The Case for Group Therapy
There’s no one-size-fits-all approach to delivering mental health care.
Posted May 27, 2021 | Reviewed by Davia Sills
- Between the rising demand and higher costs of therapy, different care modalities—such as group therapy—can be considered as treatment options.
- Group therapy is flexible and can be used to supplement one-on-one therapy depending on the individual patient's needs.
- The supportive community and opportunity to practice new skills learned in therapy are benefits of the group therapy experience.
The mental health needs of individuals shift over time, as do our preferences for how we want to receive care, and as such, there’s a need for a diverse set of care modalities that can be deployed as effective treatment options. These various modalities—from individualized therapy to self-guided care to group therapy—give people the flexibility to find the type of care that will best suit their mental health needs. But more than that, alternative care modalities are also necessary for expanding access to care and alleviating the burden that’s placed on the shoulders of individual therapists.
As a result of significant increases in demand for mental health care, it’s becoming harder for individuals to find an available and affordable therapist. And for therapists, it’s difficult to manage this demand without feeling the effects of burnout. By introducing alternative care modalities and broadening the accepted standard of care beyond one-on-one therapy, we can begin to even the scales of the current mental health care supply-demand crisis and ensure that everyone receives the right type of care at the right time.
One care modality with significant therapeutic promise is group therapy. If done correctly, a group therapy approach can be a highly effective and cost-saving alternative or supplement to one-on-one therapy for individuals who need mental health support.
The flexible format benefits many different individuals.
Group therapy is sometimes met with reluctance from individuals who feel anxious about sharing vulnerabilities in a group setting. But on the flip side, it is this aspect of community that can make group therapy incredibly effective. For example, for people with social anxiety, who may be among the most reluctant to engage in group-based care, the group model can be a form of exposure therapy, where a person is exposed to their source of anxiety in a safe and supportive environment. For example, one review paper analyzing the responses of individuals with a panic disorder found that 78 percent of patients no longer reported panic symptoms after group psychotherapy. In group therapy, generally, an individual is not just receiving care from the group leader, but change can also be facilitated by participating in the session and interacting with the other members.
The community aspect of group therapy also functions as a tool for destigmatization. Mental health challenges can be isolating experiences, but through a group discussion, individuals may come to realize that they are not alone in their experience and can receive support and validation in real-time from people with shared experiences.
The format of the group and the experiences of the individuals within the group are important to fostering a positive environment for attendees. Groups can take a variety of forms: They can be an open group, a series of drop-in sessions where individuals come and go as they please, or a closed group where the same individuals meet at a regular cadence. These format variations allow individuals to explore what works best for them; for example, there may be fewer barriers—whether in terms of time, comfort, or willingness—to sign up for a drop-in group session than signing up for a recurring group or 1:1 therapy.
This flexibility extends to the content of the group as well. Some groups may be focused on delivering evidence-based treatment through a combination of psychoeducation and practicing tools and techniques (e.g., a group following a protocol for depression treatment or a DBT skills group), while others may take more of a supportive or process-based approach.
A peer support group is more processed-oriented and is often built around shared experiences, such as grieving the loss of a loved one, navigating the world as a cancer survivor, or coping with addiction and substance abuse. These shared experiences can be based around specific topics as well, like groups for building mental resilience, quieting negative thoughts, or coping with isolation; these can also function effectively as single-session workshops. These groups give participants the room to process their emotions while fostering resilience and hope through shared human connections. The group format allows for flexibility and creates an iterative approach to therapy; the group can change depending on the evolving needs of its participants.
Whether open or closed, support groups or psychoeducational, the group therapy model offers increased choices for therapy, giving individuals agency to find the care option that will work best for them.
Group therapy can supplement or complement other care modalities
You can also think of group therapy as one stop on an individual’s longer care journey; for some people, the group model may be enough support, but for others, group therapy can be paired with other care modalities to be an even more effective tool.
A common treatment plan for individuals with borderline personality disorder (BPD), for example, often includes both one-on-one therapy and a skills-based group. In the group, people learn tactical approaches to managing and coping with BPD, including interpersonal or emotion regulation skills that complement the work they are doing with their 1:1 therapist. This model—of learning skills in a group setting and then practicing these skills in an individual therapy session—can also work in the opposite order. You could first work on skills with a therapist or coach and then maintain (and even share) that progress in a group setting.
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At its core, group therapy is highly attuned to the needs of the individual and can be integrated into care plans depending on the person’s preference. For example, some people may be excited to start their mental health support journey with blended care (i.e., working with a coach and within a group), while others may start with one modality and then engage in different modalities as their needs or circumstances change. The group therapy model can extend to group coaching sessions as well—where a group of individuals meets with a coach on an ongoing or stand-alone basis—offering yet another modality of support for individuals who may not have a clinical need. All of these modalities, coupled with the rise in digital care, allow individuals to tap into a wider breadth of care options than ever before.
If we are to address the mental health crisis in this country, we have to expand our options for mental health support beyond one-on-one therapy. As inherently social beings, community is integral to our health and happiness. Group therapy is one such option that can not only provide excellent care but also build this community among individuals, ensuring greater support and care.