For many people “group therapy can be more powerful and mutative than individual therapy,” according to Judye Hess, Ph.D, a clinical psychologist who has a private practice with couples, families and groups in Berkeley, Calif.
There are many types of group therapy. As Irvin D. Yalom, M.D., writes in The Theory and Practice of Group Psychotherapy (now in its fifth edition), “The multiplicity of forms is so evident today that it is best not to speak of group therapy but of the many group therapies.”
Psychotherapist Ali Miller, MFT, who also specializes in working with couples and groups, identified the various types: Some groups focus on interpersonal learning. Members talk about how they feel in relation to each other. In support groups, members focus more on what’s happening in their lives outside the group.
Miller leads what she calls “hybrid groups.” “[T]here is encouragement to both talk about your life outside the group and also to talk about the dynamics within the group.”
There also are psychoeducational groups, where a clinician teaches members specific skills, such as anger management or dialectical behavioral therapy.
“What I think they all have in common is people coming together, under the leadership of a trained group therapist, to work on improving their lives in one way or another,” said Miller who leads groups in San Francisco and Berkeley, Calif.
Groups typically consist of four to 10 people and meet weekly for 90 minutes, said Hess. They can be as brief as several months or last as long as five to 10 years, she said.
So why is group therapy so helpful?
Below, Miller and Hess shared five benefits.
1. Group therapy helps you realize you’re not alone.
According to Yalom in The Theory and Practice of Group Psychotherapy, “Many patients enter therapy with the disquieting thought that they are unique in their wretchedness, that they alone have certain frightening or unacceptable problems, thoughts, impulses and fantasies.”
While it’s true that each of us is unique and may have unique circumstances, none of us is alone in our struggles.
For instance, for years, Yalom has asked members of a process group to anonymously write down the one thing they wouldn’t share in the group. Members included medical students, psychiatric residents, nurses, psychiatric technicians and Peace Corps volunteers.
The secrets were “startlingly similar,” he writes. Several themes emerged: People believed they were inadequate and incompetent. They felt alienated and worried they couldn’t care for or love another person. And the third category included some kind of sexual secret.
As Miller said, group therapy reduces isolation and alienation. It increases the sense that “we’re all in this together,” and normalizes suffering, she said.
2. Group therapy facilitates giving and receiving support.
One misconception about group therapy is that members take turns receiving individual therapy from the therapist while others observe, Miller said.
However, as she clarified, members are actually encouraged to turn to each other for support, feedback and connection, instead of getting all of that from the clinician.
Miller shared this example: One member feels isolated and lonely, and doesn’t know how to make friends. The group supports her by listening when she talks and engaging with her the entire session, which by itself decreases her sense of isolation. The members also share their own experiences. And they share how they’ve navigated loneliness or overcome isolation, “offering hope, inspiration, encouragement, and sometimes suggestions.”
3. Group therapy helps you find your “voice.”
Miller defined voice as “becoming aware of your own feelings and needs and expressing them.” In her groups, she strongly encourages members to notice how they’re feeling throughout the session and to talk about it.
“Many people don’t know how they are feeling when they are interacting with other people, because it can be challenging to be self-connected when connecting with others. This is one of the things I focus on most in my groups.”
4. Group therapy helps you relate to others (and yourself) in healthier ways.
Often people don’t understand why their relationships aren’t working, said Hess, who has taught Group Dynamics at the California Institute for Integral Studies in San Francisco. “In the safe atmosphere of group therapy, members can get honest feedback from others who care about them to one degree or another.”
For instance, according to Hess, members might say: “I would like to get closer to you, but you always seem to keep me at a distance,” “It bugs me that you are always the one to break the silence” and “When you are sharing something, I get impatient, because it takes so long for you to get to the point.”
Groups provide the opportunity to see just how people relate to others in the moment, and how they relate to themselves, Miller said.
She shared these examples: Do you typically hang back until someone invites you to speak? Or do you take the lead? Do you only share positive information about yourself or things you’re struggling with? What parts of yourself do you let others see? What parts of yourself do you hide? How do you handle conflict? How do you get your needs met?
According to Miller, members also are encouraged to try other ways of relating. For instance, instead of asking someone a question, you explain why you’re asking them that question, she said. Instead of just giving advice, you share what’s motivating you to give that advice, she said.
“[Y]ou start to see you have way more choices available to you for how you relate to others. It helps people get out of relational ruts, liberates people to get unstuck from patterns of relating that are not serving them.”
Hess has witnessed her clients improve both in how they relate to others and to themselves. For instance, one member kept apologizing for himself and seemed excessively concerned about being accepted by the other members. He revealed that he’d experienced a lot of rejection in his life so he feared experiencing even more.
As members responded empathically to him, he began feeling accepted. His apologizing diminished. “He felt like he belonged and could relax and be more of himself. It turned out that could be very outspoken and articulate when he wasn’t so afraid.”
Another member was extremely extroverted and very friendly with strangers. But others noted that her friendliness didn’t seem real and they felt overwhelmed by it. For the first time she realized that her behavior turned some people off. She also realized that she “needed to be more selective with her ‘friendliness.’ She has become an integral part of the group as she has moderated her reactions to include other people’s feelings.”
5. Group therapy provides a safety net.
In Miller’s groups, called “Authentic Connection,” members struggle with being authentic and speaking up for themselves in their lives. They practice these skills in the group, and as they do, their confidence for practicing them outside the group grows.
They’re also able to carry the groups’ support with them between sessions, making it easier to take risks, she said. “[I]f you know you can report back to a group of people who care about you and will listen to your experience, you tend to feel braver. Knowing someone will catch you if you fall emboldens you to leap. The group becomes the net.”
In addition to strengthening your relationships skills, reducing isolation and finding your voice, group therapy also is especially valuable for individuals dealing with depression, social anxiety and life transitions, Miller said.
But group therapy isn’t for everyone at every stage of life, Hess said. “It takes strength and some recognition of the needs of others to function well in a group, not be destroyed by it, and not destroy others.”
Often it’s most helpful to attend both group and individual therapy, she said. “That way, people can talk about what comes up for them in the group with one’s individual therapist.”