written by Tracy Miles
(originally published at www.energytap.ca June 8, 2021)
Sometimes people ask us, what is group therapy? Many people do not understand what group therapy is and how it works. This post is about bringing you closer to being informed.
At Energy Tap and Life Medicine, we offer group therapy. This is a form of psychotherapy that involves sitting with one therapist, a physician who is also trained in psychotherapy, and other participants.
In a group, therapists are working with several people at the same time. Some people who chose group psychotherapy use it as their only form of psychotherapy and others integrate group into their individual experience.
We use an interpersonal approach to offering group:
We focus on your interpersonal relationships and social interactions, including how much support you receive and take from others and the impact these relationships are having on you. As the group begins to form, so do the relationships between members. What eventually happens is that these relationships begin to bring out the same behaviours and defenses you use in your everyday life and relationships. The group members and facilitators help you to grow in awareness of how you are impacting others and how others are impacting you. This is done through a process of connection and feedback.
Groups often involve around 8 to 12 individuals (although it is possible to have more participants, our groups remain at a cap of 8 because of COVID-19 protocols). The group meets once a week for 75 minutes.
Techniques
So, what does a typical group therapy session look like? The group will meet in a one of our larger rooms where comfortable chairs are arranged in a large circle so that each member can see every other person in the group.
A first session might begin with members of the group introducing themselves and sharing why they are in group therapy. Members might also share their experiences.
In our groups we encourage a more free-form style of dialogue, where each member participates as he or she sees fit. Our therapists do not have a specific plan for how each session goes. Members of the group choose when and what they are sharing about. Our therapists do encourage dialogue amongst the group members once a person has shared the content of their experiences.
Group therapy is used to treat a wide variety of conditions, including:
Depression
Generalized anxiety disorder
Panic disorder
Phobias
Post-traumatic stress disorder
Substance use
And more
In addition to mental health conditions, group psychotherapy has been found to help people cope with the following:
Anger management
Chronic pain
Chronic illness
Chronic stress
Divorce
Domestic violence
Grief and loss
And more
In The Theory and Practice of Group Psychotherapy, Irvin D. Yalom outlines the key therapeutic principles:
Altruism: Group members can share their strengths and help others in the group, which can boost self-esteem and confidence.
Catharsis: Sharing feelings and experiences with a group of people can help relieve pain, guilt, or stress. It can be very healing to have others witness what you are experiencing.
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.
Existential factors: While working within a group offers support and guidance, group therapy helps members realize that they are responsible for their own lives, actions, and choices.
Group cohesiveness: Because the group is united in a common goal, members gain a sense of belonging and acceptance.
Imparting information: Group members can help each other by sharing information.
Imitative behavior: Individuals can model the behavior of other members of the group or learn from the behavior of the therapist.
Instills 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.
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.
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.
Who is best suited for group therapy?
People who join an interpersonal therapy group usually want to be able to relate better with others and to feel better about themselves. Reasons a person may join an interpersonal group may include:
You often feeling angry, frustrated, or dissatisfied in relationships
You are having difficulty trusting others
You are struggling to create close (or meaningful) relationships
You feel that you are stuck in a cycle of needing to please others
You struggle to communicate your thoughts, feelings, and needs directly
You are controlling (or easily controlled) in relationships
You experience anxiety in social situations
You are struggling with substance use or addiction
You frequently experience loneliness
You find that you have to manipulate others to get your needs met
You have trouble with self-esteem
Benefits of 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 for 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.
Things you will need to Consider AND FAQS
If you or someone you love is thinking about group therapy, there are several things you should know:
You need to be willing to share and commit to a 6-month process. The group takes a while to form so you need to be patient with the process
It’s not meant for crisis, if you are experiencing crisis, individual therapy is a better choice than group therapy.
How will my relational patterns play out in the group?
It is important to see how group is a social microcosm of what happens in everyday life. People who avoid connection in life avoid connecting in group, people who consistently experience anger in life experience anger in group, people who avoid conflict in life avoid conflict in group, and people who have difficulty with trust in life struggle with trust in group. The unconscious relational patterns that govern our lives outside of group (which we have learned over the course of our life) govern our lives in group. The important difference between everyday life and group is that in group we are given the opportunity to become aware of how these patterns play out and why, which over time allows us to begin to make different choices about how we relate with ourselves and others. Quite simply, this process can be very freeing.
Do I need to be in individual therapy to be in an interpersonal group?
This depends. Some people benefit from continuing to see their individual therapist, and they participate in group because it provides the opportunity to try out what they may be working on in individual therapy. Being in a group can also help stimulate things to work on in individual therapy.
Additionally, some people choose to continue to see their individual therapist but do so on a less frequent basis. All of that said, a person does not have to be in individual therapy to be in a therapy group.
Will I be forced to cry, share, or give feedback?
Not at all. You will not have to do anything you do not want to do. Like a lot of things, though, the amount of effort you put into group will be reflected in the outcome you obtain. Everyone is encouraged to be as present as possible and to be engaged in the process. By being present and engaged you not only help yourself but you also help other group members.
How do I know things will remain confidential?
Members in the group make an agreement to keep what is said in group completely confidential. In fact, everyone in group signs a group agreement that stipulates that they will keep the material discussed in group confidential. Members are allowed to talk about their own experience in group with whomever they like but agree to refrain from talking about other group members. The group therapist is required to keep everything said in group confidential.
How long do I need to be in the group?
This depends. As a general rule, we ask that you give the process about 6 months. The scientific evidence shows that group psychotherapy begins to show significant benefit around the 3 month mark. We therefore encourage group members to commit to at least 3 months of participation, in group, and preferably 6-months.
What if I decide I want to leave?
You can always leave the group. We ask that you let the other group members know about your intent to leave and give the group enough time (preferably a session or two) to process your departure. It is preferable to have closure when people leave and we understand that sometimes this is not a possibility.
This whole process sounds interesting but different. Is getting accustomed to the group challenging?
The answer to this question is yes and no. Usually in the beginning, as a group is forming, there is a certain amount of discomfort among everyone as things can feel a little formal. People are trying to get a sense of their place in the group. After a period of time, though, the group figures out how to make use of the opportunity they have together. Members become more open and honest about their moment-to-moment reactions and develop greater comfort with authentic engagement.