Group therapy involves a small group of people talking, learning and discussing their problems and symptoms together in an effort to improve their mental health.

While most talking therapies are delivered on a one-to-one basis, not all are. Some people will attend group therapy – especially when using the NHS. While it may sound daunting, group therapy can actually be very effective.

Group therapy shouldn’t be confused with Therapeutic Communities – which is a type of therapy that takes place in a residential setting over a period of a few months, which involves multiple people.

Group Therapy involves many different patients interacting all at once

How do sessions work?

Group therapy will often be undertaken when using NHS therapy, due to the level of demand. Many mental health services request that a person tries group therapy first. Therefore, many people will start their treatment off with group therapy.

Sessions are usually held at a location near to a mental health treatment area – this might be a local GP or the actual building of the mental health service. However, local town halls, offices and school classroom’s can also be used.

The therapy itself will follow a set therapy format. This will normally be Cognitive Behavioural Therapy or Dialetical Behavioural Therapy. Both offer similar approaches, and are deemed suitable for working as a group:

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

Dialectical Behavioural Therapy (DBT): DBT is a type of therapy that is tailor-made for Borderline Personality Disorder, though can also be useful for many other conditions. The therapy runs on the basis that an individual is emotionally vulnerable, and that the individual grew up in an environment where emotions were dismissed and not treated. These factors cause an individual to feel guilty or ashamed for having upsetting emotions, which leads to more upset. DBT aims to change this system, using a range of techniques to help, with a focus on acceptance and problem-solving.

Sessions are usually led by two therapists. There are normally between 6 and 15 people in the group. Each person is encouraged to actively partake in the session – whether this be through taking notes, contributing to discussions or listening to others.

Each group member will have the opportunity to talk about their problems, their symptoms – and the personal situation they are in. This is not compulsory however, and no one will be forced to speak.

Sessions will normally involve the two therapists teaching techniques, theory and asking questions of the group. There will often be time near the end of each session for the group to have an open discussion.

Sessions will normally last between 1 and 2 hours. They will normally last 8-12 weeks. You may be thinking or picturing an “Alcoholics Anonymous”-like event. But it is far from this. It is simply normal talking therapy, just in a group.

Confidentiality

One of the main concerns that people have with group therapy is fears of confidentiality. It is important to remember that staff members won’t ever breach confidentiality rules and talk about their group members with colleagues – unless it is necessary to do so (which is only ever done under certain circumstances).

In order to facilitate trust among group members, the therapists will normally ask everyone to follow an unwritten rule based around the idea ‘what is said in therapy stays in therapy’.

It is expected that no participant talks about one another outside of therapy. Confidentiality is crucial. That is one of the most important areas of group therapy.

Advantages of Group Therapy

Group therapy offers a number of advantages. Each person in the group will have received a similar diagnosis. It will give the group a chance to work through problems together and motivate one another.

For example, many people will have been diagnosed with Depression in a group. Therefore, this also gives the advantage of meeting patients that are going through a similar predicament. Hearing the story of others and having a good support group can be very helpful.

Another example is for those who have Anxiety, they may doubt themselves or think their problems are not worthy of getting help. But seeing that others are going through similar issues can reinforce the seriousness of the symptoms.

Arguably the biggest advantage of group therapy is the lack of waiting times involved. When a person has one-to-one therapy, they will often have to wait several weeks, if not months.

However, this isn’t the case with group therapy. As there are many people able to be seen all together, waiting times can sometimes be just a few days. This is very useful if a person feels they need support sooner rather than later.

The research also suggests that group therapy can be very effective. Group therapy will often result in improved mood and better overall wellbeing. It is also known for its excellent long-term results [1]. It has showed particular effectiveness for Depression [2].

Which conditions?

The most common conditions for Group Therapy are Depression and Anxiety. As these are very common conditions, many people will be able to attend these sessions. Group therapy is especially used in cases where the symptoms are mild or mild to moderate.

Conditions like Eating Disorders, Obsessive Compulsive Disorder and trauma-based conditions like Post Traumatic Stress Disorder – can also benefit from group therapy, though these would typically be in much smaller groups.

Conditions that involve psychosis, such as Delusional Disorder, Schizophrenia or Schizoaffective Disorder, will not normally use group therapy. More specialised and one-to-one therapy is normally needed in this cases.

Summary

Group therapy can be a really useful treatment for mental health problems. Many people will find it works for them. For some, it can prove to be the only assistance they need – it may result in them no longer needing mental health assistance.

For those that find it doesn’t help, then they will have the benefit of being able to ask for one-to-one support, which is normally permitted after a patient has tried group therapy.

Overall, group therapy has the potential to be very effective for any individual seeking help. While the group element won’t be for everyone, it offers a great environment to learn from others, improve one’s state of wellbeing and focus on their mental health.

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References

[1] Lundqvist, G., Svedin, C., Hansson, K. & Broman, I. (2006). Group Therapy for Women Sexually Abused as Children: Mental Health Before and After Group Therapy. Journal of Interpersonal Violence. 21 (12): p1665-1677.

[2] Thimm, J. & Antonsen, C. (2014) Effectiveness of cognitive behavioral group therapy for depression in routine practice. BMC Psychiatry. 14 (292).