What Is Group Therapy? How Does It Work?

Group therapy is a form of psychotherapy that involves one or more therapists working with several people at the same time. This type of therapy is widely available at a variety of locations including private therapeutic practices, hospitals, mental health clinics, and community centers. Group therapy is sometimes used alone, but it is also commonly integrated into a comprehensive treatment plan that also includes individual therapy and medication.

The Principles of Group Therapy

In The Theory and Practice of Group Psychotherapy, Irvin D. Yalom outlines the key therapeutic principles that have been derived from self-reports from individuals who have been involved in the group therapy process:

The instillation of hope: The group contains members at different stages of the treatment process. Seeing people who are coping or recovering gives hope to those at the beginning of the process.
Universality: Being part of a group of people who have the same experiences helps people see that what they are going through is universal and that they are not alone.
Imparting information: Group members can help each other by sharing information.
Altruism: Group members can share their strengths and help others in the group, which can boost self-esteem and confidence.
The corrective recapitulation of the primary family group: The therapy group is much like a family in some ways. Within the group, each member can explore how childhood experiences contributed to personality and behaviors. They can also learn to avoid behaviors that are destructive or unhelpful in real life.

Development of socialization techniques: The group setting is a great place to practice new behaviors. The setting is safe and supportive, allowing group members to experiment without the fear of failure.
Imitative behavior: Individuals can model the behavior of other members of the group or observe and imitate the behavior of the therapist.

Interpersonal learning: By interacting with other people and receiving feedback from the group and the therapist, members of the group can gain a greater understanding of themselves.
Group cohesiveness: Because the group is united in a common goal, members gain a sense of belonging and acceptance.
Catharsis: Sharing feelings and experiences with a group of people can help relieve pain, guilt, or stress.
Existential factors: While working within a group offers support and guidance, group therapy helps member realize that they are responsible for their own lives, actions, and choices.

How Does Group Therapy Work?

Groups can be as small as three or four people, but group therapy sessions often involve around seven to twelve individuals (although it is possible to have more participants). The group typically meets once or twice each week for an hour or two.

According to author Oded Manor in The Handbook of Psychotherapy, the minimum number of group therapy sessions is usually around six but a full year of sessions is more common. Manor also notes that these meetings may either be open or closed. In open sessions, new participants are welcome to join at any time. In a closed group, only a core group of members are invited to participate.

So what does a typical group therapy session look like? In many cases, the group will meet in a room where the chairs are arranged in a large circle so that each member can see every other person in the group. A session might begin with members of the group introducing themselves and sharing why they are in group therapy. Members might also share their experiences and progress since the last meeting.

The precise manner in which the session is conducted depends largely on the goals of the group and the style of the therapist. Some therapists might encourage a more free-form style of dialogue, where each member participates as he or she sees fit.

Other therapists instead have a specific plan for each session that might include having clients practice new skills with other members of the group.

How Effective Is Group Therapy?

Group therapy can be very effective, especially in certain situations. Studies have shown that group therapy can be an effective treatment choice for depression and traumatic stress.

An article published in the American Psychological Association's Monitor on Psychology suggests that group therapy also meets efficacy standards established by the Society of Clinical Psychology (Division 12 of the APA) for panic disorder, bipolar disorder, obsessive-compulsive disorder, social phobia and substance abuse.

Reasons to Use Group Therapy

The principal advantages of group therapy include:

Group therapy allows people to receive the support and encouragement of the other members of the group. People participating in the group can see that others are going through the same thing, which can help them feel less alone.
Group members can serve as role models to other members of the group. By observing someone successfully coping with a problem, other members of the group can see that there is hope for recovery. As each person progresses, they can, in turn, serve as a role model and support figure for others. This can help foster feelings of success and accomplishment.
Group therapy is often very affordable. Instead of focusing on just one client at a time, the therapist can devote his or her time to a much larger group of people.
Group therapy offers a safe haven. The setting allows people to practice behaviors and actions within the safety and security of the group.
By working in a group, the therapist can see first-hand how each person responds to other people and behaves in social situations. Using this information, the therapist can provide valuable feedback to each client.

_Sources:

_{Dies, R.R. (1993). Research on Group Psychotherapy: Overview and Clinical Applications. In Anne Alonso & Hillel I. Swiller (Eds.), Group therapy in clinical practice. Washington, DC: American Psychiatric Press.}

_{Kanas, N (2005). Group Therapy for Patients with Chronic Trauma-Related Stress Disorders. International Journal of Group Psychotherapy, 55 (1), 161-6.}

_{Paturel, A. (2012). Power in Numbers. Monitor on Psychology, 43(10), 48. Retrieved from http://www.apa.org/monitor/2012/11/power.aspx.}

_{Manor, O. (1994). Group Psychotherapy. In Petrūska Clarkson & Michael Pokorny (Eds.), The Handbook of Psychotherapy. New York, NY: Routledge.}

_{McDermut W et al. (2001) The Efficacy of Group Psychotherapy for Depression: A Meta-Analysis and Review of the Empirical Research. Clinical Psychology: Science and Practice, 8, 98-116.}

_{Yalom, I. D., & Lesczc, M. (2005). The Theory and Practice of Group Psychotherapy. New York, NY: Basic Books.}