Dan J. Tomasulo PhD., MFA, MAPP

The Healing Crowd

Therapy

Differences Between Individual, Group, and Couples Therapy

Differences Between Individual, Group, and Couple's Therapy

Posted Jan 14, 2015

Therapy” is a very broad term used to describe various styles and modes of treatment. It can be confusing because in addition to the types of therapy and therapist, there are different techniques, theories, and approaches that can be used differently. While the descriptions offered below are meant to give basic differences, the style and manner in which the various therapies are offered can vary widely. Here are some general differences to keep in mind when you are considering therapy. 

In individual therapy, the focus is on the development of a one-to-one relationship with the therapist. The relationship can take on many facets depending on the approach the therapist is using, but most often involves the creation of an accepting atmosphere along with the use of techniques for the purpose of symptom reduction and/or personal development. The individual is engaged in a self-reflective process on his or her emotions and behaviors.

Couples therapy usually involves an intense focus on improving the communication pattern within the couple. Unlike individual therapy, couple’s therapy involves the therapist entering the couple’s way of life more directly. They bring their habits and routines with each other directly into the session. The therapist is involved in analyzing and offering feedback about the interactions the couple is having, and makes suggestions about ways to improve it. It is typically considered more intensive than individual therapy because both partners are invited to co-create the process of change. 

Group therapy typically rests on the dynamic interaction of the members of the group. The emphasis is on helping participants understand the projection they have toward other members, while learning from the feedback they receive from others, including the therapist.

Therapists need to be trained in each of these different types of therapy. Someone trained in individual therapy only is typically not adequately prepared to do couple’s therapy or run a group. In contrast, couples and group therapists have usually begun their training by learning individual therapy. 

To illustrate, lets take a typical person wanting to begin therapy. Mary is 34 and has a two-year old daughter. However, since the birth of her daughter her relationship with her husband has gotten worse. He is working and traveling more, and when he is home, they fight, often about money. Mary hasn’t been to therapy before, yet she realizes that she has symptoms of depression. Her concentration is off, she is tired all day, and isn’t eating enough. She doesn’t like how she feels and yet doesn’t feel close enough to her husband to talk about these feelings with him. She decides to talk to her friends about going to therapy.

Several of her friends are in treatment and make recommendations for people in her area. One friend, Jill, is in individual therapy. Another, Louise, is in couples therapy, and Samantha is in group.

Jill tells her that individual therapy is helpful because she feels she can say anything to the therapist and won’t be judged. The therapist focuses all her attention on Jill and in doing so helps her find answers for herself. Jill meets weekly with her therapist to talk primarily about her relationship with her husband, but also discusses her two children and her job. Mostly, she likes therapy because it is her time to reflect on her life. She finds support, feedback, and understanding of her situation by the therapist and over the past several months has reached some clarification about her situation.

From time to time various suggestions are made by her therapist about techniques she can try to reduce her anxiety and depression while increasing her well-being. She makes the analogy that it is like having a personal physical trainer who will support your development. She says she is glad to have the time for herself, and often finds herself feeling better after a session.

Louise is in couples therapy. She found intimate texts on her husband’s phone while looking for a phone number she didn’t have. The texts rocked her to her core. Her husband denied having an affair, but said he was not happy in the marriage. They have been married eight years and have a two-year-old boy. He agreed to come to couples therapy with her.

She says couples therapy is hard because they are fighting more often and during the sessions they accuse one another of being insensitive to the other’s needs. The therapist is working with them on improving the communication of their needs by giving them “homework” to do between sessions. She says it is very difficult because the therapist challenges her as often as her husband. She thought therapy would be different. She simply thought that what her husband did was wrong and wanted him to fix it. Instead, she is learning that she may have played a role in him looking for a connection with someone else. She said she finds it helpful, but very hard because the therapy—and their marriage—consume her thinking. She feels better as often as not after a session.

Samantha is divorced. She has no children and has been disappointed in the men she has met online. Oddly, she finds that although there are a number of different men she has dated, she has a familiar feeling emerge with each of them and the relationships rarely last longer than a few months. The familiar feeling is that she feels like she goes out of her way to make the relationship work, but the men seem to be less invested and, at times, inconsiderate about her feelings.

She says the group she has joined has men and women in it and most of them seem to be struggling with their relationships.  She often finds herself activated in group when men talk about themselves and seem to take too much time in the group. She also has noted there is one women in the group she is repeatedly upset by because she doesn’t speak up. She says she has learned that when she tells the group what she is feeling there is some support, however, the therapist often uses her sharing to help her reflect on how these reactions relate to past relationships in Samantha’s life. In the several months she has been in the group she has learned that there is a pattern emerging about who supports her, whom she is activated by, and who confronts her. As it turns out—she finds that the feelings she is having are very similar to how she felt growing up in her family, and how she felt in her marriage. She says she never realized this pattern before and, while it is difficult for her to talk about these reactions, she is realizing she is learning about how she sees others and is perceived.

Usually the safest choice is to begin with individual therapy because it allows for the easiest way to begin becoming psychologically minded. It is usually more expensive than group and typically slightly less than couple’s therapy. Couples therapy is typically best when couples are in crisis and are willing to explore the issues together. However, it is often challenging to put—and keep—the exploration of the relationship front and center in your life. It is also the most expensive of the three types. Group therapy is dynamic and typically has 5-8 people. It may be open (allowing new members) or closed (only a selected number of participants are invited to attend.) Of all the therapies, it is the most cost effective as the sessions (between one and two hours) are offered at rates considerably lower than individual.