In many hospital-settings, group therapy tends to be the norm for folks wanting to receive therapy. This is because of the high demand for mental health services and limited resources in these healthcare settings. As a result, individual therapy is more rare compared to group-based therapy.

When people think about group-based therapy, there can be concerns that come up:

  • “What should I expect?”
  • “Will I get better?”
  • “What will it be like with other people around?”
  • “What if I don’t know what to say?”
  • “Are people going to think I am weird?”

These worries can make it hard for some folks to jump into unknown and act as a barrier to get therapy. This post offers some clarity into the group treatment process to hopefully reduce some anxiety.   

Format of Group Therapy

Group therapy is usually much more structured than individual therapy. For example, a group therapy for depression might have 15 sessions where the facilitators (mental health professionals like counsellors, social workers, and psychologists) and group members meet once a week for two hours.

The first hour is usually reserved for checking in on home practice and progress over the past week. The facilitators will work with each client to figure out what has been going well and troubleshoot things that have acted as obstacles to progress. It’s not shameful to have had difficulties with home practice – that is what the groups are for!

The second hour typically focus on new teaching for the week and assigning new home practice. For example, learning how to challenge negative beliefs through thought records.

The first session can be a bit different. For example, the first session will focus on introductions, learning more about each person’s goals, and housekeeping (e.g., limits to confidentiality). Some folks worry about whether the information they share in groups are kept confidential. The answer is yes – group members and facilitators are encouraged to keep everything discussed in group to be stay in groups.

And don’t worry about what to say in any of these situations. The facilitators will take the lead, so just go in with an open mind!

Benefits of Group Therapy

Below are some benefits that I have found true over my time as a facilitator:

1. Group therapy is normalizing: Sometimes folks with certain conditions – trauma, obsessive-compulsive thoughts and urges, or anxiety – tend to feel that there is something inherently wrong with them. They feel that nobody understands their experience. Group therapy, where folks with similar challenges come together, can therefore be a normalizing experience. People can realize that their situations are not one of a kind and they can be a non-judgmental space. This recognition can be healing in and of itself to reduce stigma and shame.

2. Group therapy increase accountability: What you do outside of sessions is arguably more important than what you do inside a session. And some folks have difficulty trying out home practice between treatments sessions. However, when you have multiple pairs of eyes looking at you, you may be more likely to put in a bit of extra effort into your practice. This may lead to greater engagement and more positive outcomes.

3. Group therapy allows for shared wisdom: Although it may seem like a bit of a chore to listen to other people’s experience, this can be quite beneficial. Specifically, we may be able to take away from this community of knowledge and apply it to our own lives. On the other hand, we might also be able to provide our lived experiences and expertise to support other people. Helping other people can be affirming and increase our own resilience and self-esteem.

4. Group therapy can be cozy and supportive: Getting support from therapists is nice. Getting support from other humans who share a similar struggle can be enormously validating. I’ve had many therapy groups where group members were very supportive of each others’ progress. They were willing to let each other know how proud they are of the progress others have made. Again, this can be a very affirming experience and cultivating these type of support networks is understated in improving our mental health.

5. Group therapy is effective: There is significant research evidence to suggest that individual and group therapy can. both be equally effective. Regardless of what treatment you get, the most important. components are fairly controllable: 1) your attendance and engagement with home practice; 2) willingness to be vulnerable and stay curious; and 3) feelings of hope and expectations for progress in treatment.

Limitations of Group Therapy  

Despite the benefits, there are limitations of group therapy. A few are listed below:  

1. Group therapy can be less accessible: Because of the group format, there is a need to stay with a certain agenda and provide information in a structured way. For folks with certain accommodation needs (e.g., English is not their first language), this can be tricky to meet clients where they are at all the time. In some cases of accessibility challenges, individual therapy may be a better fit.

2. Group therapy makes it hard to go very deep: For some folks, there is usefulness in diving deep into the person’s specific thoughts, emotions, or past experiences. Because of the nature of group therapy, there is limited time to check in with each client and the check-ins are fairly superficial. This is necessarily to balance time and make sure every client feels supported.  However, there are certainly some clients that would benefit from a more in-depth approach.

3. Group therapy can be triggering: There will be times when other people say things that can bring up upsetting feelings. For example, a person may talk about substance use in the presence of someone struggling with staying abstinent. This can of course be distressing in the moment. However, I believe these experiences are important because groups can be seen as a micro-version of the larger world. It’d be pretty hard to go through life without ever hearing your triggers. Being able to sit with and process this distress in a therapeutic space is therefore an important part treatment.

How to Get the Most out of Group Therapy

Attend the sessions, do the homework, and be willing to open and honest about your experience. Just following these points will get you far. There’s no need to put pressure on yourself on what you need to say or do. Just keep a curious mind and enjoy the experience!

If this post motivated you to seek help, congratulations on taking your first step! And I do hope you have a productive and positive time in groups.

Best wishes,

P

Photo by Danie Franco on Unsplash