the theory of planned behaviour and technology acceptance theory can be used to understand the adoption of non-pharmaceutical interventions (NPIs). The relationships between attitudes, behavioural intentions towards using NPIs, actual use of NPIs and word-of-mouth (WOM) were examined and compared between early and late adopters. Design/methodology/approach A survey was conducted to test the hypotheses with partial least squares structural equation modelling ( n = 278). Findings The results indicate that relationships between attitudes, intentions and behavioural intentions were positive and significant in the whole data set – and that there were differences between the early and late adopters. WOM had no substantial relationship with actual usage and early adopters’ behavioural intentions. Originality/value This research gives a better sense of how WOM impacts attitudes, behavioural intentions and actual usage among early and late adopters of NPIs and highlights the effectiveness of WOM, especially among late adopters of NPIs. Furthermore, using the TAM allows us to make specific recommendations regarding encouraging the use of NPIs. A new three-stage communications model is introduced that uses early adopters as influencers to reduce the NPI adoption time by late adopters.

Identification and Leadership in Small Groups: Salience, Frame of Reference, and Leader Stereotypicality Effects on Leader Evaluations

Article

Full-text available

Nov 1998

Two studies tested the prediction that people who identify strongly with a group base leadership perceptions on the group prototypicality of the leader whereas leadership schemas diminish in importance. Leadership and prototypicality were operationalized as relational constructs grounded in people's salient social comparative frame of reference. Study 1 (N = 82) had participants nominate a group leader and measured perceptions of the leader relative to nonleaders on leadership effectiveness, group prototypicality, and leadership stereotypicality. In Study 2 (N = 164) prototypicality, stereotypicality, and group salience were experimentally manipulated. As predicted, leadership stereotypicality became a weaker basis for leadership among high identifiers. The role of prototypicality in leadership was complexly affected by identification, which (a) accentuated leader–follower similarity on perceived prototypicality and leadership effectiveness, (b) changed the salient frame of reference, and (c) thus changed relative prototypicality of group members and leadership perceptions.

A Stitch in Time: Self-Regulation and Proactive Coping

Article

Full-text available

May 1997

In a conceptual and temporal framework, derived from research on social cognition, social interaction, and stress and coping, the authors analyze the processes through which people anticipate or detect potential stressors and act in advance to prevent them or to mute their impact (proactive coping). The framework specifies five stages in proactive coping: (1) resource accumulation, (2) recognition of potential stressors, (3) initial appraisal, (4) preliminary coping efforts, and (5) elicitation and use of feedback concerning initial efforts. The authors detail the role of individual differences, skills, and resources at each stage. They highlight the unique predictions afforded by a focus on proactive coping and the importance of understanding how people avoid and offset potential stressors.

Online Group Psychotherapy: Challenges and Possibilities During COVID-19—A Practice Review

Article

Full-text available

Sep 2020

Haim Weinberg

Background: Online group therapy is a relatively new modality for leading groups. There is not enough research yet to evaluate its effectiveness and no clear guidelines about how to do it well. With the outbreak of the COVID-19 pandemic it became even more crucial to provide clinicians with appropriate research review and practical guidelines. The purpose of this article was to provide practice recommendations based on or despite the limited research. Method: The article reviewed research on online therapy in general, including any on groups, followed by a summary of the obstacles in leading groups online and recommendations for creative solutions. Findings: Research on online groups is still scarce, and its quality still has many limitations. Discussion: More research is needed, especially on specific elements in online group therapy, such as the establishing of cohesion and therapeutic presence online, as well as how different the working alliance and cohesion are created online when compared to face-to-face groups. Despite limited research, the author recommends being more active and increasing self-disclosure in online groups to compensate for the challenge of being present and the lack of body-to-body interaction. Training for online group therapy is necessary.

Misbehaving in the Corona crisis: The role of anxiety and unfounded beliefs

Article

Full-text available

Aug 2022
CURR PSYCHOL

The aim of our study was to explore psychological determinants of COVID-19 responsible behavior. We focused on trait anxiety and worry about the corona crisis, knowledge and unfounded beliefs about coronavirus and thinking dispositions (cognitive reflection, actively open-minded thinking, faith in intuition and science curiosity) that should drive knowledge and beliefs. Additionally, we tested the effectiveness of a one-shot intervention based on the “consider counter-arguments” debiasing technique in changing COVID-19 unfounded beliefs. We used a convenience sample of 1439 participants who filled in the questionnaire on-line. Comparison of latent means showed that the “consider counter-arguments” intervention did not affect unfounded beliefs. Structural equation model, conducted on 962 participants with data on all variables, indicated that greater worry and weaker endorsement of COVID-19 unfounded beliefs lead to more responsible COVID-19 behavior. The relationship of trait anxiety and thinking dispositions with the criterion was mediated through the worry about COVID-19 and unfounded beliefs about COVID-19, respectively.

Group-Level Resistance to Health Mandates During the COVID-19 Pandemic: A Groupthink Approach

Article

Full-text available

Aug 2020

Donelson R. Forsyth

Public health interventions, such as mandated vaccinating or quarantining during an epidemic, are necessary to limit the spread of communicable diseases, but in many cases, certain groups resist these initiatives. For example, during the COVID-19 pandemic of 2020, antiquarantine groups protested the mandate to socially distance and remain at home, claiming these directives violated their right to assemble, travel, and work. The current analysis examined media descriptions of these antiquarantine groups to determine if these groups’ divergent responses to a legally and medically warranted health initiative resulted from groupthink: the deterioration of judgment and rationality that sometimes occurs in groups. In support of this possibility, accounts of these groups indicated that (a) the conditions that cause groupthink, including high levels of cohesion and isolation, were present and potent within these groups and that (b) the groups exhibited many of the symptoms of groupthink, including group illusions and pressures to conform. Given the ubiquity of these groups—for centuries, public health interventions have generated opposing antiregulation reactions—no amount of planning may be sufficient to prevent such groups. However, a theory-driven approach based on groupthink suggests that group-level interventions that directly address the processes that cause groupthink, such as isolation, conformity pressure, and cohesion, could reduce the influence of such groups on their members and on society.

Effects of bereavement groups–a systematic review and meta-analysis

Article

Full-text available

Jun 2020

This review summarizes the evidence of bereavement groups for symptoms of grief and depression. The literature search using Web of Science, EBSCO, PubMed, CINAHL, and MEDLINE yielded 14 studies (N = 1519) meeting the inclusion criteria (i.e., randomized-controlled trials, bereaved adults, bereavement group, validated measures). Overall, bereavement groups were marginally more effective than control groups post-treatment (gG = 0.33, gD = 0.22) but not at follow-up. Although tertiary interventions yielded larger effect sizes than secondary interventions, the difference was not significant. The results imply that the evidence for bereavement groups is weak, although the large heterogeneity of concepts for intervention and control groups limits the generalizability.

Adaptive and maladaptive behavior during the COVID-19 pandemic: The roles of Dark Triad traits, collective narcissism, and health beliefs

Article

Dec 2020
PERS INDIV DIFFER

In a nationally representative sample from Poland (N = 755), we examined the relationships between the Dark Triad traits (i.e., psychopathy, Machiavellianism, and narcissism) and collective narcissism (i.e., agentic and communal) on the one hand, and behaviors related to the COVID-19 pandemic at (1) the zero-order level, at (2) the latent variance level, and (3) indirectly through health beliefs about the virus (i.e., the health belief model) on the other. We focused on preventive and hoarding behaviors as common reactions toward the pandemic. Participants characterized by the Dark Triad traits engaged less in prevention and more in hoarding, whereas those characterized by collective narcissism engaged in more hoarding only. Coronavirus-related health beliefs mediated patterns of prevention (fully) and hoarding (partially) in the latent Dark Triad (Dark Core) and collective narcissism. However, specific beliefs worked in opposite directions, resulting in a weak indirect effect for prevention and a null indirect effect for hoarding. The results point to the utility of health beliefs in predicting behaviors during the pandemic, explaining (at least in part) problematic behaviors associated with the dark personalities (i.e., Dark Triad, collective narcissism).

Multidisciplinary research priorities for the COVID-19 pandemic – Authors' reply

Article

Jul 2020

The Moderating Effect of Social Support and Social Integration on the Relationship Between Involuntary Job Loss and Health

Article

Jun 2020
J APPL GERONTOL

Background Job loss is a stressful life event that is associated with changes in somatic, behavioral, and affective well-being. This cohort study investigates whether social support and social integration moderate the relationship between job loss and mental health. Methods Data from four waves of the Americans’ Changing Lives data set were collapsed into three wave-pairs. Our sample comprised 1,474 observations, from which we identified 120 job losses. We applied longitudinal regression models in benchmark moderation analysis; finite mixture modeling was then applied to investigate complex heterogeneity. Results Our findings suggest that social support, and not social integration, buffered the involuntary job loss–depressive symptoms relationship among a subgroup of individuals who were more likely to be White, higher educated, and have higher social support prior to job loss. Conclusion Policies that incentivize education, promote financial and health literacy, and strengthen families may reduce vulnerability to the mental health effects of job loss.

Grappling with our therapeutic relationship and professional self-doubt during COVID-19: will we use video therapy again?

Article

Jun 2020

The social restrictions during the COVID-19 crisis led to many therapists providing therapy remotely, despite some therapists’ concerns regarding its efficacy, technical challenges and their ability to build a strong therapeutic relationship online. This survey study reports on the experiences of 141 therapists who transitioned to providing video therapy during the pandemic. Aspects of the therapeutic relationship (e.g. working alliance, real relationship), experienced anxiety and professional self-doubt, attitudes towards and intention of video therapy use in the future were assessed. Although therapists reported some anxiety and self-doubt, most felt that online sessions had a sufficient working alliance and a strong real relationship. Therapists with more online therapy experience, lower levels of self-doubt and anxiety, and those who experienced a strong online real relationship during the pandemic, or thought their patients viewed it positively, tended to be more accepting of video therapy. Therapists were largely undecided as to whether they planned to use video therapy in the future; however, those with prior video therapy experience were more likely to endorse future utilization. Training is needed, especially for therapists with less online therapy experience, in order to foster a better experience and to support effective use of online therapy in the future.

The Psychology of the COVID-19 Pandemic: A Group-Level Perspective

Abstract

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