Group therapy

Encyclopedia of Psychology, Apr 06, 2001

Group therapy has numerous advantages over individual therapy. The therapist's knowledge about the clients offers an added dimension through the opportunity of observing them interact with each other. Clients are helped by listening to others discuss their problems (including problems more severe than theirs) and by realizing that they are not alone. They also gain hope by watching the progress of other members and experience the satisfaction of being helpful to others. Groups give the individual client the chance to model positive behavior they observe in others. Besides learning from each other, the trust and cohesiveness developed within the group can bolster each member's self-confidence and interpersonal skills. Group therapy gives clients an opportunity to test these new skills in a safe environment. In addition, the group experience may be therapeutic by offering the clients a chance to reenact or revise the way in which they relate to their primary families. Finally, group therapy is cost-effective, reducing the use of the therapist's total time.

The average group has six to twelve clients who meet at least once a week. All matters discussed by 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.

Nevertheless, there are also 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. Some groups are organized around a specific problem (such as alcohol dependence) or a type of client (such as single parents), or with the goal of acquiring a particular skill (such as assertiveness training). 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.

Group therapy first came into widespread practice following World War II and employs numerous methods of psychotherapy, including psychodynamic, behavioral, and phenomenological. In Fritz Perls's application of his Gestalt approach to group work, the therapist tends to work with one group member at a time. Other approaches, such as J.L. Moreno's psychodrama (role playing) method, stresses the interaction among group members. Psychodrama calls for the group to act out scenes relevant to the situation of a particular member under the therapist's guidance. Influenced by Moreno's approach, new action-based methods were introduced in the 1960s, including encounter groups, sensitivity training, marathon groups, and transactional analysis, whose foremost spokesperson was Eric Berne. 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 work with T-groups at the National Training Laboratories in Bethel, Maine, during the 1940s and similar work by researchers at the Tavistock Institute in London.

Group therapy is practiced in a variety of settings, including both inpatient and outpatient facilities, and is used to treat anxiety, mood, and personality disorders as well as psychoses. 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. The primary difference of these groups from traditional group therapy sessions is the absence of facilitation by a mental health professional.

• Friedman, William H. Practical Group Therapy: A Guide for Clinicians. San Francisco: Jossey-Bass, 1989.
• Helmering, Doris Wild. Group Therapy--Who Needs It? Millbrae, CA: Celestial Arts, 1976.