Group Therapy Basics

The best paper I’ve read that simplifies and explains group therapy is from The following are excerpts from that site:

How does it work?

Group therapy focuses on interpersonal interactions and emotional difficulties, and consequently there are a number of situations that are more appropriately handled in a group context than might be handled in a standard one-to-one psychotherapy session.  Foremost amongst these, perhaps, are situations involving relationships.

Members of the group share with others personal issues which they are facing. Participants can talk about events they were involved in since the previous session, their responses to these events, and problems they had faced. Participants can also share their feelings and thoughts about what happened in previous sessions, and relate to issues raised by other members.  Other participants can respond to this material, give feedback, offer encouragement, volunteer support or criticism, or share their own thoughts and feelings.

Subjects for discussion are not usually determined by the leader but rise spontaneously from the group. As groups mature, and participants begin to feel more comfortable with other members, a synergy develops and there is bonding between participants who, in course of time, feel they are not alone, that their problems are shared, and that there are even others who are experiencing the same types of situation. The group then becomes a source of support and strength in times of stress for the participants. The feedback they get from others helps to make them aware of inappropriate, disruptive, aggressive, or maladaptive patterns of behaviour.

There are many different motivations associated with participation in group therapy.  At one extreme are the people with severe emotional difficulties and disorders such as anxiety and depression.  Some groups are, indeed, targeted towards a specific problem area.  Examples of such groups would be those devoted to victims of cancer, or people dealing with bereavement; sexually abused women have formed self-help therapy groups; the Alcoholic Anonymous organisation group meetings might be included in this category.  But at the other extreme we find groups devoted to people who want to develop their interpersonal skills; the T-Group comes into this category.

Group therapy is ideally suited to people who are trying to deal with relationship issues such as intimacy, trust and self-esteem.  Group interactions help the participants to identify, get feedback, and change the patterns that are sabotaging the relations.  The great advantage of group therapy is that you are working on these patterns in the “here and now”; the group situation is similar to the real situation and frequently the people you meet in the group represent others in your past or current life with whom you have difficulty.  In group therapy you have the opportunity to work through these situations; and, importantly, you are doing so in a safe and secure environment.

What techniques are used?

The  techniques used in group therapy can be verbal, expressive, dramatic, pacific, confrontational. and so on, depending on the discipline upon which the group is based.. Approaches can vary from psychoanalytic to cognitive-behavioural, Gestalt, Encounter.   Groups may vary from classic psychotherapy groups, where process is emphasized, to psycho-educational, which are closer to an educational class and focus on such common areas of concern as relationships, stress-management, and anger..  Each approach has its advantages and drawbacks, and participants may be advised to consult an expert to establish which techniques best match their personality.

There are, however, certain general techniques and methods from which all group members will benefit and to which all should aspire.

One of these is Active Listening.  This comprises maintaining eye contact with the speaker; giving undivided attention; non-intervention during the speaker’s “time”; ensuring that you have clearly understood the message.  And active listening is required whether it is to a suggestion by the facilitator, a statement by a single member of the group, participation in a small group, or participation in a large group.

Role Play/Psychodrama is another very useful and popularly employed technique.  This develops interpersonal skills because it is based upon real life situations.  It provides a dynamic way of exploring problems and enables group members to enjoy active participation.  It is also beneficial in providing a risk-free environment for participants to make mistakes without fear of failure or embarrassment.

Brainstorming is a quick and participative method of producing a large number of ideas quickly, usually facilitated with the aid of a black/whiteboard or flipchart, whereby the facilitator invites members to call out as many suggestions as possible and writes them down without any interruption for analysis of the ideas or their relevance.  This comes at a later stage and much useful material is produced by the subsequent consideration of the suggestions.

How is it facilitated?

A minimum of intervention is required of group facilitators.  Each member of the group, in effect, is a therapist as well as a patient, a counsellor as well as a client.  The group unit is the individual, but each individual is an integral part of the entire network of group relations.  This network includes the facilitator whose primary function is one of protection.  Facilitators are there to provide expertise, knowledge, and a safety net . . . but only when it is demanded or when their experience suggests that it is required.  Indeed the facilitator’s success may be measured by the effectiveness with which he or she has been able “to wean the group from this need for authoritative guidance…” (Foulkes, 1964)

“The leader as a facilitator of interpersonal transactions is neither passive nor claims the centre state but will be both observer and reflector of what is going on in the group . . .  The leader also models helpful group behaviour to the members . . .  The leader models respectful attention, giving full weight to what is being disclosed.”  (Bernard Ratigan and Mark Aveline)

Participants, including facilitators, are expected to develop the ability to communicate and listen to each other in a non-judgemental, non-directive, and non-manipulative way.  Conflicts which develop between individuals are resolved by the concerted action of the entire group, including the facilitator, without overt or direct intervention, but by what has been termed “a free-floating communication by the group analytic attitude” (Foulkes &  Anthony, 1965).