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Group Therapy

Group Therapy Program

Group therapy is a vital component of many addiction treatment programs. It can be utilized to treat addictive behaviors and cravings directly, though it is also an effective tool for addressing underlying mental health disorders. Group therapy is distinct from other therapeutic modalities insofar as it makes use of a group dynamic. As such, it offers a number of benefits that are unique to this method. Group therapy is one of the most common approaches used by outpatient treatment programs. Support for group therapy’s efficacy in treating substance use disorders is backed up by research.

What is Group Therapy?

The term “group therapy,” is actually an umbrella term that refers to a wide assortment of distinct therapeutic methods. At its core, what distinguishes group therapy from other forms of therapy is that it involves more than two people. According to the American Psychological Association (APA), group therapy tends to involve 5 to 15 patients. Sessions of group therapy can be administered by a single clinician, but often two or more psychologists work together to conduct a group therapy session. The purpose of a group therapy session and the type of therapy engaged in during such a session can vary considerably from group to group.

Generally, however, individuals in group therapy work together on issues that they have in common. Group therapy is therefore often fairly goal-directed. This makes it a highly suitable approach for specific conditions like substance use disorders, depression, or anxiety. 

Working together with other people who suffer from the same condition can help patients feel more supported and enable them to pick up coping tools more effectively. Group therapy is also often recommended for people who are recovering from a common experience, such as child abuse or the loss of a partner. Group therapy fosters community and builds connections among individuals who might otherwise suffer alone.

The size of a group therapy session depends upon the organization providing therapy, the type of therapy, and the issue that it is meant to address. While seven people per therapist is the average, this number often fluctuates during the course of therapy. Newer members whose issues are more severe will enter therapy, and people who are making headway in recovery can leave. 

In fact, the fluctuating size and variety of a group therapy meeting benefits the long-term attendees. Being exposed to people who are suffering more acutely can help people who are more recovered understand the nature of their condition. On the other hand, newer group therapy attendees may discover a source of hope in the more longstanding attendees, who serve as living proof that recovery is indeed possible.

Origins and History of Group Therapy

When most people think of group therapy, they likely have a powerful picture in their heads that is derived from television shows and movies. Fictionalized representations of group therapy often present caricatures that deviate significantly from the reality of group therapy. In truth, group therapy has had many forms over its long history, and the early forms of group therapy would be unrecognizable to most people.

Group therapy was originally devised in 1905 by Dr. John Pratt, a doctor working with tuberculosis patients. Dr. Pratt ran what he referred to as “thought control classes.” These classes were designed to help tuberculosis patients, who often had no hope of surviving their illness. 

Dr. Pratt hoped that by working together, they could develop the mental fortitude and coping techniques necessary to be emotionally healthy despite their medical conditions. Over time, Dr. Pratt discovered that working together as a group had therapeutic benefits that one-on-one treatment did not provide. Dr. Pratt did not consider what he practiced to be “group therapy” as we know it today, but his work created the foundations.

Jacob L. Moreno, a Romanian-American psychiatrist, developed the early principles of group therapy. He wrote a monograph on group therapy, presenting his findings to the American Psychiatric Association. Moreno practiced a type of therapy that he referred to as psychodrama, which involved patients role-playing and acting out their emotions in a group setting. 

Various practitioners worked to apply the principles of group therapy to diverse populations, including individuals with developmental difficulties. During World War II, the principles of group therapy were further refined. Clinicians used it to help soldiers who were experiencing combat fatigue. After the war, group therapy became an effective method for helping veterans suffering from post-traumatic stress disorder (PTSD).

Since then, a variety of clinical philosophies have been incorporated into the practice of group therapy. Carl Rogers’ “humanistic therapy” and Freudian psychoanalysis, among other theories, have all made their mark on group therapy. As a result, today group therapy exists as a collection of different practices that work for distinct purposes. 

The principles of group therapy have also made their mark on other activities. Human relations departments in major corporations, for example, often use group therapy principles to run sensitivity training groups. Even 12-step programs like Alcoholics Anonymous have been considerably influenced by group therapy philosophies. Group therapy conducted in a clinical setting, such as an outpatient program for substance use disorders and mental health conditions, is the heir to all of these experiments.

Types of Group Therapy

Group therapy is designed to help people who are dealing with a shared issue. This shared issue can be a mental health disorder or addiction that members have in common. It is also frequently a specific experience that group attendees are working to recover from. As such, group therapy is generally structured around a common purpose or shared trait. Clinicians who run group counseling sessions frequently have expertise that is specific to that common purpose or experience, in addition to training in clinical methods. Common group therapy topics addressed in clinical settings include:

  • Addiction, including groups designed to treat addictions to specific substances
  • Divorce
  • Communication and codependency issues
  • Anxiety
  • Depression
  • Domestic violence or abuse
  • Parenting
  • Grief and loss
  • Anger management
  • Eating disorders

There are many different types of group therapy offered in clinical settings. Clinicians with different educational backgrounds or treatment philosophies may emphasize certain methods  over others. Methods used in group therapy can include group activities for adults, group therapy games, motivational group therapy activities, and group therapy worksheets. Generally, however, despite the considerable variety found among group therapy meetings, approaches to group therapy can be divided into two distinct types: psychoeducational groups and process-oriented groups.

Psychoeducational Group Therapy

Psychoeducational group therapy is designed to help patients understand more about the issue or issues they are facing. Clinicians help patients by educating them about the nature of their condition. Clinicians often also teach tools and coping techniques for handling the side effects of mental health disorders. 

Psychoeducational group therapy is often quite goal-directed. Group attendees improve their ability to function, under the direction of a qualified therapist. Psychoeducational group therapy does not emphasize the bonds among group participants as much as it does the instruction provided by the clinician.

Process-Oriented Group Therapy

Process-oriented therapy is less about educating group attendees and more about helping  them meet the challenges of their lives as they live them. The group experience is emphasized over any abstract understanding of their shared disorder. In a process-oriented group therapy session, the therapist functions less like an educator and more like a meeting facilitator. Instead of drawing attention to themselves, therapists help foster communication and inclusivity within the group, allowing group attendees to share their common experiences. 

They may sometimes offer group therapy discussion questions or group therapy activities to help group members pen up and bond. Process-oriented group therapy can help people develop a sense of belonging, self-efficacy, self-confidence, and increased quality of life. It is often an invaluable tool for people who want support while coping with difficult emotions.

How Group Therapy Works

It is common for people to have a bit of apprehension before beginning group therapy, especially individuals who have only had experience in one-on-one counseling or no experience in therapy whatsoever. Before beginning group therapy, it can be helpful to have some idea of what to expect. Group therapy is designed, however, to ease patients into the group, allowing them to develop comfort at their own pace. 

Ultimately, joining a group therapy meeting is no different than joining any social group. Newer members will meet a variety of new people, each with a different perspective. The group dynamic of a particular group therapy meeting emerges from the unique personalities constituting it. What distinguishes a group therapy session from a regular group social interaction, however, is the presence of a trained clinician. Generally, the clinician’s job is to lend focus to the session, ensuring that the group works steadily toward goals. These goals are often decided by the group members themselves, however.

Most group therapy groups follow the stages of group development, as formulated by psychiatrist Irvin D. Yalom. Irvin D. Yalom, an existential therapist who developed many of the principles of group therapy, conceptualizes the stages of group development as such:

  • Forming. During the forming stage, new members meet each other and get a sense of the group dynamic.
  • Storming. Storming is the term used for a period of time when the differences among group members become apparent. The clinician’s role during this stage is to provide a safe and supportive space for these conflicts and disagreements to play out.
  • Norming. During the norming stage, group members reconcile themselves to their differences and come to a better understanding of both the group and themselves as individuals.
  • Performing. When the group becomes self-aware, group therapy attendees can productively work through issues as they arise. Group cohesion combined with respect for differences allow people to function successfully as individuals and as members of a group.

Group Therapy Techniques/Practices

Group therapy activities vary considerably from group to group. Some group therapy sessions consist mostly of dialogue and verbal communication. Some clinicians, however, opt to utilize group therapy games. These games can sometimes be physical in nature. It is also common for clinicians to have patients do a certain amount of writing. Group therapy worksheets are sometimes assigned as “homework” for the group, and these worksheets can then serve as a jumping off point for the next session. Whether a group is based around talking, written assignments, or physical games, however, the vast majority of group therapy sessions utilize certain techniques in common. Some practices utilized by almost all groups include:

  • Empathy. This allows members to feel understood and less isolated while dealing with their condition, as well as fostering group unity.
  • Tone setting. The clinician helps the group stay directed by moderating the tone of interactions. The tone best suited to group therapy is one that is serious, formal, social, and supportive.
  • Summarizing. Clinicians help meeting attendees get the bigger picture by paraphrasing points made in the course of a group therapy discussion.
  • Linking. By pointing out connections between the distinct experiences shared at group therapy sessions, clinicians can help patients better understand themselves and each other.
  • Active listening. Active listening involves actually engaging with what a person is saying; ways of listening actively include repeating what they’ve said to show you understand, vocalizing understanding, and making eye contact.
  • Drawing out. Some members of a group are quieter than others. It is important for the clinician to help quieter members speak up. Fun group therapy activities can aid this process.
  • Rounds. Clinicians sometimes ask group members to take turns sharing. This democratic approach involves going around the room, giving everyone an equal chance to speak.
  • Dyads. Sometimes clinicians pair group members off. This allows members to get to know each other on an individual basis before rejoining the group once more.
  • Modeling. If a group is working toward specific behavioral goals, it is essential for the clinicians to demonstrate these traits themselves. The clinician not only guides group members but functions as an example.

What to Expect During Group Therapy

The expectations and practice of group therapy differs from institution to institution. At inpatient treatment centers, group therapy often occurs several times a day, allowing fellow residents to really get to know each other. At outpatient treatment centers, however, group therapy meetings might occur on a weekly schedule. Meetings are generally one hour long, though they can sometimes extend to roughly two hours.

At the beginning of a group therapy session, it is common for physicians to begin with an icebreaker to help people relax and open up. Fun group therapy games not only serve as valuable ways of developing comfort in a new setting, but they often have clinical value as well. Group therapy activities for adults with mental illness, for example, often help people combat their anxieties and phobias in a safe and playful way. Some forms of group therapy, such as play therapy, involve group therapy activities for the entirety of each session. 

The majority of group therapy meetings, however, eventually move on to a more focused discussion period. The clinician will often come prepared with group therapy discussion questions. In process-oriented group therapy meetings, these group therapy topics will often emerge naturally from the group’s developing concerns and interests. The clinician moderates and directs the course of the group’s discussion, sometimes having the group take turns sharing in a round, and other times having them split off into two-person dyads.

During group therapy discussions, it is crucial for individuals to be able to discuss their thoughts and feelings freely. Unlike traditional one-on-one therapy, where one person simply communicates thoughts about their own life, during the course of group therapy people will inevitably express their thoughts and feelings about each other. It is natural for members to have thoughts and feelings as they react to experiences related by other members. Group therapy is designed to be a safe and supportive space for people to express themselves. In fact, getting and receiving real-time feedback in a community setting is often helpful for improving behavioral, emotional, and even physical health.

At the end of a group therapy meeting, clinicians sometimes assign homework to members. This homework, which often comes in the form of group therapy worksheets, is designed to facilitate further discussion and help members progress in their recovery. An individual who suffers from social anxiety might, for instance, be asked to fill out a worksheet listing 5 phone calls they made that week. 

Someone dealing with anger issues may be asked to describe the thoughts that led up to an outburst. Individuals recovering from substance use disorders may be asked to record the triggers they experienced that week. Group therapy homework is not graded and there are no wrong answers. Rather, it is intended to help bring issues to the forefront of the group consciousness that might have evaded detection.

Group therapy meetings sometimes meet regularly for an indefinite period, providing people with a safe space that they have the option of attending for years. Many rehabs and treatment centers provide group therapy that is finite and goal-directed. In this latter case, group therapy meetings might last for 12 to 16 weeks. After this, clinicians evaluate members’ needs on an individual basis to determine the next step of their treatment plan.

Goals and Benefits of Group Therapy

People who are enrolled in group therapy experience a range of benefits. These benefits generally depend on the specific goals of the group therapy treatment program. It is common for individuals enrolled in inpatient or outpatient programs to use group therapy in conjunction with other treatment modalities, such as individual counseling. 

Group therapy can be effective on its own, but the benefits of group therapy increase when it is supplemented by other treatment methods. Generally group therapy is designed to help people deal with the side effects of their mental illness or prevent a relapse. As such, the goals of group therapy are often based on developing important life skills and coping strategies. Pursuing these goals in the context of a group can have therapeutic effects that do not occur in individual talk therapy sessions. The benefits of group therapy include but are not limited to:

  • Helping people understand that they’re not alone. Suffering from an addiction, grief, a traumatic experience, or a mental health condition can be a deeply isolating experience. Meeting other people who are experiencing many of the same symptoms as you is often deeply healing in and of itself.
  • Getting feedback from other people with the same condition. Group therapy meetings often function as sounding boards. Hearing how other people with your condition — not just a clinician — respond to you can help you see your own behavior and thinking patterns in a new way. Getting other perspectives and points of you is also an important benefit of group therapy.
  • Seeing examples of people who have recovered. Group therapy allows people to connect with individuals who are experiencing a diverse array of symptoms. Meeting people who have made considerable progress in treating their condition can be a great way of developing hope — and these people likely have a lot of good advice and experience to share. On the other hand, people who have made progress can also benefit from meeting and helping others who are currently in a rough patch.
  • Improving social skills. Suffering from addiction, mental health disorders, grief, or trauma can make it difficult to interact with others. By learning how to handle other people, many individuals find that in the process they learn how to handle themselves.
  • Learning about yourself. While individual one-on-one therapy can be filled with revelations, the fact is that individuals are often unable to see themselves clearly. Doing group therapy allows people to fill in those gaps or blind spots by seeing themselves through the eyes of others.

Many people experience the benefits of group therapy beyond the confines of the meeting room or treatment center. Not only do group therapy meetings and activities help people recover from their mental health conditions and addictions, they also build community! People who graduate from treatment centers where they did group therapy often emerge with a multitude of new friends. These new friends can be a source of ongoing support and solace as people go about their lives. Having a strong social support system not only decreases the likelihood of relapse — it is also a profound source of joy and meaning for just about anyone.

Effectiveness of Group Therapy

Group therapy is rapidly increasing in popularity due to its effectiveness and its affordability. Over 50 clinical trials in recent years have demonstrated that group therapy is just as effective as individual therapy for a wide range of mental health conditions. These clinical trials randomly assigned people to individual therapy and group therapy. After a period of time attending therapy meetings, individuals pursuing both types of therapy experienced the same degree of improvements. In fact, for certain conditions group therapy was found to exceed the standards of efficacy used by the Society of Clinical Psychology. These conditions include:

  • Major depressive disorder
  • Bipolar disorder
  • Panic disorder
  • Post-traumatic stress disorder
  • Social phobia
  • Obsessive-compulsive disorder
  • Bulimia nervosa
  • Binge-eating disorder
  • Substance use disorder
  • Schizophrenia
  • Borderline personality disorder
  • General personality disorder

Researchers are only beginning to understand the mechanisms that make group therapy so effective. One common finding is that groups with a common identity and a strong sense of shared purpose tend to be the most effective. These qualities allow individuals to progress as a group. Some studies have also shown that group therapy meetings with more than one clinician are more effective than those with one. Having two or more clinicians in a meeting can guarantee that everyone is heard, that all social cues are responded to, and that no one is left behind.

One provocative new book by Stanford psychologist Irvin D. Yalom claims that interaction with peers is more healing than receiving direct guidance from a clinician. Being able to identify with other people and share experiences not only reduces stigma and isolation, it also produces concrete changes in how people behave and think. Ultimately, even for people who are not in group therapy, having strong peer support systems is associated with a decreased likelihood of developing mental health disorders. By building up strong social support systems, members of group therapy sessions improve their own emotional fortitude.

Group Therapy in Mental Health and Addiction Treatment

Group therapy is particularly beneficial for people suffering from substance use disorders or other mental health conditions. Group therapy is all about shedding light on issues that have caused challenges for people. In a group setting, individuals suffering from addictions can get feedback on their behavior from other people who have had common experiences. People dealing with anxiety, depression, and other mental illnesses can find support and solidarity. Addiction and mental illness can be deeply isolating, with many sufferers frequently reporting that they feel misunderstood. 

Many people, especially those suffering from active addiction, are more likely to respond to advice and feedback from their peers than from a clinician, no matter how much education or expertise the latter has. Spending time with individuals who have made progress in their recovery can also give hope to newer group therapy members.

Group therapy meetings for addiction and mental health disorders include both psychoeducational group therapy and process-oriented group therapy. Psychoeducational group therapy for addictions and mental illness often focus on providing evidence-based strategies and coping tools to handle specific life situations and challenges. These group therapy sessions can also be opportunities for individuals to learn more about their disorders and address behavioral patterns. Process-oriented group therapy meetings, on the other hand, can be invaluable tools for people in recovery. 

For people working to stay sober or mentally healthy, the benefits of group therapy are enormous, allowing them to address difficulties and challenges as they crop up on a weekly or even daily basis. These programs also provide a social support system that research has shown is essential to staying sober and mentally healthy.

Finding Group Therapy Near Me

Individuals who are processing difficult experiences, suffering from mental health conditions, or trapped in the cycle of a substance use disorder can all benefit from group therapy. It doesn’t matter how severe a person’s suffering is. Everyone can use support. Group therapy meetings are not difficult to enroll in, but finding the right meeting to address your unique situation and needs sometimes requires a little research. A variety of outpatient treatment centers in Los Angeles offer group therapy.

Addiction Group Therapy in Los Angeles

NuView Treatment Center, located in West Los Angeles, offers group therapy for a wide range of mental health disorders and addictions. Whether you’re just beginning your recovery journey or simply need additional support while meeting life’s challenges, NuView Treatment Center’s group therapy programs are designed around your needs. NuView Treatment Center also offers a wide variety of other treatment modalities to complement the group therapy experience. 

It is NuView Treatment Center’s philosophy that treatment for any addiction or mental health disorder begins with the individual, not with the diagnosis. To that end, clinicians at our Los Angeles rehab work with people on a patient-centered basis. Our holistic individualized treatment plans work to address all of a person’s needs, from their relationships to their life goals. If you are ready to begin a new way of life, reach out to us today.

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