Group Therapy

The simultaneous treatment of several clients who meet regularly under the guidance of a therapist to obtain relief from particular symptoms or to pursue personal change.

Group therapy is a general term for a form of psychotherapy in which one or two therapists treat several clients as a group. The approach may employ various specific methods of psychotherapy, including psychodynamic, cognitive-behavioral, interpersonal, and phenomenological, but is most often associated with psychodynamic therapy, in which group process is used to effect change in the members by developing and examining the interpersonal relationships within the group.




A group of men attend a substance abuse therapy session.





A group of men attend a substance abuse therapy session.
(© David Grossman/Photo Researchers, Inc.)

Practitioners of group therapy are mental health professionals licensed or certified as psychiatrists, clinical psychologists, social workers, pastoral counselors, marriage and family counselors, or substance abuse counselors. They can receive specific certification as group therapists from the International Board for Certification of Group Psychotherapists, which is located in the headquarters of the American Group Psychotherapy Association (AGPA).

Background




Meeting of a support group.





Meeting of a support group.
(© Monkey Business Images/Shutterstock.com)

Influenced by Moreno's approach, new actionbased methods were introduced in the 1960s, including encounter groups, sensitivity training, marathon groups, and transactional analysis, whose foremost spokesperson was Eric Berne (1910–1970). Marathon groups, which can last for extended periods of time, are geared toward wearing down the members’ defenses to allow for more intense interaction. In addition to the adaptation of individual psychotherapeutic methods for groups, the popularity of group therapy has also grown out of the development of methods initially intended for groups, including Kurt Lewin's (1890–1947) work with T-groups at the National Training Laboratories (now the NTL Institute for Applied Behavioral Science) in Bethel, Maine, during the 1940s and similar work by researchers at the Tavistock Institute in London.

Basic structure and principles

The average group has 6–12 clients who meet at least once a week. All matters discussed within the group remain confidential. The therapist's functions include facilitating member participation and interaction, focusing conversation, mediating conflicts among members, offering emotional support when needed, facilitating the establishment of group rules, and ensuring that the rules are followed.

There are some possible disadvantages to group therapy. Some clients may be less comfortable speaking openly in a group setting than in individual therapy, and some group feedback may actually be harmful to members. In addition, the process of group interaction itself may become a focal point of discussion, consuming a disproportionate amount of time compared with that spent on the actual problems from which its members are seeking relief.

There are many different types of therapy groups, and a wide variety of approaches are used in them. Group therapy may be used in such different settings as hospital psychiatric inpatient wards, day hospitals, and private psychotherapy offices. Some groups are organized around a specific problem (such as eating disorders or alcohol dependence) or a type of client (such as single parents), or with the goal of acquiring a particular skill (such as assertiveness training). Although most groups are based on classical psychotherapeutic “talk” therapy, there are also groups based on such expressive therapies as art, music, or dance therapy.

Groups can be open or closed to accepting new members after the initial session, and their meetings may be either time-limited or open-ended sessions. Most group therapy sessions are 60–90 minutes in length.

Self-help mental health groups

Since the 1980s, techniques borrowed from group therapy have been widely used by a profusion of self-help groups consisting of people who share a specific problem or situation ranging from single parenthood and overeating to drug addiction, child abuse, and cancer. Some, like Emotions Anonymous (EA) and GROW, are based on the Twelve Steps of Alcoholics Anonymous. The primary difference between these groups and traditional group therapy sessions is the absence of facilitation by a mental health professional. Most mental health professionals in the United States have a favorable opinion of self-help groups and refer clients to them. In addition, there is very little evidence of antagonism toward mental health professionals on the part of members of self-help groups.

KEY TERMS

Gestalt therapy—
An existentialist form of psychotherapy developed by Fritz Perls that emphasized the relationship between therapist and client, living in the here-and-now, and taking personal responsibility for one's life. It should not be confused with Gestalt psychology.
Psychodrama—
A form of group psychotherapy in which members of the group engage in spontaneous self-dramatization and role playing underthe guidance of a therapist in order to gain insight into their lives.
T-groups—
Also called training groups or sensitivity training groups, small groups of people (typically 8 to 15) who usefeedback, problem solving, and role playing to gain insights into themselves and one another.
Transactional analysis—
An approach to psychology and psychotherapy based on the premise that humans are social creatures and that insights can be gained by examining the interactions (transactions) among people.

See also Gestalt therapy ; Transactional analysis .

Resources

BOOKS

Corey, Gerald. Theory and Practice of Group Counseling, 9th ed. Boston, MA: Cengage Learning, 2015.

Derrickson, Hellen, ed. Group Therapy: Theory, Practices and Effectiveness. New York: Nova Publishers, 2015.

Jacobs, Ed E., et al. Group Counseling: Strategies and Skills, 8th ed. Boston, MA: Cengage Learning, 2016.

PERIODICALS

Heru, A.M. “Role Play in Medical Education to Address Student Mistreatment.” AMA Journal of Ethics 16 (March 2014): 177–181.

Hundt, N.E., et al. “Veterans’ Perspectives on Benefits and Drawbacks of Peer Support for Posttraumatic Stress Disorder.” Military Medicine 180 (August 2015): 851–856.

WEBSITES

American Group Psychotherapy Association (AGPA). “What Is Group Psychotherapy?” http://www.agpa.org/home/practice-resources/what-is-group-psychotherapy- (accessed August 12, 2015)

American Psychological Association (APA). “Psychotherapy: Understanding Group Therapy.” (accessed August 12, 2015). http://apa.org/helpcenter/group-therapy.aspx (Accessed August 12, 2015).

Emotions Anonymous International (EA). “EA's Twelve Step Program.” http://emotionsanonymous.org/EATwelveStepProgram.pdf (accessed August 12, 2015).

GoodTherapy.org. “Group Therapy.” This is an overview of contemporary models of group therapy.” http://www.goodtherapy.org/group-therapy.html (accessed August 12, 2015).

ORGANIZATIONS

American Group Psychotherapy Association (AGPA), 25 East 21st St, 6th Fl, New York, NY, 10010, (212) 4772677, Fax: (212) 979-6627, info@agpa. org, http://www.agpa.org/ .

Emotions Anonymous International (EA), P.O. Box 4245, St. Paul, MN, 55104-0245, (651) 647-9712, Fax: (651) 6471593, http://emotionsanonymous.org/ .

NTL Institute for Applied Behavioral Science, 8380 Coles-ville Road, Suite 560, Silver Spring, MD, 20910, (301) 565-3200, http://www.ntl.org/ .