Unsure about Group Therapy?

 

Since coming to Ontario in 2004, I have done more than half of my clinical work as a group therapist.  While no method is right for everyone, group therapies fit more people than you might think.

 

All the studies of individual versus group therapies point to several broad conclusions:  Both approaches work about 85% of the time, with group therapy being marginally better at improving interpersonal skills and reducing anxiety.  A major benefit of group therapy is that it is less expensive.  For some conditions, such as Post Traumatic Stress Disorders or personality disorders, a combined approach seems to have the most positive outcomes. I have some criticisms of the current state of research on group therapy that I will share in a future blog.

 

I think that there are two really important things to consider regarding the public shyness about group therapy.  What you think you know about group therapy may not be accurate.

 

The first is the TV and movie portrayal of therapy in general and group therapy in particular.  “Newhart”, “Celebrity Couples Therapy” and the more recent “Go On” with Mathew Perry are all about the circle of chairs and people making comments about each other’s business – often snide or bizarre.  The intent to entertain is the main content here – not the therapeutic value of belonging to a group of persons with similar challenges learning coping skills in a supportive environment.  I wouldn’t set foot in a room like that if I thought someone would use my problem as a way to amuse themselves.  On the other hand, and at least as important, laughter is a very common element in group therapy.  Just not ‘at someone’.  Sharing a common experience, having an ‘aha!’ moment, or someone cracking a joke at their own struggles often brings laughter to the group and is healthy when good boundaries are in place between the group members.

 

The second issue is that circle conversation.  Not all group therapy is about sitting in a circle unprotected.  Many different ways are used, including around a table, or in rows such as AA uses, or scattering around a room to work on materials individually or in small groups.  Group therapy comes in different modes as well.  Some groups are informational and are intended to provide the participants with ideas they can put to use in daily life.  This is called psychoeducation.  Some groups are support groups – these may be run with peer leaders or may be led by a professional.  Some groups are called process groups, and these are intended to create personal reflection and insight in the participants.  Depending on the approach used, these may be more or less intensely personal.  In every case, participants have control over how much they reveal about themselves.  While coming to an informational group may require virtually no personal exchanges, it is expected in a process group that people speak bout themselves and how the material affects them.  Most therapy programs that include groups use a combination of all these types, and certain specific groups may use two approaches in the same session.

 

What I have found is that meeting the group leader ahead of the first day of attendance is helpful for most people.  Another way of easing into a group is by knowing another participant.  When signing up for a group therapy, it may be helpful to ask someone with a similar issue to consider attending as well.  And when there is no alternative to taking the plunge alone, remember what I tell people at the public program I work in:  “Try it three times before you make up your mind.  The first day you might be too anxious to do more than settle into the room and watch the way the people behave.  The second day you will be able to listen fully.  By the third visit you will know in yourself if the group has anything useful to offer you specifically”.

 

Group therapy has some advantages over individual therapy.  There is an energetic transference in a group that is missing in one to one work.  Also, it is possible to become emotionally dependent on a therapist, but this is less likely to occur in group work.  The opportunity to listen to another person work out a problem may give additional ideas, or tell you what would not work without having to have the experience yourself.  It is generally less expensive for the same amount of individual treatment.  And you may make social connections you would not have had any other way of forming.  By and large, people who seek therapy are interested in becoming better people – which is a pretty great way to be.

 

I am not recommending you ‘do therapy’ to make friends, but in attending group therapy, don’t be surprised if you find positive relationships among the members.

 

Hope we see you there!

 

 

 

Reference:

Chen, E., Touyz, S.W., Beumont, P., Fairburn, C.G., & Griffiths, R., et al (2002). Comparison of Group

and Individual Cognitive-Behavioral Therapy for Patients with Bulimia Nervosa. Eating Disorders

Research Society, Retrieved 10/22/08,from http://www.interscience.wiley.com.

DeRubeis, R, & Crits-Christoph, P (1998). Empirically supported individual and group psychological

treatments for adult mental disorders. Journal of Consulting and Clinical Psychology. 22, 37 – 52.

Fals-Stewart, W, Marks, A, & Schafer, J (1993). A comparison of behavioral group therapy and individual

behavior therapy in treating obsessive-compulsive disorder. The Journal of Nervous and Mental Disease.

181, 189-193.

Manassis, K., Mendlowitz, S., Scapillato, D., Avery, D., Fiksenbaum, L., & Freire, M., et al (2002). Group

and individual cognitive-behavioral therapy for childhood anxiety disorders: a randomized trial. 41, 1423-

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Stangier, U, Heidenreich, T, Peitz, M, Lauterback, W, & Clark, D.M Cognitive therapy for social phobia:

individual versus group treatment. Behavior Research and Therapy. 41, 991-1007.