What is Group Therapy?
Group therapy was adopted as a treatment approach in the period after the second world war, when there was a sharp increase in the number of people requiring mental health services but not enough practitioners to provide them. Due to its effectiveness, it remains an efficient and affordable form of therapy, still widely used today.
Group therapy is a type of psychotherapy, where one or more trained therapists lead a group of people – typically 5–12 participants. The group meetings normally run for a few hours each week, and may be set for a fixed number of weeks, or continue over a full year.
While group therapy is still sometimes used as a standalone treatment, it is now more common to find group therapy sessions integrated into wider treatment plans where they are used in addition to one-on-one therapy sessions, medication and other types of care.
Some group therapies are ‘open’ and new participants are welcome to join at any time. Others are ‘closed’, where all participants join at the same time, and only these core group members attend sessions.
Unlike individual therapy sessions, group therapy offers participants the opportunity to interact with others with similar issues in a safe, supportive environment. Participants can try out new behaviours, role-play scenarios, and engage with others to give and receive valuable feedback and insight.
The content of the group sessions is always confidential; what members talk about or disclose is not discussed outside of the group.
There are many different types of therapeutic groups, but most therapy groups can be divided into two main approaches:
This type of group therapy provides participants with information about specific issues, such as depression, panic disorder, process addictions and substance abuse. It is also used to teach concepts, skills and practices, such as interpersonal skills and mindfulness techniques. These groups are led by a qualified therapist, who structures the content, directs the sessions and sets the goals. The therapist provides most of the content through instruction, taking on the role of teacher, and is primarily in charge of the direction each session takes.
These groups focus more on the group experience, with the therapist acting as a facilitator rather than an instructor. Group members participate more fully and freely by engaging in group discussions and a range of activities. In process-oriented group therapy, the group is primarily in charge of the direction each session takes.
Groups work best when there is open and honest communication between participants, which means confidentiality is a hugely important part of the ground rules for any type of group.
Depending on the nature of the content, group therapy can be an ideal opportunity for addressing concerns and making positive changes in our lives, providing a valuable and trusted source of support.
Many people find it helpful to participate in both group therapy and individual one-on-one sessions. Participating in both types of psychotherapy has been shown to significantly increase the chances of making valuable and lasting changes.
What are the Different Types of Group Therapy
Group therapy can play a significant role in the prevention and treatment of a wide range of mental health disorders, including depression, substance abuse, anxiety disorders, bipolar disorder and some process addictions.
There are many types of group therapy treatments now available, including:
- Psychotherapy Groups
- Cognitive Therapy Groups
- Modified Dynamic Group Therapy
- Relapse Prevention Groups
- Mutual Self-Help Groups
- Network Therapy
These groups focus on what members can do in the here and now, and help members work together to form a unified group in which they can freely share their successes and setbacks in a safe and supportive environment. These groups can also help those new in recovery to build the interpersonal skills needed to effectively communicate with others in a healthy manner.
CT groups use cognitive behaviour therapy, and other similar therapy styles, to help members identify, understand and change unhelpful patterns of behaviour. Therapists take an active role in working with group members, to help them manage their thought processes, emotions and behaviours and teach them coping skills to deal more effectively with the stressors and triggers they may encounter.
This is a popular group therapy option used with substance abusers and addicts, to help address and overcome addictive behaviours. It provides a supportive environment in which to examine shared issues, allowing members to overcome feelings of isolation and shame. The therapist establishes a safe environment, developing shared responsibility and mutual respect, with the goal of helping members maintain self-regulation and abstinence.
Often, the real work in recovery begins when an individual transitions back into their normal daily routines. This is when they are at their most vulnerable, and need extra support to make the transition easier. Relapse prevention groups can play a major part in aftercare programs, and involve education, peer support and therapy focused on coping with interpersonal difficulties and internal states more effectively.
One of the most common and effective types of group therapy, outside a treatment program, is mutual self-help groups, such as Alcoholics Anonymous. These groups are typically made up of members who share a common condition and a common goal. They are self-run, without professional leaders, free of charge, and focus on mutual support and maintaining sobriety.
A big indicator of success in sustained recovery is the presence of a support network, including family and friends. Network therapy involves using this social support network in a group format to provide continued support for behavioural change and relapse prevention. Cognitive behaviour therapy provides the foundations for network therapy. It focuses on the patient, and requires great skill and sensitivity on the part of the lead therapist.
There are many other types of group therapy, with techniques adapted to best meet the needs of group members and the goals of treatment. There is also a growing number of specialised group therapies, to support specific patient populations, including female-only, adolescents, LGBTQ+ community members and the elderly.
What are the Benefits of Group Therapy?
While discussing personal problems in a group setting may seem a bit intimidating at first, many people find that once they have overcome these concerns, they really benefit from meeting and sharing with other people.
Research shows that people in group therapy improve not only from the interventions of the therapist, but also from their interactions with other group members. While the group format does not provide the same one-on-one attention of individual formats, it can offer a wide range of benefits, including:
- Group therapy is often more affordable / cost effective
- Group therapy provides a safe haven
- Group therapy offers additional support and connection
- Group therapy can foster new insights
- Group members can serve as role models
- Group therapy can help participants find their own voice
- Group therapy can help to improve interpersonal skills
- The ability to thrive in a ‘community’ greatly impacts mental health
In addition to giving participants a safe time and space to talk about their issues – and to practise new behaviours and actions – group therapy also provides a safety net between sessions. Knowing they are going to be reporting back to people who care about them, support them and will listen to what they have to say, can help participants feel less isolated and more empowered.
While we are each unique, with a different set of circumstances, a group setting helps participants realise they are not alone in their struggles. They can see that others are going through similar experiences, so they feel less isolated and more connected. It can be difficult to speak openly about mental health problems, but hearing others share their experiences and receiving support can give participants the confidence to open up more and be more vulnerable.
People participating in group therapy often speak about situations with deep experiential knowing, which can resonate with other group members in a deeper way and provide a piece of insight that the therapist may not be able to offer. The diversity of a group setting, with so many different perspectives, can help participants discover new strategies or to see their own challenges in a different way.
By seeing how others handle similar problems and make positive changes, participants in the group can add new coping methods to their own methods – and begin to see that there is hope for recovery. As each person progresses, they can, in turn, serve as a role model and support figure for others.
By talking with others in similar situations, we often become more aware of our own feelings and begin to learn how to express them in positive ways. The safety of the group can help participants to access and express their feelings with more confidence and freedom, which might not be possible in other settings. They can begin to ask for the support they need, knowing they will be heard.
While it might not be the focus of the group, with guidance from the therapist participants will learn to communicate more clearly and effectively within a group setting. They can observe how others relate to each other, try out different ways of relating to others, and learn to moderate their behaviour where necessary. New interpersonal skills learnt in the safety of the group can then be practised outside of the group, rebuilding and strengthening all relationships.
A recent Harvard study showed that a person’s happiness largely depends on the health of their relationships. Time talking about problems, listening to others, and encouraging and supporting one another in a ‘community’ of group therapy, can be a hugely positive influence on an individual’s recovery journey.
While certain forms of treatment may be better suited for specific issues or individuals, a review of the research literature on individual and group therapy found that they are generally equivalent in effectiveness.
In many situations it is most helpful to attend both group and individual therapy, so we can talk about what comes up for us in the group with our individual therapist and potentially make greater strides in our progress.
There are clinicians and researchers who claim that the group psychotherapy process produces stronger and longer-lasting results for many people compared to individual psychotherapy.