By Jeanne C. Folks, D.Min, LPC
When is group therapy the best choice of treatment? How is it different from individual therapy? How do groups differ? How do you find the right group for you? This article is intended to provide a “map” that might be helpful if you’re trying to make the decision to give group therapy a try.
Obviously, all types of group therapy differ from individual treatment in that you’re not alone with your therapist. The therapist’s attention and time are not all yours. It’s a different experience to have to share. All kinds of questions can come up for group members. Is the therapist more interested in somebody else’s problem than yours? Does she/he like other people in group better? Is everyone else’s pain/problems bigger and more important that yours (and therefore you shouldn’t take up valuable time)? Do other group members wish you weren’t part of the group? In other words, are you welcome?
Group can be a wonderful place to learn about the value of your presence to others, and to experience entitlement to time, space and attention. That learning however, comes at times at the price of living through a whole lot of risk and fear. Times when this might not be a good idea for you would be if you’re in a place of feeling so fragile or vulnerable that dealing with just one other human being (and one that has lots of skill and no demands at that) seems like almost too much. It’s also okay to want and need the privacy of individual work and not want additional variables in treatment which the presence of others creates. Questioning in your own mind what it might be like to be in a group, to be interactive with others, may be a sign that you’re ready for group. Just remember, therapy in any form is meant to be compassionately challenging ‑ not overwhelming.
Group can be a very broad therapeutic experience as well as one which is financially manageable. With few exceptions, group is one of the most economical forms of therapy available. Dollar for dollar you are getting more therapeutic time (usually 1½ ‑ 2 hours) with equal frequency of contact (every week or every other week). Some people alternate weeks of individual and group therapy as a way maximize therapeutic experience and keep costs down.
Depending on the type and size of a group, fees can run anywhere from $35 ‑ $75 per session whereas individual treatment will run on average $90 – $175 for a 50 minute hour. For this reason, it is also true that group therapy is the only therapeutic option for some people. If this is your situation, the group you choose is even more important.
There are a wide variety of groups available. Making your choice can be a therapeutic process in itself because you have to examine your particular needs. In terms of structure, groups can be time specific or ongoing. The time specific group may last six, ten or perhaps twelve weeks. The time specific group is also most likely to be topic specific, addressing a particular experience, such as healing the grief of a loss, or addressing a particular problem such as compulsive overeating. Such groups can be very useful, and are especially good for a first time experience of group. It won’t feel like such a huge commitment. You know what you’re going to address and when the experience will end. This also means there will be limits to how much intimacy and trust can grow in a short time.
Ongoing groups are both a bigger commitment and hold the potential for a broader psychotherapeutic encounter. Ongoing groups are less likely to assigned topic for each week, although there may be an overarching concern such as general support for women or men, being trauma survivors, dealing with chronic illness, parenting, etc. This can create a beginning context for the group ‑ a starting place of shared experience from which the exploration and examination of many life experiences can flow.
Ultimately, group is a microcosm of the world. Whatever we do and experience “out there” we will do and experience in the “in here” of group. If you have a problem with jealousy, things will start happening in group that will make you jealous. If you have a big issue with trust, things people say in group will make them sound very untrustworthy to you. Believe it or not, this is good news. Group is the place where such patterns and experiences can be mercifully explored and made more conscious. Group is a place where our value as human beings can be celebrated not as “finished products” but as unique combinations of gifts and wounds that don’t require apology for being. Group is a place where you can rediscover that a sense of closeness and intimacy with others comes from the feelings of being authentically seen, known and wanted.
As mentioned earlier, some people find a combination of group and individual treatment useful, affording them the benefits of both experiences, and therefore maximizing the effectiveness of each. This can be either with the same, or with two different therapists. Doing group therapy and individual therapy with the same therapist can feel safer in some ways, especially if you started with individual first. The therapist is already a safe person for you. His or her therapeutic style is already familiar to you.
There can also be drawbacks, however. Being with your therapist in a different context can be confusing ‑ watching her/him interact with others disturbing. It can also be a temptation to not face issues in group, but rather to bring back questions, problems or reactions which came up in group to your individual session. This can create a situation in which you and your therapist are then “keeping secrets” from the group. It takes a strong, therapist with clear boundaries to make room for the client to learn to share him/her with others and to be clear that group issues are to be worked out in group. If you or your individual therapist have any misgivings about this, doing group and individual therapy with different therapists makes sense. It also makes sense to ask your individual therapist and group therapist to confer, at least once, to make sure that treatment goals are shared and that treatment styles don’t conflict.
Most therapists doing groups invite initial, private consultations (often at no charge) prior to starting in group. This gives the potential group member a chance to ask specific questions about group and for the therapist and potential client to get a sense of each other. Don’t be afraid to interview several therapists before you decide.
As you interview, however, recognize that starting in group therapy can feel risky. Try not to confuse that anxiety with a real inner caution that this particular group isn’t right for you. The fear of taking a positive risk may be a signal that something is very right. It can be a sign of growth and readiness to stretch. If you still can’t decide, see if the group therapist you’re considering offers one time workshops or classes. This would give you the chance to observe him/her interacting with others in a setting that’s low risk for you.
Once you’ve made the decision to join a therapy group, promise yourself you’ll give group it a multiple session try. Because of the fear factor, it can be tempting to quit after the first week or two. This will be hard on you and is also disruptive to group. In truth, those first feelings might indicate the very areas where you most hope to grow. Also, just as with individuals, groups develop their own unique “personality”. It takes a little time to get a complete “sample” of a group. Have a little patience and trust that where people come together for the express purpose of accepting themselves, growing and being good to one another, in time, wondrous things can happen.