INTRODUCTION

Are you thinking about starting therapy? Group therapy is a unique and highly effective form of treatment for a variety of mental health problems. Here you will learn how group therapy works and why it can be a powerful alternative or complement to individual therapy. As an experienced group psychologist, I want to share how this form of therapy can help you. In this post, I will describe how it works, as I conduct it, and what advantages it has over individual psychotherapy.

WHAT IS GROUP THERAPY?

A group usually consists of 5-8 people, men and women of different ages who do not know each other beforehand. The group is so-called semi-open, meaning that participants join and leave based on when their respective objectives are met. This means that the group may look different when you start and when you finish. Everyone will have different issues and difficulties, but there are often great similarities in experiences.

The group meets regularly every week for 90 minutes. The duration of the therapy depends entirely on your specific problem and individual needs. Many people find it rewarding to attend for several years, but expect to attend for at least six months to get what you want out of your participation. It is possible to attend individual psychotherapy in parallel, either with me who runs the group, or with another therapist.

HOW DOES IT WORK?

There is no predetermined agenda for each session. You are encouraged to talk about personal, emotional and relational issues that are relevant to your own issues and the goals that brought you to therapy.

Participants are encouraged to provide support, ask questions, name what is said or not said, and to share their associations and thoughts. Much emphasis will be placed on exploring the relationships between participants 'here-and-now'. As a group participant, you will often be asked to share your impressions of the other participants - your thoughts and feelings in the room. The more work the group does here-and-now, the more effective the therapy will be.

Sharing oneself is necessary to get something out of group therapy, but participants choose to share with the group at their own pace.

To create a therapeutic group environment, we ask participants to always try to speak to other members in a constructive way. Helpful feedback tends to focus on the here-and-now. This type of feedback and engagement is unusual in our culture where we rarely speak so honestly and directly. It may feel scary and risky at first, but will probably also feel engaging, meaningful and rewarding.

Giving direct advice to other participants or the group leader is rarely helpful, although there are of course exceptions. So are general discussions about politics or the weather, unless there is something in a current event that has a direct link and particular relevance to one's personal and relational difficulties.

*William Blake - Group of Men Seated in a Circle*

You will probably form strong bonds with the group participants, but group therapy is not a place to make friends. Think of it more as a social laboratory - a place where you acquire the skills to develop meaningful and rewarding relationships. In fact, participants in group therapy (as opposed to support or social groups) are encouraged to have no contact with each other outside the group. A relationship with one or more participants outside the group generally tends to inhibit therapeutic work.

In the group, you will have the chance to explore how you work with others. You will discover new aspects of yourself by sharing your thoughts and feelings about the other participants in the room, and by receiving others' reactions and feedback on you. At first, this may seem confusing or unrelated to your original reason for searching. But it will become clearer when you consider the group as a social microcosm - i.e. the social problems you experience in life will sooner or later show up in your relationships within the group. So by exploring and understanding all aspects of your relationships with the other participants and then transferring this knowledge to your own life outside the group, you will begin the process of creating more satisfying relationships.

If you were to develop a close relationship with one or more participants outside the group, you would probably be more reluctant to share your thoughts and feelings within the group. Why is that? Because the friendship may take on such importance that you would avoid saying anything that could risk breaking it. When openness and honesty are compromised, the therapeutic process will stall and suffer.

Therefore, socializing between participants is prohibited. However, if you happen to meet someone outside the group or have any contact online, please share this information with the rest of the group. Any secrets about relationships in the group make therapeutic work more difficult. Sometimes participants have strong feelings for and against each other. You are encouraged to discuss these feelings openly, whether they are positive feelings or negative ones such as irritation or disappointment. In general, group members are expected to talk openly about their feelings without acting on them.

In addition to the no socializing rule, there are other basic rules and common agreements that the group adheres to in order to create a safe environment, for example

Everything said in the room stays in the room (confidentiality)
You regularly arrive on time to our sessions
You share your experiences at your own pace
You give feedback to others in a respectful way

Role of the group leader

My role as group leader is first and foremost to help create an atmosphere of safety within the group, which means introducing and ensuring that we follow the group contract (for which members also have a responsibility). There will be times when I remind the group of aspects of the group contract and wonder aloud with the group about the meaning of any deviations from the contract (members should do the same). In addition, I work to facilitate effective sharing of feelings, exchanges between group members, keeping the group focused on important issues, and modeling effective relationship skills.

I am also responsible for identifying my own emotional reactions and expressing them in an authentic and respectful way. At different times, I will emphasize different levels of the group experience: the group as a whole, interpersonal exchanges, individual processes and my own reactions. I will often focus on the here-and-now interactions in the group and will work to help members make sense of their experiences.

As a group leader, I will not determine the direction of the therapy. My role is to facilitate the therapeutic work and create free communication rather than to instruct you. Therapy is most helpful when it is based on collaboration and shared goals. Remember that the feedback you get from the other members is often as helpful - or more helpful - than the psychologist's comments. I may share observations about group interactions and behaviors or what individual participants do and say in the group. I also try to highlight both progress and obstacles within the group.

Whenever you have something to say to me, I would like you to do so as often as possible during the group sessions. Try to put into words the thoughts and feelings that arise towards me, whether they are positive or negative. If you feel anxious about how the therapy is being conducted or the direction in which the group is heading, this is of the utmost importance to discuss. Likewise, if you feel that you lack support or guidance from me. My job is to facilitate your therapeutic process.

However, if there is something urgent that needs to be said to me outside the group, this can be arranged. In such cases, it is most helpful if it is possible to share this with the rest of the group during the next session. Hopefully there are no topics that feel impossible to raise in front of the group. At the same time, it is important that trust is built up over time and that certain parts of you are only revealed when you feel safe enough in the group.

COMPARISON WITH INDIVIDUAL PSYCHOTHERAPY

Group therapy has been used as a form of treatment for more than 50 years. A large body of research has shown that group therapy is as effective and in some cases more effective than individual therapy. For many people, a combination of both is ideal. Often the intimacy and more personal focus of individual therapy is the most comfortable way for many to get started. The group can then provide a forum to behaviorally test some of the insights gained in individual therapy in a safe environment.

Let me give you an example. In individual therapy, you may find that you are afraid of being judged when you show yourself vulnerable. You can work on this with your psychologist. But in group therapy, you will have the opportunity to try out new ways of relating to several different people at once. You get to practice being vulnerable in a safe environment. You can then take this experience with you into all your relationships.

There are important similarities and differences between individual psychotherapy and group therapy. One important similarity is that any problem or issue can be addressed in both settings. In both, patients are invited to talk about anything that is emotionally important to them. Both involve talking about feelings, sharing emotional experiences, engaging in self-reflection and being open to giving and receiving feedback from others. Good therapy of all kinds helps people understand the role they play in shaping their lives.

*Maurice Brazil Prendergast - Group of Figures*

While individual therapy gives you an intense personal focus, the group provides a more varied view of how you relate to others and they to you. In group, there are often times when people have more direct contact with the psychologist or an individual member in a way that is similar to individual therapy, but when this happens in group, it can also positively affect the observing members and it promotes feedback from others than the psychologist.

Just as it takes time to form a relationship with your individual psychologist, it takes time to form group relationships. Members need to get to know each other well before the main benefits of group therapy are created. For this reason, you will be asked to commit to participating in the group for three months (approximately 12 sessions) before deciding whether or not you want to be an ongoing group member. The more each group member shares feelings, gives feedback to others and takes emotional risks, the faster the group will come together to create increasingly deep and meaningful experiences for members.

Benefits of group therapy

Mimics the 'real world' to a greater extent, making it easier to apply lessons learned in everyday life
As a psychologist, I can see you and help you act directly in situations that we could otherwise only analyze afterwards
Your own words tend to carry even more weight when received by a group
It is harder to hide your self-destructive behaviors in a group
It is possible to see how others spontaneously react to you
A group contains a collective wisdom that an individual practitioner can never carry alone
It provides a more diversified view of your behavior and greater mix of different reactions to it
Greater opportunity to move from intellectualization to a new experience
Provides a more direct opportunity to practice new behaviors
Lower cost

HOW TO START?

Everyone who registers their interest in starting group therapy will first meet with me individually. This gives you an opportunity to ask your questions and see if you think I can be helpful to you. It also gives me an opportunity to understand how I can best help you and whether group therapy might be appropriate.

We will then make sure that both you and I know what we need to know to make your participation in the group as helpful and effective as possible. While waiting for a suitable time to start participating in the group, you can meet me individually. Otherwise, during the waiting period, you will be provided with ongoing information and ways to prepare for your first time in the group.

Contact me if you are interested in group therapy in Gothenburg. If you want to know more, there is more to read on this link.

Understanding group therapy: A description of the process and benefits