When I teach graduate courses on group psychotherapy, I usually find many of my students are surprised that scientific research strongly supports group therapy as an effective treatment. I'm actually embarrassed to admit that I used to think that way, too. But I have had many years of training, learning, practice, and also have participated in group therapy many times myself, and I now feel very differently.
Group therapy is not a substitute for individual therapy; rather, both forms of treatment are best suited for different aspects of the same problems. There are benefits and problems with each form of treatment. Some benefits of individual treatment are that it can be laser-focused on particular issues, high-risk (e.g., suicide) situations can be adequately monitored, and a variety of specialty treatments have been tailored for individual use only. However, there are some unique benefits that only a group therapy setting can offer.
For example, group therapy (when done correctly) provides you with an almost instant, safe new support system. In addition, hope usually builds quickly because new group members observe as older group members, with similar life experiences and problems, discuss the progress they have made toward their goals. Further, feelings of isolation (and of being secretly "defective") usually start to dissolve swiftly within the group setting as it is discovered that other people have been through the same awful experiences and have had the same embarrassing symptoms or reactions. Finding out that you are not alone can provide a huge sense of relief and accelerate the healing process.
Another benefit of group therapy is that clients (who often enter treatment feeling a deep sense of having “nothing to offer” others) regularly find that within a group setting, the other members truly appreciate their support, ideas, and suggestions. This can boost self-esteem and begin the process of thinking about themselves in a new, less critical way.
The most important benefit of group therapy, in my opinion, is that the many interpersonal patterns that play out in real life but that do not show up in the more focused and controlled individual therapy environment, often come to light during group therapy. This is important to note because most psychological issues can, at least partly, be traced to the way we misperceive and then interact with others, meaning that a treatment that can target these issues—like group therapy—is invaluable. Consider these examples:
Anxiety: As humans, anxiety is often related to worries about safety or of being criticized or humiliated—sometimes this is a very appropriate response to particular unsafe or unfriendly situations. However, when we begin treating all situations and people as scary, we humans have a tendency to worry about them, then avoid them. Since this is often followed by NOT feeling worse, our minds conclude that worry and avoidance are actually the key to keeping us safe. Unfortunately, this process strengthens the anxiety response further. The big problem in all this is that, if only a few of the people and situations in our lives are truly unsafe, yet we avoid and then label ALL people and situations as unsafe, we miss out on life and spend most of what is left feeling worried all the time. One part of the cure is learning to distinguish between safe and unsafe people and situations, and then experimenting so that your mind can see that your ability to identify and handle safe situations is the actual key to keeping you safe. Group therapy can provide an opportunity to learn these new skills.
Trust issues: Trust issues that may have developed (oftentimes, for a very good reason) in one part of our lives may be inappropriate when applied to other areas. This can cause us to miss out on experiencing deep, fulfilling relationships with safe others. One part of the cure is having a controlled, safe place to practice and learn how to trust others appropriately. A well-run group fosters such an environment and can be transformative for many struggling with generalized trust issues.
Depression: Depression is usually accompanied by the strong urge to withdraw from all people. One reason many clients site is that it “takes too much energy” to be around people or that their interactions with key others are dysfunctional and feel bad. But social isolation can cause a vicious cycle of withdrawing, feeling lonely and hopeless, becoming more depressed, then withdrawing some more. However, our brains have a hard-wired need to be around others and our brains are biologically wired with the ability to regulate each other’s emotions. One part of the cure is exposure to warm, supportive social interactions with safe others so their brains can help us emotionally regulate, and so that we can also remind our minds how to feel happy again. By simply attending the group each week, a depressed client is exposed to a supportive network of new friends and has decreased the number of days per week spent in social isolation. It is worth noting one more thing. Another common aspect of depression is that when we are feeling depressed, isolated, alone, and worthless we may not realize that our body language or the way they speak with others is inadvertently sending the message to stay away or "leave me alone." Therefore, another part of the cure is becoming better at noticing interaction patterns and changing any misperceptions or unintentional off-putting behaviors—first within the group and then outside in the real world.
To summarize, a major strength of high-quality group therapy is that it can offer group members accurate interpersonal feedback as they safely experiment outside of their usual social environment. It can help members learn where they have discrepancies or blind spots in their thinking and behavior. It can expose members to a whole new source of social support. members can practice using different reactions within the group where they can get honest feedback and process their experience. Eventually, most of my clients find they begin naturally using their newly created patterns outside of the therapy room, without even trying to do so. It is pretty great!
In conclusion, I give group therapy a great big “Yay!” It could become your most valued social support network; a safe sounding board for all sorts of issues and ideas; a great source of ideas for improving a difficult or challenging situation; and a great place to discover, experiment, and practice interpersonal patterns. The bottom line here is that group therapy is a great modality all by itself, and it is often just what is needed to round out individual treatment. Why not give it a try?
I hope this was helpful!
Dr. Carey
P.S. Please contact us and let us know what groups you would like us to offer in the future, or if you would like to be placed on a group’s waiting list!