Likely, you've seen enough movies to have watched the cliched group therapy opening. What may be less apparent is why a group of individuals sitting in a circle of chairs can provide a potentially life-changing experience. This blog aims to explore group therapy and consider the opportunity it presents.
What is Group Therapy?
Countless forms of group therapy exist, and there are myriad forms and structures. In essence, group therapy requires that a group of individuals meet, with the purpose of engaging in some therapeutic process, such as gaining insight, support, changing behaviour and so forth. A founding approach was developed by Foulkes and Anthony (1965) and has had a profound impact in this domain. Their approach presupposes that all human interaction occurs in groups, and therefore it is appropriate for therapeutic change to be advanced in a group context. This is defined by Foulkes (1975, p. 3) as:
"A form of psychotherapy by the group, of the group, including its conductor."
A distinguishing feature is open and closed groups. An open group may allow new members at different moments, whereas closed groups do not admit new members in the course of the group. Groups may also have a time-limited approach; these are often short-term (e.g. ten sessions) and have a specific focus. Alternatively, groups may continue in the long-term without a specific time limit. Some groups are led by members whereas others have a professional (or professionals) which lead the group. This facilitation may be more or less directive and structured.
I find a non-directive approach most transformative, allowing group members to develop their own discourse, allowing space for whatever the group situation may elicit. The material aspects of the group are simple: chairs in a circle and weekly meetings for 90 minutes. Within this approach, I offer closed short-term groups as well as slow-open groups. I also normally begin by meeting with an individual who is interested in joining a group. This allows them to get information about the group and understand my approach, enabling them to decide if joining a group could be productive. Meeting a prospective member also informs my professional decision on whether a particular group would be a good fit for them.
Safety in Numbers?
Some people may find it much easier to talk to a group rather than a therapist, especially knowing that other members have similar experiences. However, there is the valid concern of confidentiality. It is important that there is an agreement by all members to this, often in the form of a written contract. Members should commit to not share any personal information outside of the group, although are free to share about their experience and process. The group conductor also undertakes to keep what is shared confidential, except under extenuating circumstances (such as legal reasons or imminent danger). As in any relationship, safety is built through trust, and confidentiality is fundamental to this.
What happens in the group, stays in the group.
Individual or Group Therapy?
There is no simple answer to this question. The answer depends on the unique personality of the person and what particular challenges they are facing. Group therapy does provide some distinct advantages. The group nature allows for input from others facing similar challenges, in the form of support, empathy or helpful suggestions. The group space also presents a safe space to explore relationships. Lastly, group therapy is less financially intensive.
While the cost is shared among the group, the space is also shared, so group therapy can afford a person less attention than one-on-one therapy. Certain individuals may be faced with problems that might be handled better with one-on-one therapy. Moreover, the group situation can be challenging to some, and sharing with a single professional may be easier. Of course, it is possible to benefit from the process of individual and group therapy, concurrently or at separate stages. If you are unsure, it may be best to consult with a health professional to make an informed choice.
How to Find a Group
If you think you may benefit from group therapy, there are many ways to find a group suited to your needs in South Africa:
Ask a mental health professional you know, such a psychologist, psychiatrist, social worker or any qualified professional in a relevant field.
The South African Depression and Anxiety Group (SADAG) has an excellent directory of support groups. They are also responsible for coordinating groups for a range of purpose, most of which are free. They can be contacted on 0800 21 22 23.
I am also running a trauma support group in my own private practice, which you can find out more about here.
References and Resources
Behr, H., & Hearst, L. (2005). Group-analytic psychotherapy. London: Whurr Publishers.
Foulkes, S. G. (1965). Group psychotherapy and group-analysis: Basic considerations. In Group psychotherapy: The psychoanalytic approach. London: Karnac.
Foulkes, S. H. (1975). Group-analytic psychotherapy: methods and principles. London: Gordon and Breach.
What About Group Therapy? A blog by Ryan Howes.