What Is Group Therapy?

Group therapy is one of the over 400 modalities of therapy available worldwide, involving group 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 it as a standalone treatment.

The benefits of group therapy have been shown to reduce distressing symptoms in those living with mental health conditions and physical diseases, including coronary heart disease. The group therapy experience may enable clients to benefit from a supportive and positive environment where they can meet with larger groups going through related experiences or having similar treatment goals. 

Group therapy may benefit many clients. 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 published in Indian J Psychiatry concluded that for individuals diagnosed with substance use disorder, treatments that combined group therapy with pharmacological interventions were more effective than treatment plans in which pharmacological interventions were used alone. Group therapy provides a beneficial space for people to work through substance abuse health concerns with a group.  Additionally, individuals in the early stages of anxiety have been shown to benefit from cognitive behavioral groups teaching preventative measures.    

What is group therapy? 

By definition, group therapy involves one or more clinicians facilitating group therapy activities with more than one client simultaneously. Group treatment is offered in many mental health settings, including exclusive practices, hospitals, clinics, and community centers. 

Clients can sometimes join group psychotherapy sessions with others in the group who are at different stages in their personal growth, allowing everyone to share experiences and positivity at different points in their treatment. However, in a closed group, all members of the group begin treatment at the same time. In either case, sharing experiences is part of group dynamics in the therapeutic process and can offer support, inspiration, and insight into symptoms and behaviors. In many groups, one or more psychologists often 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. 

Various modalities 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

In Irvine D. Yalom's The Theory and Practice of Group Psychotherapy, a distinct set of guidelines and principles are outlined describing the commonly reported experiences from individual reports by those who have experienced various types of psychotherapy on top of their group experiences. The Irvin Yalom group psychotherapy process consists of the following principles. 

Principles of Irvin Yalom psychotherapy process

1. Persistence of hope: As sessions in groups contain individuals at different stages of group psychotherapy, seeing the success of others during the process may instill a sense of hope in others that may be starting therapy activities with groups for the first time.
2. Being one: Discussing and moving past challenging events or experiences with others in group therapy who are doing the same within the groups can allow a sense of oneness and camaraderie that may be unattainable with one-on-one treatment.
3. Imparting information: By working as a group, participants can share information that may be vital for another individual's treatment and healing.
4. Altruism: Sharing strengths with other group participants during the sessions can boost morale, self-esteem, and confidence in those just beginning therapy.
5. Corrective behavioral commentary: The group community may take the form of a primary support system in each client's life. During sessions with the groups, participants can explore past childhood experiences they believe shaped their personalities and behaviors. By sharing these experiences and behaviors while in groups, participants can learn new habits from others that are more effective, positive, and empowering.
6. Remaining social while healing in groups: The social aspect of group therapy is often beneficial. Many people withdraw when recovering or attempting to recover from a challenging experience or symptom. In therapy, others do not turn away when challenges arise.
7. Imitation: Group therapy offers the ability for members of the group to imitate others' responses and actions to scenarios that are beneficial and positive. These ideas of the groups can translate into helpful everyday social techniques.
8. Interpersonal learning: Interacting in groups with a greater diversity of people and receiving feedback in real-time can teach interpersonal skills. By getting feedback from other participants and the group therapist, new perspectives and techniques can be developed in a safe and welcoming environment in the groups without risk.
9. Catharsis: Allowing yourself to share your own problems in the groups, feelings and experiences with a group of people confronting similar experiences can allow you and the others in the groups sessions to let go of unwanted emotions.
10. Existential factors: While working through traumatic issues in a safe setting while in groups, a sense of responsibility is also absorbed through the guidance and support of group participants. Through this process in groups, individuals become aware that they are responsible for their actions and choices.

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
• 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 can also be done not just in groups, but also in an individual setting with a therapist. DBT groups are often targeted toward those experiencing symptoms of borderline personality disorder (BPD) or intense emotional reactions. Another common modality utilized by a therapist during group sessions is cognitive behavioral therapy, which can help in the management of symptoms of depression, anxiety, substance use disorder, and other conditions.

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

Some groups focus on sharing, while the focus in other groups may be more on individual concerns or lessons. Before entering a group, you may be educated 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

• 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
• Sharing stories to the group and the therapist for support and validation from the group
• Educational lectures or group workshops with a therapist

What to expect

Often, sessions in groups are around one to three hours in length, depending on the group and the therapist. In an open group, new members may join the groups at any time, whereas in closed groups, all group members begin working with a therapist at once. Groups may be held in smaller numbers so as not to overwhelm clients or the therapist. Many groups include about eight to 12 individuals with one mental health professional, such as a therapist, 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 sessions of the groups on your own. 

Support through non-individual psychotherapy and shared experiences

Group psychotherapy topics and content can vary depending on who shares their experiences. With this sense of group cohesiveness and oneness persisting in sessions, the group inadvertently provides support to all those who share 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 share opinions and ideas to help you work through challenges. 

Learning through others

For example, if you are going through a divorce, you might share your feelings or experiences and gain invaluable perspective from others in the groups who have gone through a divorce, plus the therapist. The group participants may have learned a technique that helped them and can share the information with 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 feels like the best option, small groups with a therapist 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 share with the therapist or groups you join in, you might not experience the full expected benefit of sessions. Note that the insights you share may prompt someone else to open up and feel less alone. Three common ways to get the most out of group therapy can involve the following. 

Pledge

Group therapy is a serious process for each client. Many therapists have the clients sign a contract or discuss boundaries and rules for the group during the first session before they set up meeting times. 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 share but think about skipping, try to participate in group discussion. 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. 

Share your own experiences

Sharing your trauma with others in the group allows you to remove the burdens of your experience from you while also allowing others to relate to you for their recovery. By sharing your healing journey and inner thoughts, you can support others.

Group therapy 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. 

Counseling options to support mental health

Participation, research, and responsibility may be crucial in understanding group therapy. Researching where these sessions are offered and what type of group therapy you want to try can be beneficial. Many exclusive practice therapists provide group therapy outside 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 is 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.

Benefits of online counseling

Online counseling groups enable therapists and group participants to connect from separate locations. Having a way in to 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. Other platforms, such as Regain, offer couples treatment with therapists through the internet, as well.