Group Therapy

Group psychotherapy is a therapeutic approach in which a several people meet together under the guidance of a professionally trained therapist to help themselves and one another. The therapy has been widely used and has been a standard treatment option for over half a century.

Group psychotherapy helps people who would like to improve their ability to cope with problems. While in individual therapy the therapist meets with only the client, in group therapy the meeting is with a whole group and one or  more therapists. Group therapy helps people learn about themselves and improve their interpersonal relationships.

Group therapy often consists of "talk" therapy, but may also include other therapeutic forms than such as expressive therapy and psychodrama.  In group therapy the interactions between the members of the group and the therapists become the material with which the therapy is conducted, along with past experiences and experiences outside the therapeutic group. Group therapy is not based on a single psychotherapeutic theory, but takes from many different therapies.

Studies have shown that group therapy has been as effective and, depending on the nature of the problem, sometimes even more effective than individual psychotherapy. 

Group psychotherapists are mental health professionals trained in one of several areas: psychiatry, psychology, social work, psychiatric nursing, marriage and family therapy, pastoral counseling, creative arts therapy or substance abuse counseling. The group therapy session itself usually lasts about 75-120 minutes.  During the session each member works to express their own problems, feelings, ideas and reactions as freely and honestly as possible. Accordingly, the group members have an opportunity to learn not only about themselves and their own issues, but also the value of helping other group members.

Group therapy is very diverse. Psychologists with different theoretical training will use group therapy for many different types of psychological problems and concerns.  Group therapy has been effective in addressing many types of problems including, but not limited to:

feelings of isolation
depression and anxiety
difficulties with interpersonal relationships
aging
medical illness and physical problems
addictive disorders
sexual problems
death and other losses
lifestyle issues within a traditional culture

The following has been adapted from the Psychologyinfo: treatment-group therapy website.

There are two general ways of categorizing group therapy, by the time limits set on the duration of the group, and by the focus of the group and the way group members are selected.

First, group therapy can be offered on an ongoing basis or for a specific number of sessions. In an ongoing group, once the group starts, it continues indefinitely, with some group members completing treatment and leaving the group, and others joining along the way as openings are available in the group. Most of these groups have between six and twelve members, plus the psychologist. There are some psychologists who have had a therapy group running for ten years or more.

Time limited groups are just as you would expect, limited in the amount of time they will run. This does not refer to the length of the group sessions, but to the number of sessions, or the number of weeks, the group will run. Time limited groups have a distinct beginning, middle and end, and usually do not add additional members after the first few sessions. Most time limited groups run for a minimum of eight to ten sessions, and many will run for up to twenty sessions. The length of these groups always depends on the purpose of the group, and the group membership. The psychologist running the group will structure it to run for the number of sessions necessary to accomplish the goals of the group.

The focus of the group is another way of categorizing group therapy. Some groups are more general in focus, with goals related to improving overall life satisfaction and effective life functioning, especially in the area of interpersonal relationships. These groups tend to be heterogeneous. This means that the group members will have varying backgrounds, and varying psychological issues that they bring to the treatment group. The psychologist will select group members who are likely to interact ways that will help all group members. These groups tend to be open-ended, because of the nature of the group therapy process. However, some of these groups are also time-limited, but they may run longer than most time-limited groups.

Other groups are "focused" or "topical" therapy groups. The group members tend to have similar problems because the group is focused on a specific topic or problem area. For example, there are therapy groups for Depression, Adult Children of Alcoholics, or Parents of ADHD Children. Some focus therapy groups are skill development groups, with an emphasis on learning new coping skills or changing maladaptive behavior. There are groups to help people develop Stress Management Skills, Parenting Skills, Assertiveness, and Anger Management Skills, among others. Focus therapy groups can be either open-ended or time-limited groups. The skill development groups (Stress Management, etc.) tend to be time limited and usually run between eight and sixteen sessions. The single-issue focus groups (Adult Children of Alcoholics, Women's or Men's Groups, etc.) may be open-ended or they may run for a specified number of sessions.

Group therapy is different from individual therapy in a number of ways, with the most obvious difference being the number of people in the room with the psychologist. In conducting research on the effectiveness of these therapy groups, psychologists discovered that the group experience benefited people in many ways that were not always addressed in individual psychotherapy. Likewise, it was also discovered that some people did not benefit from group therapy.

In group therapy, you learn that you are not alone in experiencing psychological adjustment problems, and you can experiment with trying to relate to people differently in a safe environment, with a psychologist present to assist as needed. Additionally, group therapy allows you to learn from the experiences of others with similar problems, and also allows you to better understand how people very different from yourself view the world and interact with people. Of course, there are many other differences between group therapy and individual psychotherapy. Many people are anxious about participating in group therapy, because they don't want other people (in addition to the psychologist) to know about their problems. Group members are told not to discuss information shared in the group with others, and usually the need for mutual confidentiality preserves the privacy of the information.

The following has been adapted from the American Group Psychotherapy Association website.

How does group work?

A group therapist appropriately selects people (usually 5 to 10) who would be helped by the group experience and who can be learning partners for one another. In meetings, people are encouraged to talk with each other in a spontaneous and honest fashion. A professionally trained therapist, who provides productive examination of the issues or concerns affecting the individuals and the group, guides the discussion.

Not every group is alike. There are a variety of styles that different groups use. For instance, some focus more on interpersonal development, where much of the learning actually comes from the interaction between members. Others address thoughts and behaviors, where the emphasis is on learning how to control negative thoughts, address phobias or relieve anxiety-inducing situations.

If someone is in a group, do they also need individual therapy?

It depends on the individual. Sometimes group therapy is used as the main or only treatment approach. Sometimes it’s used along with individual therapy. Often people find that working simultaneously in both group and individual therapy stimulates growth in mutually complementary ways. And clients may see two different therapists for individual and group therapies. In such cases, it’s generally considered important for the two therapists to communicate with each other periodically for the client’s benefit. Ask your therapist about the type of therapy that will best meet your needs.

How is group therapy different from support groups and self-help groups?

Group therapy focuses on interpersonal relationships and helps individuals learn how to get along better with other people under the guidance of a professional. Group psychotherapy also provides a support network for specific problems or
challenges. The psychotherapy group is different from support and self-help groups in that it not only helps people cope with their problems, but also provides for change and growth. Support groups, which are generally led by professionals, help people cope with difficult situations at various times but are usually geared toward alleviating symptoms. Self-help groups usually focus on a particular shared symptom or situation and are usually not led by a trained therapist.

Why is group therapy useful?

When someone is thinking about joining a group, it is normal to have questions or concerns. What am I going to get out of this? Will there be enough time to deal with my own problems in a group setting? What if I don’t like the people in my group?

Joining a group is useful because it provides opportunities to learn with and from other people, to understand one’s own patterns of thought and behavior and those of others, and to perceive how group members react to one another. We live and interact with people every day and often there are things that other people are experiencing or grappling with that can be beneficial to share with others. In group therapy, you learn that perhaps you’re not as different as you think or that you’re not alone. You’ll meet and interact with people, and the whole group learns to work on shared problems -- one of the most beneficial aspects. The more you involve yourself in the group, the more you get out of it.

What kinds of people should participate in group therapy?

Group therapy can benefit many different people, from those having difficulties with interpersonal relationships to those dealing with specific problems such as depression, anxiety, serious medical illness, loss, addictive disorders or behavioral problems. With adolescents, for example, group therapy teaches socialization skills needed to help function in environments outside the home.

Will there be people with similar problems in my group?

The therapist's role is to evaluate each member's problems prior to forming the group. Usually there is a mix of members who can learn from each other. While some members will have similar circumstances, it's not necessary for all to be dealing with exactly the same problem. In fact, people with different strengths and difficulties are often in the best position to help one another.

What kind of commitment do I need to make?

The time commitment depends on the type of group and the nature and extent of your problems. Short-term groups devoted to concrete issues can last anywhere from 6 to 20 weeks. Support therapy groups (for example, those dealing with a medical illness such as cancer) may be more long-term. There are also more open-ended groups in which members work at their own pace and leave when their particular needs or goals have been met. It’s best to talk with your therapist to determine the length of time that’s right for you.

What if I’m uncomfortable discussing my problems in front of others?

It’s not unusual to feel uneasy or embarrassed when first joining a group, but soon you begin to develop feelings of interest and trust. Most clients find that group therapy provides a great deal of relief because it allows them a chance to talk with others who are experiencing similar problems -- in a private, confidential setting. Many people who have experienced group therapy believe that working together with others is helpful and they feel better by participating in this form of therapy.

What does group cost?

The cost varies depending on the type of therapist and perhaps even the geographic area of the country. Typically, group therapy is about half the price of individual therapy.

About the American Group Psychotherapy Association

The American Group Psychotherapy Association is the oldest and largest professional association dedicated to the field of group psychotherapy. The association has thousands of members and maintains the highest professional standards in the field. AGPA is a multidisciplinary association, representing all of the group psychotherapy disciplines.

For more information about Group Therapy and other therapeutic approaches, please click on the linked websites listed below.

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