GETTING STARTED IN GROUP THERAPY
Attending a pre-group preparatory meeting is the first step to becoming part of a group. In this meeting, you will be assessed to determine your therapeutic goals and the appropriateness of your participation in a particular group. Some goals of this meeting include:
To begin to build the foundation for a therapeutic relationship with your therapist. Your therapist will be a continuous resource and source of support and feedback for you throughout the group therapy process.
To dispel any fears that you might have about joining a group or sharing your thoughts and feelings with others. Anxiety about entering a group is common among all people, so addressing those concerns before joining the group is important for your peace of mind and group success.
To create an understanding of what the group therapy process is and to answer any questions that you might have about joining a group. You will gain an understanding about what role you have in the group and what role your therapist has.
Some other aspects of group therapy you will learn about include:
How the group will be run
How to participate in a group
How to effectively self-disclose and give feedback to others
How to ensure confidentiality
How to leave the group
How to avoid the potential risks and take advantage of the potential benefits of group therapy and other treatment options available to you
To determine your personal goals for joining the group and an understanding of what you’d like to get out of the group.
Combining Group Therapy with Other Therapies
Group therapy clients also commonly participate in other forms of treatment while being part of a group, including individual therapy, pharmacotherapy, or a 12-step group. If needed, with your permission, your therapist will work with other healthcare providers with whom you work to ensure that your therapies are integrated and consistent.
Individual Therapy and Group Therapy
Group therapy primarily focuses on interpersonal interactions, while individual therapy primarily focuses on what your own thoughts, feelings, and behavior. Working together, these two avenues for exploring yourself can lead to powerful insights and results. You can add group therapy or individual therapy at any time to gain a greater understanding of yourself and to learn new skills in either dimension. The best outcome occurs when you provide consistent information to both your group and individual therapist.
Psychopharmacology and Group Therapy
If you are already on psychotropic medication, your therapist can be a resource to your medical provider. Alternatively, if it becomes apparent during the course of group therapy that you would benefit from psychotropic medication, your therapist can make an appropriate referral to a medical provider.
12-Step Groups and Group Therapy
Your group therapist will facilitate the collaboration between the two methods of treatment, using the 12-step process as a foundation for group psychotherapy. However, important differences between psychotherapy groups and 12-step groups exist:
Psychotherapy groups require feedback from group members to other group members as part of the therapeutic process.
Boundaries between the group psychotherapist and group members and between group members are more clearly defined than between a sponsor and sponsee or between members of a 12-step group.
Group psychotherapy can complement the relational work done in any 12-step program through the examination of improvement in the way you relate to and communicate with others.
Achieving a positive outcome in group therapy
Many psychologists and counselors have studied the factors contributing to a positive outcome in group therapy. Irving Yalom and Molyn Leszcz, in The Theory and Practice of Group Psychotherapy, outline the following therapeutic factors in group psychotherapy:
Universality: Members recognize that other group members share similar feelings, thoughts, and problems.
Altruism: Members experience a boost to their self-concept by extending help to other group members.
Instillation of Hope: Members recognize that other group members’ success can be helpful, and they develop optimism for their own improvement.
Imparting Information: Members benefit from the education and advice provided by the therapist or other group members.
Corrective Recapitulation of Primary Family Experience: Members have the opportunity to reenact critical family dynamics with other group members in a corrective manner.
Development of Socializing Techniques: The group provides members with an environment that fosters adaptive and effective communication.
Imitative Behavior: Members expand their personal knowledge and skills through the observation of other group members’ self-exploration, working through, and personal development.
Cohesiveness: Members experience feelings of trust, belonging, and togetherness with other group members.
Existential Factors: Members accept responsibility for their life decisions.
Catharsis: Members release strong feelings about past or present experiences.
Interpersonal Learning-Input: Members gain personal insight about their interpersonal impact through feedback provided by other group members.
Interpersonal Learning-Output: The group provides members with an environment that allows them to interact in a more adaptive manner.
Self-Understanding: Members gain insight into the psychological motivation underlying behavior and emotional reactions.
Yalom and his colleagues studied these therapeutic factors by asking clients who had successfully completed group therapy what they found to be most helpful about the process. The clients in his studies reported the following factors to be most helpful (listed in order of importance):
Discovering and accepting previously unknown or unacceptable parts of myself.
Being able to say what was bothering me instead of holding it in.
Other members honestly telling me what they think of me.
Learning how to express my feelings.
The group’s teaching me about the type of impression I make on others.
Expressing negative and/or positive feelings toward another member.
Learning that I must take ultimate responsibility for the way I live no matter how much guidance and support I get from others.
Learning how I come across to others.
Seeing that others could reveal embarrassing things and take other risks and benefit from it helped me to do the same.
Feeling more trusting of groups and of other people.