HOW DOES GROUP THERAPY WORK?
Information and Guidelines for Participation in Group Therapy
Psychotherapy outcome studies demonstrate that group therapy is as efficacious as any mode of individual therapy. It is as helpful as, and in some cases more helpful than, individual therapy, particularly when social support and learning about interpersonal relationships are important objectives of treatment. In fact, research shows that group therapy is actually the treatment of choice for many relational issues such as certain forms of depression, anxiety, isolation, anger, shyness, intimacy concerns, friendship troubles and work issues. The vast majority of individuals who participate in group therapy benefit from it substantially.
Who Are These Groups For?
These groups are for people who are motivated to:
Improve your relationship skills and manage related anxiety, depression, anger and isolation.
Deepen your capacity for intimacy, closeness and connection.
Learn more about yourself as an individual and as part of larger relational contexts such as partnerships, families, friendships, work environments, etc.
Explore how you impact others and how others impact you.
Understand yourself in ways that promote informed healthy, choices.
Augment your individual or couples therapy with opportunities to try out new “ways of being” in a safe, supportive environment so you can communicate your needs more effectively.
Why Group Therapy?
There are many times in people’s lives when it would have been beneficial to clarify a relationship, to have been really honest about their positive and negative feelings, or to have gotten reciprocally honest feedback. The general structure of society, however, does not often permit such open communication.
A therapy group, on the other hand, is a place where honest interpersonal exploration among group members is not only permitted but encouraged. It is meant to be a different type of social situation, one that hopefully will provide members with a clear opportunity to learn many valuable things about themselves. Although group therapy is generally highly supportive, working on your relationships with other group members will not be easy; in fact it may even be stressful. But it is crucial because if people can understand and work out their relationships with other group members, there will be enormous carryover into other areas of their lives. You will discover pathways to more rewarding relationships with significant people in your life now and with people you have yet to meet. Typically, people find the first group less uncomfortable and much more interesting then they anticipated.
Group Psychotherapy provides an amazing forum for personal change and growth. As social mammals, we find ourselves immersed in groups throughout our lives such as families, school, communities, extra-curricular activities, work environments, etc. We can’t get away from the powerful influence of groups in how they shape and impact us. Most human concerns that lead one to therapy involve relationships.
Every one of us wants to get our needs met, whether it’s intimacy, attention, connection, recognition, respect, care, companionship, or love. Unfortunately, based on numerous factors, many of us learn unhealthy ways to meet these needs that create more difficulties than are necessary. Group therapy provides a unique and useful way to address these unhelpful behavior patterns that are often unknown to us. The main goal of group therapy is to identify these maladaptive behavior patterns (often known to us as relational “blind spots”) in a safe, supportive environment and to find more adaptive ways to connect with others to get our needs met.
Group therapy offers several important growth-enhancing factors. One is that group members feel less alone, more connected, and more able to accept themselves simply by being with others who struggle with similar issues. This experience of “universality” provides much relief to many members. The second, and even more powerful component of group, is that it’s like a “social laboratory.” It’s a unique, confidential and safe place to try on new ways of being and to learn about how you impact others and how they impact you. Group offers a “hall of mirrors” where you can learn about yourself through what you see in others and what others see in you.
What Do You Do In the Group?
There will not be a prescribed agenda for each session. Participants are encouraged to talk about any personal or relationship issues relevant to the problems and goals that led them to therapy.
Participants are encouraged to offer support, to ask questions, to wonder about things said or not said, to share associations and thoughts. Much emphasis will be placed on examining the relations between members—that is, the “here-and-now.” Members will often be asked to share their impressions of one another—their thoughts, fears, and positive feelings. The more we work in the here-and-now of the group, the more effective we will be.
The way to use group therapy best is to be honest and direct with your feelings in the group at the moment, especially your feelings toward the other group members and the therapist. The group is a forum for risk taking. I want you to try new types of behavior in the group setting.
Disclosure about oneself is necessary for one to profit from group therapy, but members should choose to disclose at their own pace. We never pressure members for confessions.
In order to construct a therapeutic group environment, we ask that members always try to say things to other members in a way that is constructive. Helpful feedback focuses on what is happening in the here-and-now, does not blame, is relevant, and connects the members receiving the feedback with the member offering the feedback. This kind of direct feedback and engagement is novel: rarely in our culture do individuals speak so honestly and directly. Hence, it may at first feel risky, but it may also feel deeply engaging and meaningful.
Direct advice-giving from group members and therapists is not generally useful. Neither are general discussions of such topics as sports or politics helpful unless there is something about a current event that has particular relevance to one's personal or interpersonal issues.
The therapy group is not a place to make friends. Rather, it is a social laboratory—a place in which one acquires the skills to develop meaningful and satisfying relationships. In fact, therapy groups (unlike support or social groups) do not encourage social contact with other members outside the group. Why? Because an outside relationship with another member or members generally impedes therapy!
How is therapy impeded? To explain this we need first to emphasize that your primary task in the therapy group is to explore fully your relationships with each and every member of the group. At first, that may seem puzzling or unrelated to the reasons you sought therapy.
Yet it begins to make sense when you consider the fact that the group is a social microcosm—that is, the problems you experience in your social life will emerge also in you relationship within the group. Why? Because that friendship may mean so much that you may be reluctant to say anything that might jeopardize it in any way. What happens in a therapy group when openness and honesty are compromised? Therapy grinds to a halt!
Therefore, it is best that members who meet outside the group (by chance or design) share all relevant information with the group. Any type of secrecy about relationships slows down the work of therapy. At times members develop strong feelings toward other members. We encourage that these feelings be discussed, both positive feelings as well as other feelings such as irritation or disappointment. Group members are expected to talk about feelings without acting on their feelings.
Your group therapist(s) are not going to “run the show.” Their role is more that of a participant/facilitator rather than of an instructor. Therapy is most productive when it is a collaborative and a shared enterprise. Keep in mind that the input from other members may often be as important as, or even more important than, the leader(s)' comments. The therapist(s) may make observations about group interactions and behavior, or about what particular individuals say or do in the group. They might also comment of progress or obstructions within the group.
Initial Length of Trial Period or Commitment
Group therapy does not generally show immediate positive benefit to its participants. Because of this fact, participants sometimes find themselves wanting to leave therapy early on if it becomes stressful for them. We ask that you suspend your early judgment of the group's possible benefits and continue to attend and to talk about the stresses involved and your doubts about group therapy.
We ask that you make an initial commitment to attend and participate in your therapy group for at least 12 sessions. By then you will have a clearer sense of the potential helpfulness of the group.
All statements by participants in psychotherapy must be treated with the utmost respect and confidentiality. Group members must maintain confidentiality to create a safe environment for the work of therapy and to develop trust within the group. Most individuals in therapy prefer to keep the therapy a private place and refrain from any discussions about it with others. If, however, in discussions with friends or family, you wish at some point to refer to your group therapy, you should speak only about your own experience, not about any other member's experience. Never mention any other member's name or say anything that might inadvertently identify any group members (i.e. where they go to school or work, etc.).
Attendance and Group Cohesion
The group works most effectively if it is cohesive, reliable, and predictable. Regular attendance is a key part of that, so we request that you make it a priority in your schedule. Group therapy progresses best when each member values and respects the commitment and work of each participant. Regular attendance and active participation in the meetings is an important way to demonstrate that respect and valuing. Similarly, arriving on time to each session is important. If you know that you are going to late or absent, we ask that you call the group therapists as far ahead of time as possible so that they can let the group know at the beginning of the session.
If you know a week or more ahead of time of a necessary lateness or absence, inform the group at an earlier session. We ask that you also inform the group of your vacation plans well ahead of time if possible. The group therapists will do the same.
There may be times when the group is the last place you want to be, because of uncomfortable feelings. These times may in fact be unusually productive opportunities to do the work of psychotherapy. In the same vein, you can anticipate that some of the difficulties that you have experienced in your life will express themselves in the group. Don't be discouraged by this. It is in fact a great opportunity, because it means that you and the group members are tackling the important issues that concern you.
You have decided, by agreeing to participate in group therapy, to begin a process of giving and receiving support and working toward needed changes in your personal and interpersonal life. We look forward to the opportunity of working together with you in this group.