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What is Group Therapy?
The origins of the group therapy we know today began in the early twentieth century when it was used to support Tuberculosis patients in the hospital setting and later to support WWII soldiers (Barlow et al., 2004). Since then group therapy has undergone many changes, theoretical modalities have been created, and researchers have studied its effectiveness. Group therapy relies on the restorative power of relationships developed in a dedicated and supportive community. Joining a group provides a dedicated space for growth alongside a group of individuals who are committed to uplifting one another through the process.
What happens in a group session?
Groups can be focused on a theme, diagnosis, or lived experience (to name a few), and group members will gravitate towards themes that resonate with their goals and needs. For some, this may be the first time they have been in a community space with people who can uniquely understand part of their lived experience.
Group therapy allows for connection over common ground, whether that is the commitment to personal growth or a history of a particular diagnosis. The diversity of the group provides a wealth of unique perspectives.
Group therapy leverages the interpersonal dynamics present in the session as a vehicle for growth, and these dynamics can also shed light on specific behaviors that may not play out in individual therapy. As these dynamics unfold, they can be re-written in the here-and-now with the support of other members and the facilitator(s).
Please know that this is a high-level view of groups, and each group's content and flow will depend on the facilitators' style and modality. However, most sessions will begin and end with a check-in/out, and the rest of the session will focus on the primary theme, skill, activity, and/or a certain amount of processing.
The facilitator, a therapist, plays a pivotal role in the progression of the therapeutic aspects of group therapy. As noted above, the group leverages interpersonal dynamics and community as vehicles for growth. This process is supported by the therapist, who creates a space for these forces to unfold. Additionally, the facilitator provides feedback, supports insight development amongst members, and aids in conflict resolution as it arises.
The Seattle Psychiatrist Interview Series will be interviewing thought leaders in the group therapy space over the next few months, so please check back to hear from group therapists bringing creativity, research, and evidence-based practice to the therapeutic space.
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Is Group Therapy for Me?
Individual therapy and group therapy have their unique place in helping you achieve your personal growth goals. One of the core elements of group therapy is the community element and the focus on group dynamics as a medium for growth. Group therapy may happen in parallel to individual treatment.
Depending on group content, facilitators may have certain exclusionary criteria or requirements (e.g., suicidal ideation). Contact the facilitator if you are unsure if you qualify for a group or if the group context will appropriately meet your needs.
Reflection questions as you consider group therapy:
What goals do I have for group therapy?
What is prompting me to explore this now?
What is my previous experience with group experiences (activities, therapy, etc.), and how may that have an impact on how I show up in the group?
What concerns about the process do I have that may have an impact on how fully I show up and the extent to which I commit to the experience?
In what environment do I learn best?
Getting the most out of a group requires a commitment to the process, a willingness to be open and present, and an interest in learning from others.
Group effectiveness
Group therapy is equally effective as individual therapy in treating a wide variety of clinical concerns. In fact, in a research study comparing the two modalities, the authors concluded that there was a "significant reduction in both depression and anxiety scores... with no significant difference between group and individual therapy outcomes" (Fawcet et. al, 2019, p. 430).
Furthermore, they challenged the notion that individual therapy is the primary medium through which intense change can occur and stated, "group therapy need not be viewed as a 'step down' from individual therapy, but that it can be just as intensive of an intervention as individual therapy" (Fawcet et. al, 2019, p. 436).
Irvin Yalom, one of the primary thought leaders and researchers in group therapy, studied the factors which contribute to group effectiveness and identified a “construct of the curative process in group psychotherapy” (Butler & Fuhriman, 1983, p.131). Through decades of research on group therapy, "the triad of self-understanding, catharsis, and interpersonal learning (input) [are shown] as the most highly valued factors in outpatient therapy groups" (Butler & Fuhriman, 1983, p.140).
Image Source: The Theory and Practice of Group Psychotherapy, Yalom (1995): PositivePsychology.com
6 tips to get the most out of group:
Intention: Set a clear intention for your group experience
Fit: Identify a group that fits your needs (seek out an individual therapist and discuss with the group leader for additional support)
Relationships: Invest in the interpersonal relationship and respect each person's unique perspective and process
Growth: Utilize a growth mindset by conceptualizing tension as an opportunity for progress
Commitment: Commit to the experience and embrace the process
Openness: lead with curiosity and presence
Additional Resources
Here are a few resources to explore as you continue to learn more about group therapy and identify the best fit:
Group: How One Therapist and a Circle of Strangers Saved My Life (A New York Times Bestseller by Christie Tate, 2021)
Check out these two lighthearted videos that provide additional insight into the group process: "What is Group Therapy? An Animated Short" and this clip from The Looney Tunes Show
If you’re ever interested in joining a group, you can always reach out to the facilitator and inquire if you have specific questions about the content and/or structure of their group - or to ask if they have any further resources you can use in your journey.
If you would like to learn more about participating in an upcoming group at Seattle Anxiety Specialists, PLLC, please reach out to info@seattleanxiety.com or check here for more information.
Contributed by: Sonya Jendoubi, MS., LMHC
Editor: Jennifer (Ghahari) Smith, Ph.D.
References
1 Barlow, S. H., Fuhriman, A. J., & Burlingame, G. M. (2004). The History of Group Counseling and Psychotherapy. In J. L. DeLucia-Waack, D. A. Gerrity, C. R. Kalodner, & M. T. Riva (Eds.), Handbook of group counseling and psychotherapy (pp. 3–22). Sage Publications Ltd.
2 Fawcett, E., Neary, M., Ginsburg, R., & Cornish, P. (2019). Comparing the effectiveness of individual and group therapy for students with symptoms of anxiety and depression: A randomized pilot study. Journal of American College Health, 68(4), 430–437. https://doi.org/10.1080/07448481.2019.1577862
3 Butler, T., & Fuhriman, A. (1983). Curative factors in group therapy. Small Group Behavior, 14(2), 131–142. https://doi.org/10.1177/104649648301400201