50-3 Effects and Therapeutic Factors of a Counseling Group Based on Bowen's Concept of Differentiation for Adolescents with Codependency in Taiwan

Chiung-Shan Liu Shih-Hua Chang
National Taiwan Normal University

Evolving from the treatment of families of alcoholics, the construct of codependency has been expanded and mainly refers to excessively other-oriented caretaking traits and behaviors that are derived from a stressful or dysfunctional family environment. Current research findings and clinical observations have consistently shown codependency traits and related symptoms including low self-esteem, relationship difficulties, and psychological maladjustment among adolescents and college students in both Western countries and Taiwan. However, there is limited work examining and assessing the effectiveness of treatment
model based on a theoretical framework for codependency. Chang (2012, 2016) has proposed and provided empirical support for a Bowen-based model of codependency for adolescents and college students in Taiwan. Particularly, differentiation of self was found to be negatively related to codependency traits and was a significant mediator of the relationship between family-of-origin dysfunction and codependency traits. Consistent with previous research, codependency traits were found to be significantly associated with low self-esteem, relationship anxiety and avoidance, as well as psychological adjustment problems including somatic symptoms, anxiety, depression, and social dysfunction. The purpose of this study was to develop a group counseling model based on Bowen's concept of differentiation of self and explore the effects and therapeutic factors of the counseling group for adolescents with codependency in Taiwan. With a mixed method embedded design, the core qualitative method was used to understand participants’ perceptions of the helpfulness and therapeutic factors of the counseling group. The supplemental quantitative method was used to examine their changes in measures of differentiation of self, interpersonal competence, and self-concept at the end of the group and a three-month follow up. The group model consisted of eight two-hour sessions for a total of sixteen hours for eight successive weeks. The group goals were to increase members’ differentiation of self, to help them understand the impact of their family-of-origin experiences on intimate relationships, as well as to enhance their ability to recognize and take care of their own needs. Participants were six female students in a five-year junior college in Taipei, and their ages ranged from 15 to 18 with a mean age of 16 years. They had an average score higher than 3 on the Chinese version of the Spann-Fischer Codependency Scale, and experienced codependent relationships or had problems in the current or past intimate relationships. With semi-structured interviews and a phenomenological approach, qualitative data were coded and analyzed using thematic analysis. Participants' perceptions of the ways in which the group was helpful included: (1) development and differentiation of self, (2) balance of intimacy and autonomy, (3) learning solutions for relationship problems. The therapeutic factors of the group included: (1) awareness of the experiences in family and interpersonal interaction, (2) understanding and resonating with others’ experiences, (3) a warm environment of trust and feedback exchange in the group, (4) helping members solve problems. Results of Wilcoxon Matched-Pairs Signed-Ranks tests indicated that participants’ levels of differentiation of self, interpersonal competence, and social self-concept improved significantly at the end of the group. Also, their interpersonal competence and social self-concept continued to improve at a three-month follow up. The findings of the study provide preliminarily empirical support for the effectiveness of the Bowen-based treatment group for adolescents with codependency in Taiwan. Counselors and therapists are encouraged to use the group counseling model and extend the group sessions or time for adolescents and college students who struggle with codependent relationships. The implications of the findings for group counseling for codependency as well as suggestions for future research are discussed.

Keywords
Adolescents, Bowen theory, codependency, counseling group, differentiation of self.

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