Group Therapy

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Definition

Group therapy is a form of psychosocial treatment where a small group of patients meet regularly to talk, interact, and discuss problems with each other and the group leader (therapist).

Description

A psychologist, psychiatrist, social worker, or other healthcare professional typically arranges and conducts group therapy sessions. In some therapy groups, two cotherapists share the responsibility of group leadership. Patients are selected on the basis of what they might gain from group therapy interaction and what they can contribute to the group as a whole.

Therapy groups may be homogeneous or heterogeneous. Homogeneous groups have members with similar diagnostic backgrounds (for example, they may all suffer from depression). Heterogeneous groups have a mix of individuals with different emotional issues. The number of group members varies widely, but is typically no more than 12. Groups may be time limited (with a predetermined number of sessions) or indefinite (where the group determines when therapy ends). Membership may be closed or open to new members once sessions begin.

The number of sessions in group therapy depends on the makeup, goals, and setting of the group. For example, a therapy group that is part of a substance abuse program to rehabilitate inpatients would be called short-term group therapy. This term is used because, as patients, the group members will only be in the hospital for a relatively short period of time. Long-term therapy groups may meet for six months, a year, or longer. The therapeutic approach used in therapy depends on the focus of the group and the psychological training of the therapist. Some common techniques include psychodynamic, cognitive-behavioral, and Gestalt therapy.

In a group therapy session, group members are encouraged to openly and honestly discuss the issues that brought them to therapy. They try to help other group members by offering their own suggestions, insights, and empathy regarding their problems. There are no definite rules for group therapy, only that members participate to the best of their ability. However, most therapy groups do have some basic ground rules that are usually discussed during the first session. Patients are asked not to share what goes on in therapy sessions with anyone outside of the group. This protects the confidentiality of the other members. They may also be asked not to see other group members socially outside of therapy because of the harmful effect it might have on the dynamics of the group.

The therapist's main task is to guide the group in self-discovery. Depending on the goals of the group and the training and style of the therapist, he or she may lead the group interaction or allow the group to take their own direction. Typically, the group leader does some of both, providing direction when the group gets off track while letting them set their own agenda. The therapist may guide the group by simply reinforcing the positive behaviors they engage in. For example, if a group member shows empathy to another member, or offers a constructive suggestion, the therapist will point this out and explain the value of these actions to the group. In almost all group therapy situations, the therapist will attempt to emphasize the common traits among group members so that members can gain a sense of group identity. Group members realize that others share the same issues they do.

The main benefit group therapy may have over individual psychotherapy is that some patients behave and react more like themselves in a group setting than they would one-on-one with a therapist. The group therapy patient gains a certain sense of identity and social acceptance from their membership in the group. Suddenly, they are not alone. They are surrounded by others who have the same anxieties and emotional issues that they have. Seeing how others deal with these issues may give them new solutions to their problems. Feedback from group members also offers them a unique insight into their own behavior, and the group provides a safe forum in which to practice new behaviors. Lastly, by helping others in the group work through their problems, group therapy members can gain more self-esteem. Group therapy may also simulate family experiences of patients and will allow family dynamic issues to emerge.

Self-help groups like Alcoholics Anonymous and Weight Watchers fall outside of the psychotherapy realm. These self-help groups do offer many of the same benefits of social support, identity, and belonging that make group therapy effective for many. Self-help group members meet to discuss a common area of concern (like alcoholism, eating disorders, bereavement, parenting). Group sessions are not run by a therapist, but by a nonprofessional leader, group member, or the group as a whole. Self-help groups are sometimes used in addition to psychotherapy or regular group therapy.

— Paula Anne Ford-Martin

A form of psychotherapy that involves sessions guided by a therapist and attended by several clients who confront their personal problems together. The interaction among clients is considered to be an integral part of the therapeutic process.

For more information on group therapy, visit Britannica.com.

The notion of group psychotherapies encompasses a considerable number of techniques and different theoretical points of view. Strictly speaking, group psychotherapy is a method for treating psychopathology and its concomitant suffering by means of the specific action of the group's processes on the individuals who comprise it. There is also a model of group psychotherapy that seeks to treat the group as a specific whole. To accomplish its therapeutic aims and bring about the corresponding changes in personality, group psychotherapy mobilizes in the participants the psychological exploration and work that ensues necessarily as a result of the development of intersubjective and transsubjective links. Various appropriate mechanisms are directed toward this end.

This method of psychotherapy is probably the oldest form of mental and psychosomatic care. Treatment regimens practiced in the Asclepion at Pergamon (Bergama) included group sessions of dream interpretation, as the ancient writings of Aelius Aristides reveal. However, the term "group psychotherapy" is recent: It was introduced by Jacob Moreno around 1930. Various attempts had been made prior to that, from Franz von Mesmer's tub to the explorations of J. H. Pratt (1905) or Trigant Burrow (1914). On the eve and at the beginning of the Second World War, Kurt Lewin and his collaborators developed the basics of group dynamics, based on Gestalt theory, observations of experimental groups, and group training programs. Siegmund Foulkes and Wilfred R. Bion established the groundwork for group analysis and psychoanalytic group psychotherapy. During the 1950s and 1960s this trend saw a remarkable upsurge in the United States, Latin America (Enrique Pichon-Rivière, José Bleger), and in Europe, notably in Great Britain, France, and Italy.

There is considerable variation among the theories, practical techniques, and goals of group psychotherapies, but a certain number of characteristics are common to all its forms. The group is composed of a relatively small number of participants (from three to about a dozen) who come together for a limited time. The restricted size of the group enables each of its participants to perceive and enter into relationship with each of the others; the time limitation, whether or not it is predetermined (long-term groups, short-term therapies, groups that gradually become more open), makes it possible to work with the resistance effects provoked by the group's institutionalization.

Several combinable classification criteria can be used to distinguish different types of groups: mono-therapy or cotherapy groups; groups centered on the group or on the individual; on speech or on nonverbal modes of expression (ergotherapies, art therapies, writing, music); on psychodramatic role-playing or on the body (bioenergy, primal scream, relaxation); on family relations (psychoanalytic and systemic family therapies); on instituted groups (therapy groups within institutions, therapeutic communities). Regardless of the form of communication used to put the therapeutic processes into play (words, screams, improvised or scripted role-playing, sculpting, painting, music, puppets), each theory has its own way of assessing the therapy's processes and effects.

According to the psychoanalytic conception, the group constitutes a staging ground for the externalization, figuration, and contention of pathogenic representations that are unacceptable in the intrapsychic space; it is a mechanism for linking and dynamic transformation of the formations and processes that cannot be internally bound without this detour through the work of intersubjectivity. Groups result in specific modes of transference and resistance. Interpreting these produces a reorganization of the psyche in its encounter with the object-based reality of others, with the prohibitions and founding statements of psychic life and of intersubjectivity. For its members, the group constitutes a powerful identificatory anaclisis; it generates creativity and the capacity for symbolization between intrapsychic and bodily reality and intersubjective and social reality. However, numerous clinical, methodological, and theoretical problems have yet to be worked out. Group psychotherapies are not a panacea. They require a personal demand and personal training; their effectiveness depends on the specific indications, limits, and principles involved.

Bibliography

Bion, Wilfred Ruprecht. (1965). Transformations: Change from learning to growth. London: Tavistock Publications.

Bleandonu, Gérard. (1991). Les groupes thérapeutiques familiaux et institutionnels. Paris: Presses Universitaires de France.

Foulkes, Siegmund Heinrich. (1964). Therapeutic group analysis. New York: International Universities Press.

Moreno, Jacob L. (1966). The international handbook of group psychotherapy. New York: Philosophical Library.

Schneider, Pierre-Bernard. (1965-1972). Pratique de la psychothérapie de groupe. Paris: Presses Universitaires de France.

Further Reading

Brown, Dennis, and Zinkin, Louis. (Eds.) (1994). The psyche and the social world: Developments in group-analytic theory. London/New York: Routledge.

—RENÉ KAËS

Any form of psychotherapy involving a group of patients, rather than a one-on-one session between a patient and a therapist. (See encounter group).

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