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What Exactly Is Group Therapy?
Group therapy might be the most misunderstood form of therapy out there. Many people think it’s just a simple group discussion or a type of learning session. At OpenCounseling, we’ve seen apps, online therapy platforms, and even some in-person therapy providers claim to offer group therapy while offering everything but.
We’re sympathetic. Group therapy is a little bit obscure, like that one album that only true fans know about. OG therapists know what it is, while everyone else just takes everyone else’s word when they point to something and call it group therapy. It’s not just app makers; there are many community agencies out there that offer “therapy groups” that just… aren’t.
So, what is group therapy? What makes it special? And what other kinds of groups can be helpful? Keep reading to learn more—and to learn why we think true group therapy is an overlooked gem in the therapy world.
What Isn't Group Therapy?
We think it’s easier to understand what group therapy is if you start with what it isn’t. Things that aren’t group therapy include:
- Support groups
- Coaching groups
- Educational groups
- Psychoeducation groups
- Activity-based groups
We’ll go into more detail about these kinds of groups later. They’re all valuable, and they’re all worth doing, so it’s worth spending a little time explaining their benefits in greater detail. But for the immediate purpose of understanding what group therapy is, we’ll start by explaining why each of these groups aren’t therapy groups.
What's a Support Group?
Support groups aren’t therapy groups because their purpose isn’t therapy, it’s support. It’s to give people a space to talk about personal, emotional, or difficult subjects. This can be therapeutic, but it’s not therapy because it doesn’t treat the root cause of psychological issues. Instead, it supports people on their journey to deal with those issues and makes that journey less lonely.
Group coaching isn’t therapy because coaching isn’t therapy. The main distinction between coaching and therapy is that therapy is insight-oriented while coaching is action-oriented. Therapy groups help people heal, while coaching groups help people clarify their goals and take action to achieve them.
Psychoeducation and general education groups aren’t therapy because their purpose is to educate their members rather than treat their symptoms. This is tricky because many groups that claim to be therapy groups are actually psychoeducation groups that help people learn about their conditions. This is valuable, and it goes well with therapy—but it isn’t therapy.
Activity-based groups aren’t therapy no matter how therapeutic the shared activity might be. Meditation, breathwork, and relaxation exercises are all incredibly helpful, and can help reduce anxiety, but they’re not therapy, because they aren’t focused on helping you gain insight into what is causing your anxiety in the first place.
…We could go on, but we think you get the idea.
What Is Group Therapy?
Group therapy is therapy delivered in a group format rather than an individual format.
Okay, we know that definition isn’t super helpful, so let’s break it down a little more.
Let’s start with what therapy is. The traditional purpose of therapy is to help people gain insight. The idea is that it helps you overcome depression, anxiety, or other mental health issues by helping you figure out what’s driving your symptoms. That underlying cause could be:
- An early trauma,
- A certain way of thinking, or
- An environmental trigger.
No matter what is driving your symptoms, the reason it affects you the way it does is always buried in your psyche. And therapy is the shovel that can dig it out.
What Makes Therapy What It Is?
Therapy is personal. Therapy isn’t one-size-fits-all. It’s not learning general principles from a textbook or listening to a lecture. It’s something that gives you answers that only you can get because it helps you find them inside your own mind.
Therapy groups operate on the same principle as individual therapy. If you’re learning general knowledge in a group, it isn’t giving you access to personal information or insight. In order to help you get that personal insight, the focus of a therapy group is process rather than content.
What does this mean? In a therapy group, you and the other members notice how you respond to one another. You notice patterns in your interactions. You talk to each other about each other, not generic concepts. By noticing and talking about these things, you can gain personal insights into yourself and the other members of the group.
Group therapy uses the power of the group dynamic to uncover truths even individual therapy can't always unearth.
To experience this, members have to be willing to gently challenge each other. You have to be interested in respectfully helping each other out by telling the truth. This means you have to be willing to get personal and say things that are a little more off-the-cuff.
What Is the Role of the Therapist in a Therapy Group?
The role of the therapist in a therapy group is to steer the group in a direction that helps members uncover personal truths.
In other words, group therapists facilitate groups. They use their training to encourage productive discussion. Part of their role is to keep things from going off the rails and to make sure group members remain civil with one another, but that’s only a small part of it.
Their main role of the group therapist is to notice what's happening between members and to encourage important conversations to continue.
In many cases, the therapist will spend much of the group in silence, especially if a productive interaction is already happening. They’ll occasionally pipe up to direct your attention to important moments as they unfold. They might ask a few questions and make an observation or two, then get quiet again.
Group therapists help you pay attention to dynamics that are easier to notice than they are when they come up in everyday life. In everyday conversations, important moments can get run off the rails by distractions or by someone changing the subject. In a therapy group, the therapist will often steer you back to important interactions and ask you to look closer at what just happened.
How Does Group Therapy Work?
Group therapy uses the power of group interaction to help you learn about yourself. It’s especially good at helping you see patterns in how you relate to others. This can help you identify and address things you want to change in your personal relationships.
Group therapy gives you a container in which you can observe and study how you are with others. As you trip into the same things that trigger you when they come up in your relationships with friends, family, or partners, the therapist and other group members can help you see yourself more clearly than is usually possible in those heated personal interactions.
Group therapy helps you see when you’re reacting in an unconscious way. It helps you identify the filters through which you interpret others’ words and actions—and the distortions those filters create. When you go home from a group, you’ll probably catch yourself doing the same things you were doing—and discussing—in group. By making those reactive patterns conscious, group therapy gives you power to interrupt them and try something else.
What Is Group Therapy Like? A Vignette
Let’s join an imaginary group therapy session to learn a little more about how it works. As we join, Julia is speaking.
She says, “Well, anyway, it went like most talks with my mother go. She said I was never going to succeed, that I’d never been practical, that it was about time I got my head out of the clouds. I think she—”
“It’s not important,” group member George interjects. “Why do you—”
“Whoa, George, you’re not supposed to interrupt Julia,” group member Katie says.
“She’s right, George,” therapist Sam says. “We need to let Julia finish—”
“WHO ARE YOU TO SAY WHAT’S IMPORTANT!?!” Julia’s intensity shuts down the patter and everyone looks at her, including Sam. “It’s important to me, so it should matter, but of course it doesn’t matter, because it’s me. You’re just like my mother,” she says, trailing off.
“Can I finish what I was going to say? I’m sorry I interrupted, but…” George begins saying.
“Why should I let you finish if you’re not going to let me?” Julia says.
“Fair enough, Julia, but I think it might help to hear what George was trying to say,” Sam says.
“Okay.” Julia relents. “Just don’t piss me off.”
Everyone laughs. Even Julia laughs a little when George’s eyes widen.
“I was trying to say that what your mother thinks isn’t important. I think what’s important is what you’re working on, and I admire you for doing it! In fact, you’ve inspired me to start working on something I gave up on before.
“Because I see myself doing the same thing you do. I give more power to what other people think than what I think. And it’s so obvious to me your mother doesn’t know what the hell she’s talking about. Seeing that made it easier to see that the ‘friends’ who try to cut me down to size don’t know what they’re talking about, either…”
We’ll stop here. George’s feedback and the group process helped Julia see how she keeps second-guessing herself even though she knows deep down her mother doesn’t know more than her. This was only possible because George empathized with her and recognized the same pattern in his own behavior, prompting the rest of the group to share about how they do the same thing.
Why Therapy Groups Aren't Just Conversations
Group therapy is informed by the principle that it's easier to recognize another person's patterns than it is to recognize your own. Other people can help us see our patterns sooner than we can.
Therapy groups make it easier to have insightful moments for a number of reasons. For one, they’re composed of people who are seeking insight into their patterns. When you join a group, you’re agreeing to being gently “called out” when others notice distortions in your thinking.
This only works when groups operate on the principles of empathy and respect. Therapists are there in part to make sure groups don’t devolve into judgement or shaming.
Insight can only happen when you and the rest of the group recognize that you all have the same capacity to engage in unproductive patterns as well as the same capacity to change those patterns and grow.
It’s possible for everyday interactions with friends and family members to be therapeutic and to yield healing insights. It’s rare, though. Why? Usually, we’re not entering those conversations with the purpose of learning about ourselves. We’re often in competition with one another—for sympathy, for laughs, for respect. And we’re much more defensive when things get personal.
Whether interaction leads to insight often depends more on the person having the insight than the interaction. It depends on whether you are open to learning from that experience.
Groups are designed so that everyone shares the same intention to learn and to help other group members learn about themselves.
The therapist helps by coaxing the group in a therapeutic direction. And by sharing the same commitment to truth and the same intention to uncover it, you and other group members can see what is right there to be seen when someone else encourages you to look at it long enough.
Other Kinds of Groups, Revisited
So, let’s revisit these other kinds of groups and discuss their potential virtues now that we’ve established what group therapy actually is. It’s important to point out that we think every last one of these kinds of groups are valuable. (We just wish people would stop calling them therapy.)
In support groups, people share their stories, and other group members give them empathy, validation, and advice. Some support groups are led by therapists, but most are not. Instead, they’re led by peers, or by no one at all, with everyone in the group having equal standing and sharing the same role.
Support groups can be really powerful. Like therapy groups, support groups operate on the principle that relationships are our most powerful sources of healing and insight. Support groups can help you overcome addiction, work through grief, and get through things that are impossible to get through alone.
Support groups can help you make lifelong friendships. They can help you find meaning and hope. They are usually very affordable and are often free. They’re a fantastic resource. Just don’t go to one when what you need is therapy! (Unless you’re also already getting therapy. They can be a great therapy add-on.)
Education groups give you important information that you can use to solve problems and take effective action. Because the information they provide is tailored to the specific needs of the people in the group, they can be more focused and helpful than books on the same subject.
What's a Psychoeducation Group?
Psychoeducation groups are education groups that help you learn about issues related to your mental health. They can help you learn how to recognize and deal with symptoms and teach you coping skills. They can help you understand that you are not alone and that you can get better.
Coaching groups use the creative power of collaboration to help you come up with solutions to problems you share in common with other group members. They put people together who have similar goals who can encourage one another in the quest to achieve them. The inspiration, camaraderie, and advice you get in one can help you find your way through a challenging task.
Activity-based groups guide you and other group members through a shared activity. You may do relaxation exercises together, stretch, do yoga, paint, make crafts, or meditate. These groups can be really helpful because the group activity can help you relax and improve your mood. They are another great therapy add-on because they can provide immediate relief for certain symptoms while you’re addressing the underlying causes of those symptoms in therapy.
There are a ton of helpful groups out there, but most of them aren’t therapy groups. We love all of these different kinds of groups—we just wish people wouldn’t incorrectly label them as therapy groups when they’re not. Knowing the difference is important because knowing what kind of group you’re doing can help you make sure you’re getting the right level of care.
Therapy groups are a special kind of group that gives you the same level of care as individual therapy, just in a different format. While individual therapy is better for some things, group therapy excels at helping you gain insight into your patterns in relationships. Therapy groups also give you a safe place where you can practice changing those patterns.
As much as big corporate mental health providers love groups, true group therapy seems to be a rare bird these days. That’s too bad, because there’s nothing quite like it. Ultimately, individual therapy can help you with a wider range of issues than group therapy, and it’s the better overall choice, but there are things you can learn about yourself in a group that you can’t learn anywhere else. If you get a chance to try a therapy group, we hope you do. It’s a wonderful opportunity to see others—and yourself—in a way that normal everyday life rarely allows.
Starting therapy can be scary, but we’re here to help
Stephanie Hairston is a freelance mental health writer who spent several years in the field of adult mental health before transitioning to professional writing and editing. As a clinical social worker, she provided group and individual therapy, crisis intervention services, and psychological assessments.