WHY GROUP THERAPY?
Why do people consider group therapy? There are several reasons why group therapy is recommended for individuals experiencing life challenges. Group therapy can be lively, challenging, poignant and sometimes difficult; experiences which can help individuals examine and explore their issues in greater detail and achieve greater clarity, understanding and acceptance of oneself and others.Group therapy is not suitable for everyone. Most therapists interview potential participants to determine if group is likely to meet their needs given the format, purpose and experience of the particular group.
Group therapy is a support group with additional parts. A support group (such as Alcoholics Anonymous, a grief group, or pregnant teenagers group) brings together individuals with one or more common issues. It provides a safe place to explore and connect with those in similar circumstances. A support group encourages ventilation (members speak candidly about their feelings, concerns and views), validation and normalizing (acknowledging shared experiences) and usually helps participants feel less isolated, alone, and different from others.
Group therapy is distinguished from a support group in several key ways. The first difference is that feedback is an integral part of the group experience. Participants may ask for direct feedback regarding an issue they have brought to the group, or they may hear how others perceive them in group interactions. Issues broached in group evoke differing viewpoints from group members; the ensuing discussion has the potential to allow participants to see alternative perspectives which may help broaden their understanding. The second distinction is that a large part of group time is devoted to process, here simply defined as understanding and working with the relationships in the therapy room. Here are three examples of process comments from John, a group member:
Group process suggests that participants’ issues and experiences in life outside of the group will most likely reoccur in the group dynamic (for example, people who avoid anger in their daily lives will most likely try to avoid anger in the group; people who are easily frustrated and annoyed will very likely be frustrated and annoyed in the group). In this way group therapy presents a poignant opportunity to work through predominant patterns in one’s life.
In the beginning stages of group, process is infrequently discussed. As a group matures, building on trust and safety, process is more likely to surface, helping the group focus and work on problems in the "here and now". In support groups, process is either missing or discussed in a limited context, usually due to the group's definition and/or lack of time. An experience focusing on process could take a large portion of group time; the benefit is that each member will potentially learn something significant about themselves and others.
A final distinction between a therapy and support group is that a therapy group utilizes conflict to help reach greater depth and intimacy. This conflict is not physical in nature and is not left unmoderated; group guidelines clearly state behavioral norms expected of members. The Facilitator's role includes helping maintain safety in the group while conflict exists. Issues of conflict can be particularly helpful when they are analyzed from a variety of perspectives, such as: 1) Acknowledging a personal "sore spot" or "button" that adds intensity not related to the issue experienced; 2) An issue that historically may remind one of past experiences and/or persons, such as family members, partners, etc.; and, 3) A re-creation of past difficult experiences. Group members are often asked to step back from an immediate conflict and examine the issue from these different perspectives.
Benefits of working through conflict include a new understanding of an issue or of a fellow group participant; feeling more understood after the conflict; and, a sense of completion around issues that heretofore may have lacked clarity.
DIFFERENCES BETWEEN INDIVIDUAL & GROUP PSYCHOTHERAPY
Comparing individual and group therapy, there are both similarities and differences. A therapist can help you decide which of the two, or both, is particularly suited for your needs. For individuals in crisis or with problems that require time-intensive, direct focus, individual therapy can be the better choice. In individual therapy, a dialogue is usually reflective of two experiences; the client and the therapist's, whereas a group offers multiple peer perspectives and feedback. In general, people react differently to challenges by their peers as compared to those by authority figures, as therapists are often perceived.
Sometimes clients "hide out" in individual therapy; that is a client can control, to some degree, how vulnerable and disclosing she becomes, and to what degree he resists the therapist's interpretations and insights. This is much harder to accomplish in group, as participants inevitably are challenged by other group members or the group as a whole with regard to their group presentation, which may include observations about avoidance and denial.
Group participation requires patience, sharing time with others, listening skills, giving and receiving feedback in constructive manners, being on the occasional "hot seat," and the ability to leave some issues unfinished, given time and other constraints of the group therapy process.
At any given moment, group members can experience frustration with the ups and downs of the group's progress or lack of progress. Conversely, group is often used as a kind of "laboratory," where members try out behaviors and get feedback and encouragement as it relates to outside issues.
ISSUES ESPECIALLY AMENABLE TO GROUP PROCESS
Any issue or problem that can utilize the benefits of group dynamics is usually a good indicator for group participation. Generally, topics of an interpersonal nature, including issues of intimacy and relationship, self-esteem and self-value, and communication and listening skills can especially benefit from interactive group proceedings. A basic goal of most groups is to be understood on many issues and to be accepted for whom one is (including the more intimate or secret parts of ourselves).
Participants dealing with issues that are stigmatized (for example, sexual addiction, perpetrators of violence) can also benefit in group. Connections are made emphasizing common struggles and perspectives as well as feelings of difference, judgment and inferiority.
Group therapy for gay and bisexual men may have particular benefits. Many gay and bisexual men have had difficult, if not traumatizing experiences, in group settings growing up, particularly with other males. Group can offer a different experience which can help repair and recover these devastating experiences in groups. Emphasizing safety, support, access to and expressing feelings, and encouragement of vulnerability and risk taking are all powerful means to address life's issues.
The experience in group challenges all men, regardless of their sexual orientation, to examine socialization patterns that inhibit them and take a large toll. These include highly valued competitive and confrontational drives; the need or desire to be tough and invincible; the avoidance of any attributes that may appear feminine; a sense of isolation and the need to carry one's burdens alone; and a tendency to focus on issues of power and control.
Conversely, many gay and bisexual men avoid group for these same reasons: Experiences with men, including Gay Men, have left them feeling dismissed, rejected, isolated, and inferior. In essence, these experiences can re-create the difficulties these men experienced in their youth. Group provides a safe context in which men have the potential to heal through these challenging emotions.
In sum, group therapy can provide a powerful therapeutic benefit for those willing to consider the risk of joining such a group, and undertaking a personal challenge to utilize the group for its intended purpose.
© 2006 Jamie Moran