What Is Group Therapy, And How Can It Improve Mental Health?

Group therapy can be described as therapy sessions with more than one client, often led by one mental health practitioner like a therapist or psychologist. You can find many ways to incorporate a group session (also known as group psychotherapy) into your treatment plan or utilize the group process as a standalone treatment.

The benefits of group therapy include reductions in distressing symptoms in those living with mental health conditions and physical diseases, including coronary heart disease. Therapy in a group setting may enable clients to benefit from a supportive and positive environment where they can meet with larger groups going through related experiences or working toward similar treatment goals. Receiving mental health care in a group environment can lead to a variety of positive changes.

Group therapy may benefit many clients, as research supports group therapy effectiveness for a variety of concerns. For example, group therapy may be particularly beneficial in treating substance use disorder as long as the group leader has received specialized training. One study concluded that, for individuals diagnosed with substance use disorder, treatments that combined group therapy with pharmacological interventions were more effective than pharmacological interventions alone.

Group therapy can provide a beneficial space for people to work through substance use-related health concerns with a group. Group therapy may also be helpful for a variety of other mental health conditions.

What is group therapy? 

By definition, group therapy involves one or more therapists facilitating group therapy activities with more than one client simultaneously. Most groups comprise five to 15 members, as well as one or two therapists. Group treatment is offered in many mental health settings, including exclusive practices, hospitals, clinics, and community centers. 

Discussing personal experiences tends to be a vital part of group dynamics in the therapeutic process, and it can provide support, inspiration, and insight into symptoms and behaviors. In many groups, one or more psychologists may spend time addressing the whole group and leading group activities. 

One unique benefit of group psychotherapy is that members in group treatment may be encouraged by witnessing the success of other members of the group. This encouragement can be a valuable part of this type of mental health care.

Various modalities of group therapy

Below, find brief descriptions of various types of group therapy:

• Psychoeducational groups, where a therapist educates group clients about their disorder
• Skills development groups, where a therapist teaches clients of the group better coping skills
• Cognitive behavioral groups, where a therapist addresses patterns of thinking and behaving when in a group
• Support groups, in which members of the group hold each other accountable for change 
• Interpersonal process group psychotherapy, in which members of the group explore cognitive distortions and learn new behaviors in the group that may improve interpersonal skills

Group format basics: Open vs. closed groups

When choosing the right group for your needs, the group format–in particular, whether it is an open or closed group–may be an important consideration. In an open group, members can join and leave at any time. However, in a closed group, all members join at the same time and remain together throughout the group process, which can help them develop stronger bonds in the group setting. 

Since closed groups typically begin on a set date and only accept a certain number of participants, you may have to wait to join one. Open groups, meanwhile, often meet on a particular day of the week or month, which may allow you to join the group environment when it is convenient for you.

Safety in a group environment

For individuals to talk about strong emotions, work through physiological arousal, and receive valuable feedback, they generally require a supportive environment in which they can trust that the information they talk about will not leave the group environment. Therefore, it’s common for group members to sign an agreement in which they pledge not to talk about other members or the information discussed in group therapy outside of group sessions.

What does group counseling treat?

Group therapy can be used to treat a wide array of different mental health conditions and symptoms with a therapist, including, but not limited to, the following: 

• Low self-esteem or low confidence
• Depression
• Anxiety disorders
• Grief and loss 
• Emotional or physical trauma
• Social anxiety or interpersonal difficulties
• Personality disorders 
• Anger management 
• Obsessive-compulsive disorder (OCD) 

Dialectical behavior therapy (DBT)

One common specialized form of group therapy is dialectical behavior therapy (DBT), which typically involves an individual therapy component as well. DBT groups are often targeted toward those living with borderline personality disorder (BPD) or intense emotional reactions. DBT frequently teaches effective communication techniques and coping skills.

Another common modality utilized by a therapist during group sessions is cognitive behavioral therapy, which can promote effective management of symptoms of depression, anxiety disorders, substance use disorder, schizophrenia, and other conditions by teaching individuals new skills to manage symptoms. 

Education and navigating issues: What activities happen during clinical counseling with a group? 

Some groups focus on discussions, while the focus in other groups may be more on individual concerns or lessons. Before entering a group, you may learn about the types of activities commonly practiced in the group and any requirements for workbooks or homework given by a therapist. 

A few activities you might encounter in a setting with others

In the group environment, participants often engage in the following activities:

• Educational, cultural, or social outings or group activities
• Expressive group therapies like art, writing, group acting, or group dance
• Integrative group therapies like yoga, group pilates, or acupuncture
• Telling stories to the group and the therapist for support and validation 
• Educational lectures or group workshops with a therapist

What to expect

Often, sessions in the group format are around one to three hours in length, depending on the group and the therapist.

Groups may be held in smaller numbers so as not to overwhelm clients or the therapist. Many groups typically include about eight to 12 individuals with one mental health professional present. The flexibility of weekly group sessions can be up to your therapist, depending on if you are incorporating group therapy into your treatment plan or are attending group sessions on your own. 

Support through non-individual psychotherapy and shared experiences

Group psychotherapy topics and content can vary, depending on who talks about their experiences. With this sense of group cohesiveness and oneness persisting in sessions, the group can provide support to all those who join the discussion or allow themselves to be vulnerable. A sense of objectiveness within the groups may also be achieved during group sessions with a therapist. Since other group members aren't personally involved with your life, the people in these groups have the opportunity to give more objective opinions and ideas to help you work through challenges. 

Learning through others

Group therapy can provide you with the opportunity to learn from others. For example, if you are going through a divorce, you might talk about your feelings or experiences and gain invaluable perspective from others in the group who have also gone through a divorce, as well as the therapist. The group participants may have learned techniques that helped them and can give the information to you as you cope with your experiences. 

Topics can also lead to the inspiration of others. Learning about the success of other group participants in their treatment can give you hope that you can also achieve your goals. Group activities with a therapist may also strengthen your social skills. Even when isolation may seem like the most appealing option, small groups with a therapist can offer a chance to socialize in a safe and structured environment.

The most effective way to benefit from a group therapy session may be to take it seriously and do the work requested by the mediator or therapist. If you use group therapy to meet new friends or sit back and never join the discussion, you might not experience the full benefits of group therapy. Note that the insights you bring up may prompt someone else to open up and feel less alone. Below are three ways to get the most out of group therapy. 

Pledge

Group therapy is a serious process for each client. Many therapists ask clients to sign a contract or discuss boundaries and rules for the group. When you pledge to participate, you may also commit to finishing the sessions outlined by the therapist during the sign-up process. 

Participate in sessions

Even when you don't feel like attending sessions, or in moments where you're expected to speak but think about skipping, try to participate in group discussions. Participation can also benefit others in the group, and partaking in the planned activities with the therapist or group can help you learn more about yourself. 

Talk about your own experiences

Discussing your experiences with others in the group may empower you to remove the burdens of your experience from yourself while also allowing others to relate to you for their recovery. By talking about your healing journey and inner thoughts, you can support others as well.

Group therapy usually focuses on the benefit of all group participants. Although you are in the group to address your own concerns, other group participants may look to you for advice, input, or solidarity. Although you are not responsible for anyone else's healing, you can support yourself and others by participating in the group, finding commonality through vulnerability, and growing through your experiences.

How group therapy compares to individual therapy and other forms of mental health care

Group therapy tends to differ from individual therapy and other forms of mental health care because so many people are involved in the process. Group therapy can cultivate positive changes in one’s own situation using different strategies than are typical in one-on-one therapy sessions. Having a strong, understanding support system can make a significant difference in many individuals’ mental health journeys.

Group therapy evidence and effectiveness by condition and population

Group therapy can be an effective type of treatment (often in conjunction with other forms of mental health care) for various mental health conditions. These may include anxiety disorders, personality disorders, and post-traumatic stress disorder, both in service members and in other populations. Group therapy may also help individuals cope with certain types of medical illness, learn to manage strong emotions, and effectively respond to physiological arousal.

For example, a 2020 systematic review and meta-analysis reported that group therapy produced similar results to individual therapy in the treatment of anxiety disorders. This appeared to be true even in groups whose members lived with different types of anxiety disorders.

A 2019 study showed that group therapy significantly reduced post-traumatic stress disorder (PTSD) symptoms, with no differences seen between the effects of group therapy and other forms of treatment. Additional research also supports the idea that group therapy can lead to positive changes like developing self-understanding, learning effective socializing techniques, and incorporating valuable feedback into one’s own situation. The therapeutic factors at play in group therapy can make a significant difference in participants’ mental health.

The factors that drive change in groups

A willingness to fully engage in the process may be one of the most important therapeutic factors driving change in groups. Without a willingness to participate and try new things, it can be challenging for individuals to develop self-understanding, cultivate new skills to manage physiological arousal, learn socializing techniques, and practice effective communication techniques. Full participation can lead to unconscious processes like imitative behavior, in which group members learn new ways to manage emotions from the therapist running the group and the other group members.

Counseling options to support mental health

Participation, research, and responsibility may be crucial in understanding group therapy, whether you’re considering an open or closed group. Researching where these sessions are offered and what type of group therapy you want to try can be beneficial. Many therapists with their own practices provide group therapy outside of individual sessions, whereas other therapists may work online or in a clinic setting. 

Online counseling with others

If you choose an online therapy group, know that online therapy can be as effective as in-person counseling. For example, one study found that people who used BetterHelp experienced a significant decrease in the severity of depression symptoms. Please note that BetterHelp provides individual therapy sessions with a professionally trained therapist, as well as the opportunity to attend sessions in a group format once a week as part of a mental health care subscription plan. Other forms of support, such as online journaling and goal-tracking, can also be used as tools to supplement one’s own situation as needed.

Benefits of online counseling

Online counseling groups can enable therapists and group participants to connect from separate locations. Having a way to learn from multiple cultural viewpoints and ideas can also benefit clients. This benefit potentially opens up more doors to greater perspective and understanding on various topics. Additionally, online therapy is often more cost-effective than face-to-face services, as therapists do not have to pay to rent out an office space or parking spot. With BetterHelp you can attend group sessions in which you can have a discussion with other individuals led by a therapist.