Some people think of group therapy as a second-best to traditional one-on-one therapy.
Maybe that’s because it tends to be more affordable. Or perhaps it’s all because it’s often mistaken for support groups.
Truth is, group therapy can be every bit as effective as its individual counterpart.
At Recreate Behavioral Health Network, we see group counseling as the valuable tool it is, and we incorporate it into treatment plans as needed.
Understanding Group Therapy
Let’s start by breaking this form of therapy down to its mechanisms, therapeutic factors, applications, and overall effectiveness.
How It Works
Part of the reason group counseling works is that it draws power from the typical group dynamic. It creates a safe space where you can observe others, recognize patterns, and reflect on your own behaviors/thoughts.
Another major component is leadership. The group is led by a licensed therapist who can offer sound mental health advice tailored to your needs.
When It Can Be Helpful
Group therapy is actually an evidence-based intervention that can be beneficial for several conditions, including:
- Substance use disorder
- Anxiety
- Depression
- Post-traumatic stress disorder
- Personality disorders
- Attention-deficit/hyperactivity disorder
- Eating disorders
Key Therapeutic Factors
The American Group Psychotherapy Association (AGPA)’s practical guidelines recognize a few factors that account for the therapy outcomes. The list covers everything from hope to behavior imitation in group settings.
Here are some of the most important factors:
- Universality: Members realize that others in the group share similar feelings, thoughts, and problems.
- Altruism: Extending help to others gives a self-concept boost to members.
- Cohesiveness: A feeling of trust and belonging among the members.
- Catharsis: A strong emotional release experienced by members after participating in the sessions.
- Self-Understanding: Members start gaining insight into the psychological motivations behind their behaviors and emotions.
- Existentialism: Members accept responsibility for their life decisions.
The Role of the Therapist
According to the AGPA’s guidelines, the role of the therapist leading the group counselling session can be split into four functions.
The first is the executive function (think timing, topics, boundaries, and so on).
The second is the caring element. Maintaining the members’ well-being is a priority for the therapist, so they monitor responsiveness to treatment and set the standard for client-client interactions.
As for the third function, it’s emotional stimulation, where therapists assist members in identifying and expressing their feelings.
Finally, the last function category is meaning attribution. That’s when the therapist helps members understand the group dynamics and fosters self-awareness.
Side Note: Groups can have more than one leader.
Group vs. Individual Therapy
Individual therapy isn’t inherently better than group therapy. In fact, they can be equally effective interventions, and each has its time and place.
3 Possible Challenges to Overcome in Group Therapy
So, group therapy provides therapeutic guidance, much-needed personal insights, and some peer support. That doesn’t mean it’s all smooth sailing, though.
Here are three common concerns:
Confidentiality Concerns
Naturally, therapists have to comply with HIPAA. They can’t disclose information about your mental health or recovery.
But what about the other members in the group? They’re not healthcare professionals bound by HIPAA. Asking them to keep what goes on a secret may not work each time. This can leave many people hesitant to open up in group therapy.
To overcome this challenge, facilitators are to stress the importance of anonymity. This way, even if members talk about something they heard in session, they still leave out all the identifying details.
Client-Client Conflict
Miscommunication, microaggressions, and outright conflict aren’t exactly foreign concepts in group psychotherapy.
Conflict is particularly common during the storming (the second stage of group development). That’s when the initial politeness fades and leaves room for competition, disagreements, and boundary testing. You may even see competing alliances forming at this stage.
It’s worth noting that group counseling often provides a microcosm of the real world. So, a bit of conflict isn’t a deal breaker, as long as the group therapist keeps the situation under control.
Difficulty Opening Up
Social anxiety and fear can keep people from entering group therapy. And if they do join, they might find it hard to be vulnerable.
The important thing to keep in mind here is that engaging with your therapist and your peers is difficult but highly rewarding.
It may also help to remind yourself that everyone is here because they’re trying to heal. Odds are, they’re going through at least some of the challenges you’re facing now.
Don’t hesitate to share these fears with your therapist. They may recommend a period of individual therapy first and ease you into the group setting later.
Alternatively, they may encourage the expression of shameful experiences. That sounds tough, but holding fears and shame in a shared, accepting space may actually help you process them.
How to Decide if a Particular Group Is Right for You
If you check local hospitals and medical centers, you’ll likely find plenty of group sessions. And a lot is riding on you making the right decision.
Here are some variables to consider before joining a group:
Open vs. Closed Groups
We can split group therapy into two broad categories based on the format.
On the one hand, you have closed groups, in which all members join at the same time. In this format, the facilitator creates the group with a set number of members in mind and a set end date.
On the other hand, members can join an ongoing open group therapy at any point.
Now, it’s clear that the open format offers more flexibility. But that doesn’t make it inherently better than its closed counterpart. In fact, they can be equally effective (albeit for different reasons).
Your therapy provider can help you decide on the “right” format for your needs. You can also consider the advantages and drawbacks of each type.
Closed therapy groups tend to offer more consistency and predictability. They can feel more intimate, too. But with open formats, there’s more room for the constant modification of culture.
Co-Therapists or Just the One
As we mentioned earlier, groups can have one or two facilitators.
Research points out that the presence of a co-leader gives the group advantages over similar individually led groups.
For one, there’s the task-sharing aspect. Rather than having to juggle the moderation, planning, outcome tracking, and conflict resolution alone, the facilitator can now have a partner to help with the workload. Plus, each leader can bring in a different perspective and coping techniques.
Of course, having two leaders can also help with the consistency aspect. If one can’t make it to a session, the other can cover for them.
Group Size
If you end up in a smaller group, your facilitator may have more time to focus on your individual needs.
That said, larger groups aren’t all bad, either. The large number of participants can translate to more diversity.
Group Homogeneity
Odds are, you’ll find that you already have something in common with the peers in your group. After all, you’re likely all in therapy for the same broad mental health concern.
For instance, group therapy in a substance abuse treatment center may bring together 10 people suffering from addiction. The addictions, socioeconomic needs, and stages of recovery may vary, but there’s still a common struggle to bond over.
Still, it can be helpful to consider the homogeneity of the group.
Does the common ground allow for cohesion? Can you identify with at least one other member? Is there still enough diversity within the group to make it function like a microcosm of the real world?
Session Logistics
The location and timing of the group counseling sessions matter. However, the room itself matters as well.
A well-run group therapy environment should feel safe, support vulnerability, and create a sense of equality.
The circle setting is the most common layout. U-shaped settings options are also a viable option for facilitator-led discussion. Rows, however, tend to limit peer interaction, almost as if you’re in a classroom.
5 Tips for Making the Most Out of Group Therapy
Ready to join group therapy? Check out these five golden tips first:
1. Accept Gentle (But Important) Challenges
As we mentioned earlier, part of the reason group therapy works is that it relies on the power of the group dynamic to help members gain personal insights.
But you can’t gain that insight into yourself if you’re not willing to hear others. Just know that your therapist and peers may be able to recognize your behavior patterns before you do. So, be open to a challenge and consider your capacity to change.
2. Share the Positives, Too
Don’t just offload the heavy stuff. If you’ve made progress in your treatment, share it with the group. Remember that you’re all here to support each other through recovery!
3. Be Consistent
Consistency is key for therapy in general, and group therapy is no exception.
Different groups may have rules regarding punctuality and attendance. Ask about them in advance, so you can provide the commitment level expected of you.
4. Watch Out for Dependent Attachment
As you enter therapy, you have a few treatment goals in mind. A good facilitator keeps track of your progress as time goes by.
In some cases, however, a member doesn’t trend towards their goals. This may be because they’ve formed a dependent attachment to the group, which hinders them from actually benefiting from the sessions and working on the core problems.
If you ever feel that this might be the case, don’t hesitate to share your fears with the therapist.
5. Know That Group Therapy May Not Be Enough on Its Own
Group therapy definitely has its benefits and can be an effective tool in recovery. But for many patients, it’s not effective enough to be the only form of treatment they pursue.
Some people benefit more from receiving both group and individual therapy.
This may be in the form of a combined therapeutic approach, where the group facilitator also serves as the individual therapist. Alternatively, it could follow a conjoined form, where the group and one-on-one sessions are led by different therapists.
Plus, depending on your condition, there’s a chance that you’ll need medications. This may be the case for people suffering from opioid use disorders or intense psychiatric symptoms, for instance.
Either way, you have to be open to trying group therapy simultaneously with other treatment options. After all, your healthcare providers want to boost your odds of making meaningful, long-lasting changes for the better. And this might call for a layered treatment plan.
Group Therapy vs. Other Kinds of Groups
There are several group settings that, while incredibly valuable, don’t exactly constitute therapy.
Here are three common examples:
- Support Group: Creates a space to talk about emotions and difficult subjects, but doesn’t necessarily address the root psychological causes.
- Group Psychoeducation: Curriculum-based and more about learning about mental health issues.
- Activity-Based Group: Guides you through relaxing activities and can provide immediate relief.
Learn More About Group Therapy
Still have questions about how it all works? Need help finding a group that matches your therapy needs?
The Recreate Behavioral Health Network team is here to help you out. Give us a call on our 24/7 confidential treatment helpline for more details.
