What is group Therapy?
Group therapy involves one or more therapists leading a group of 6 to 15 members. Typically, groups will meet for between one and two hours each week. Many groups are designed to target a specific problem, such as depression, obesity, panic disorder, social anxiety, chronic pain or substance abuse. Other groups focus more generally on improving social skills, helping people deal with a range of issues such as anger, shyness, loneliness and low self-esteem. Some groups work for a specific length of time - 10 weeks for example, whilst others are open-ended. Often, fixed-term groups will be set up with a specific focus, and have a series of activities which will allow the group to focus on different aspects of that focus. Open-ended groups may not have a specific focus, but can allow for relationships within the group to deepen and become very creative and productive. One of our introductory workshops can give you a taste of what you might expect from being in a group, and give you a taste of the experience.
Some groups have predefined rules for the group, often around aspects such as attendance, confidentiality, start and finish times etc; whilst other groups might explore the formation of group rules and what we all need to create a space for exploration and experimentation whilst at the same time being safe, as the group develops. What each individual might need in order for a group to be safe enough for them whilst at the same time flexible enough to allow for risk and challenge will be different for each person.
Benefits of Group Therapy
Joining a group of strangers may sound intimidating at first, but group therapy provides benefits that individual therapy may not. Group members are almost always surprised by how rewarding the group experience can be; have a look at the testimonial statements in the right-hand column.
Why group therapy is so effective
If you are considering counselling/psychotherapy, group therapy is an option for you to consider. Even if life is not presenting you with difficulties, and you aren’t considering psychotherapy/counselling, group therapy is worth doing as an experience that can support you in getting even more out of life. Very often people only seek our services when difficulty has not only arisen in their lives, but has also been a source of difficulty, sometimes for many years. Couples often come for therapy after enduring many years of conflict. One of the principle aims of OTS is to let you know about the rare and creative opportunities which group work offers whatever your individual circumstances, and to take advantage of this area of psychological and emotional development prior to even needing it.
Here are some of the many reasons, in no particular order, why group psychotherapy can be such a powerful, effective and productive experience.
Universality: The recognition of shared experiences and feelings.
As a group develops relationships between members deepen and become more trusting. When this happens, you get to appreciate how your experiences and feelings are quite common. Exploring the human condition or universal human concerns reduces your sense of isolation, validates your experiences, and raises self-esteem.
Universality: Habitual Positions
As neuroscience now supports, one of the most profound benefits of being in a group is realising that we all have blind spots in what we know about ourselves. As we each develop, we do so with different rules, belief systems and ways of relating both to ourselves and each other. In other words we develop our own habitual patterns in how we behave, feel and respond. Exploring these habitual patterns, which are bound to arise in a group, and trying out new ones can be very powerful in making changes in your life.
The group is a place where you can help each other, and the experience of being able to give something to another person can lift your self esteem and help develop better coping styles and interpersonal skills.
Instillation of hope
In a mixed group that has members at various stages of development/emotional maturity, you can be inspired and encouraged by another member who has overcome the problems with which you are still struggling.
We all know stuff! Because a group is an opportunity to talk about life at a depth and in a way that is not available in everyday social circumstances, you can learn things from each other that can be useful for what you are dealing with in your everyday life.
Development of socialising techniques
The group setting provides a safe and supportive environment for you to take risks by exploring and extending your repertoire of interpersonal behaviour and social skills.
It has been suggested that this is the primary therapeutic factor from which all others flow. Humans are herd animals with an instinctive need to belong to groups, and personal development can only take place in an interpersonal context. A cohesive group is one in which all members feel a sense of belonging, acceptance, and validation.
Catharsis is the experience of relief from emotional distress through the free and uninhibited expression of emotion. When members tell their story to a supportive audience, they can obtain relief from chronic feelings of shame and guilt.
You will achieve a greater level of self-awareness through the process of interacting with others in the group, who give feedback on the your behaviour and impact on others.
This factor overlaps with interpersonal learning but refers to the achievement of greater levels of insight into the genesis of one's problems and the unconscious motivations that underlie one's behaviour.
Research on group therapy effectiveness
There is clear evidence for the effectiveness of group psychotherapy
Most outcome research referenced here is carried out using time-limited therapy. However, good outcomes have also been demonstrated for long-term group psychotherapy (2) with a diverse group membership and an open-ended time scale. (1) Group Therapy has been shown to be as or more effective than individual therapy for higher functioning adults (Gardenswartz, 2009, Los Angeles, CA). Clinical cases have shown that the combination of both individual and group therapy can be most beneficial.
For depression: a meta-analysis of 48 studies showed an overall effect size of 1.03, which is clinically highly significant.(3) Similarly, a meta-analysis of five studies of group psychotherapy for adult sexual abuse survivors showed moderate to strong effect sizes,(4) and there is also good evidence for effectiveness with chronic traumatic stress in war veterans.(5) There is less robust evidence of good outcomes for patients with borderline personality disorder, with some studies showing only small to moderate effect sizes.(6) These poor outcomes might reflect a need for additional support for some patients, in addition to the group therapy. This is borne out by the impressive results obtained using group psychotherapy with individual psychotherapy.(7)
(1)Yalom and Leszcz (2005) The Theory and Practice of Group Psychotherapy, 5th edition, Basic Books p. 272
(2)Lorentzen S, Bogwald K, Hoglend P. (2002) "Change during and after long-term analytic group psychotherapy." International Journal of Group Psychotherapy. 52 (3), 419–30
(3) 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
(4)Callahan, K (2004) A review of interpersonal-psychodynamic group psychotherapy outcomes for adult survivors of childhood sexual abuse. International Journal of Group Psychotherapy, 54 (4): 491–519
(5)Kanas, N (2005) "Group Therapy for Patients with Chronic Trauma-Related Stress Disorders." International Journal of Group Psychotherapy, 55 (1), 161–6
(6)Kanas, N (2006) "Long-Term Psychodynamic Group Therapy for Patients with Personality Disorders." International Journal of Group Psychotherapy 56 (2), 245–51
(7)Bateman A (2008) "8-Year Follow-Up of Patients Treated for Borderline Personality Disorder." American Journal of Psychiatry, 165 (5)
So which should I do?
It is in the nature of group therapy that you will be invited to explore new ways of relating. However, there is no expectation that you will stretch yourself beyond your willingness, as it is important that the group develops as a safe place; when we try out new things, we don't try them out in a dangerous situation, we try them out in a safe place. Group therapy is a very rare and unusual creative social space precisely because there is this balance between safety, and a commitment to explore and experiment.
The group, with a diversity of members, becomes a microcosm of our lives, and grows more effective and efficient over time, as you learn to use the group to experiment and to reflect on the different responses and reactions each member has, enabling you to discover new ways of living more joyously, harmoniously and effectively.
Individual counselling and psychotherapy is by definition one-to-one. Whilst there is no requirement to talk about anything in a group, you may feel more comfortable in a one-to-one relationship, where the entire therapy hour is for you directly. In a group it can take some people time to 'find their voice', and take space and time in the group for their issues. In individual therapy, there is not this competition.
If you explore the research referenced above, you will find ample evidence that being in both kinds of therapy at the same time is highly supportive. Participating in both types of psychotherapy can boost your chances of making valuable, lasting changes. Although sometimes cost can be a consideration, group therapy is usually accessed for a lower fee than individual therapy. If it is achievable to do both, individual therapy is a great benefit to help you process and benefit from your experiences in the group. If you are already in individual therapy, you are encouraged to discuss the option with your therapist.