In the 23 years that I have been facilitating therapy groups, there have been certain consistencies. One is that the experience is helpful, uplifting, and healing for most people who enter the process. I have had the honor of witnessing people utilize group therapy for such diverse benefits as leaving abusive relationships, entering healthy relationships, pursuing dreams, making career changes, breaking patterns of acquiescing to others, learning to identify and meet needs and goals, overcoming addictions, raising self-esteem, overcoming fears, and developing spirituality. Another consistency, however, is that people unfamiliar with group therapy have not understood this unique therapeutic form, and therefore have been reluctant to enter a group.
So, what is a therapy group? Simply stated, it is when a therapist works with several people at once for a common purpose, typically to address common challenges or problems. A group usually has five to ten people, but this can vary. Usually the group meets weekly, though I have also facilitated half-day and all-day groups that meet only once. Members of a therapy group agree that everything said will remain confidential and that the identities of those who attend will also remain confidential. They also agree to relate to one another in a respectful manner. These guidelines contribute to establishing trust and safety, which creates an atmosphere where they feel more comfortable sharing.
Therapists will each facilitate their groups somewhat differently, but to give you a better understanding of what group therapy is like, here’s what I do. I usually start with a check-in, during which each member has about two minutes to say how he or she is, and what their week has been like. I encourage them to be concise and to focus on themselves rather than sharing excessive details. The check-in gives a feel for who might be struggling and who is at ease. Next, participants share their reflections and insights from any previous group meeting, ask questions, and follow up on any unfinished business. I then “open the floor” to see who would like to describe a challenge that he or she is struggling with. Other group members then ask questions to help the person explore the problem, consider different viewpoints, and contemplate solutions. We might use role-playing as well.
Therapy groups can have a particular focus, such as healing from sexual trauma, eating disorders, substance abuse, and other topics. Or, the group can be open to address any challenges or problems that come up. (The latter approach is the one I prefer to facilitate.) Examples of the many issues that group members work on are relationship problems, depression, anxiety, anger management, self-esteem, parenting challenges, sexual addiction, caring for aging parents, divorce, phobias, career difficulties, coping with illness of oneself or a loved one, overcoming procrastination, inability to identify and meet one’s needs, coping with a family member’s addiction, spiritual seeking, feeling unworthy and “empty,” and healing from trauma. Addressing any one of these often improves all aspects of one’s life.
The group process is different in several ways from individual psychotherapy. Here are some examples of what
can emerge from the group process:
Experimenting with new behaviors. The group can be utilized as a laboratory where people can try new behaviors to determine how effective they might be. For example, a person can practice different ways to be supportive, to express anger, to be assertive, or to be vulnerable.
Identifying strengths and weaknesses. Group members help one another discovering weaknesses and strengths. For example, some people believe they are poor communicators. Yet the group might give them input that they, in fact, communicate clearly and directly. This would help a person understand that a perceived weakness is actually a strength. Conversely, a person might believe they communicate clearly. The group might give them input that they are verbose and digressive, and that listening to them results in loss of attention and feelings of frustration. This would help a person to understand that a perceived strength is actually a weakness, and help them to modify their communication style. The group can also validate that one’s perception of strengths and weaknesses are accurate.
Learning conflict resolution skills. As in any group of people, conflict arises in the therapeutic group. By focusing on the group process in the present moment, members learn healthy conflict resolution skills. In fact, discussing the dynamics and tendencies of the group is often more valuable than discussing the specifics of situations the members bring to the sessions.
Normalizing feelings and problems. When a person talks about a painful struggle, an abusive past, or actions they aren’t happy about, others in the group often reveal similar stories or feelings. Clients repeatedly say, “I never knew others felt this way,” or “It’s such a relief to know I’m not alone.” This revelation decreases their sense of isolation and shame. Shame can be more damaging to the person than the problem that produced it.
Re-creating and working through patterns. Groups serve as a microcosm of society. How a person acts, communicates, and relates to others in a therapy group is very likely how they behave at work, at home, with friends, in their family, and so on. I have seen this many times. An example is a person who interrupts and talks over others. By identifying this behavior in the group, and hearing how it affects others, the person learns that this is a destructive pattern. The group session often reveals that interrupting is a manifestation of anxiety, or a strong need to be heard. The group and I will help the person learn to be more patient and to respond in healthy, respectful, and effective ways.
Discovering family roles. Groups are also like a family. Members tend to “play out” roles they have played in their family of origin (the one they grew up in). Someone who has grown up in a dysfunctional family has learned unhealthy behaviors and coping mechanisms. The group enables such a person to understand the role she or he plays, and to modify it as needed. Examples of this would be acting as caretaker, mediator, scapegoat, hero, victim, parent, or child. Or, the person may be overly aggressive/assertive, or overly passive. It is fascinating to see how these roles carry through into daily life outside the family, and it is uplifting to see people modify them once they recognize the pattern.
Through the years of facilitating groups, I have seen how committed participants become to their own growth and development, as well as to that of the other group members. One reflection of this is that they come to hold others accountable while also taking responsibility for their own growth. As a result, members attend sessions quite consistently. That increases the connection among them, which elevates their trust and willingness to share openly and honestly. They learn to give and receive honest and constructive feedback. They also learn important group skills, such as effective conflict resolution and negotiation skills, a willingness to try new things, and getting one’s needs met in a healthy manner. What’s more, the group therapy participants have been able to take these newly developed skills and insights back into their lives, and become happier and healthier people.
