Group therapy

Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Reviewed by Kaye Bewley
Last updated 3rd January 2023 | Next update due 2nd January 2026

Group therapy is a kind of psychological therapy that takes place with a group of people together, rather than with an individual during a one-on-one session. While the term can technically be applied to any kind of psychotherapy that is delivered to a group, it is usually associated with a specific therapy type that makes use of the group dynamic.


What is group therapy?

Having therapy in a group environment can have many benefits as it offers a support network and provides the opportunity to meet others experiencing similar concerns. Together with the therapist and the other group members, you should be encouraged to share your experiences and work on understanding yourself better.

S.H. Foulkes and Wilfred Bion pioneered group therapy in the UK by (independently) using the method as a way of treating combat fatigue during the Second World War. However, it was in America where group therapy was first used, after Joseph H. Pratt, Trigant Burrow and Paul Schilder founded the approach in the early 20th century. After the Second World War, several psychotherapists including Irvin Yalom developed the concept further. In terms of modern group therapy and group analysis in the UK, it is S.H. Foulkes' theory model that is considered the most influential.

Integrative Counsellor Gerry Ritchie (MNCS Accred) explains what group therapy is, the advantages of group therapy, and the various types of group therapy available to you.


What to expect from group therapy

Today, group therapy typically involves a small group of people (between seven and 12 is considered the norm) and a therapist. During the first therapy session, members of the group may start by introducing themselves and sharing why they are there. After this, the therapist may encourage members to discuss their experiences and progress. The way in which a therapy session is structured will depend on the style of the therapist running the session and the nature of the concern(s) being explored.

The sessions are confidential, just as they would be in a one-to-one therapy session. Also, if you agree to attend group therapy, it is likely that you will be asked to commit to a certain number of sessions.

Some sessions may involve discussion only, while others may involve group therapy activities. Such activities could include skill development, problem-solving or trust-building exercises. If you do not want to talk or take part in the activities, you do not have to. For some people, it takes a few weeks of sitting in and listening before they feel ready to talk about their own experience, so you should not feel pressured to do anything you don't want to do.

Group analysis

Group analysis is a specific method of group psychotherapy that was originated by S.H. Foulkes in the 1940s. Within group analysis, there is a key interest in the relationship between the individual and the rest of the group. Combining psychoanalytic insights and an understanding of interpersonal functioning, this approach aims to improve the integration of the individual with their community, family and social network.

There are differences to be found between group analysis, group psychotherapy and groups that are therapeutic. The varying terminology, however, can be confusing, so we always recommend that you talk to your therapist about their approach before deciding on which route to take in terms of group therapy.


What are the aims of group therapy?

In some respects, group therapy and individual therapy are alike and the aims are usually similar. With group therapy, however, the therapist may make use of the group dynamic to achieve these aims in a different way.

Speaking in general terms, the aims of group therapy are:

1. To help individuals identify maladaptive behaviour

Being in a group setting in a therapy environment can help people identify their own behaviours and differences better. As there is room for comparison, you may discover that you are not perhaps as adaptive as you would like. Group therapy aims to help people see themselves and their behaviours more clearly.

2. To help with emotional difficulties through feedback

Discussing emotional difficulties with your therapist and other members of the group therapy session will provide you with extensive feedback. This feedback could be advice from the therapist or even practical tips from others in the group who have experienced a similar problem themselves. The aim is to help you learn your own coping methods so you can handle things if/when problems arise.

3. To offer a supportive environment

Group therapy is not only an opportunity to receive feedback and advice, but it is also an opportunity to reach out and support others. What is discussed within your therapy sessions is done so in confidence. Speaking to people who are going through similar issues to yourself also helps you to feel less isolated and therefore more supported.

The bond that people build in the group becomes an important part of the therapeutic process. Once you join a group you belong to the group, even after members leave they are remembered as a part of the group's experience and history. Many people find the idea of being part of something bigger than them containing and supportive.

- A counsellor explores the advantages of group therapy.

What can group therapy help with?

While group therapy can technically be applied to a variety of approaches and a variety of concerns, there are certain areas that may particularly benefit from a group dynamic. The following topics are examples:

Addiction

Having a strong support network is key when it comes to overcoming addiction. For some people, this kind of network isn't available at home and they may benefit more from the support of others with addiction. Hearing how others cope, learning interpersonal skills and uncovering how your behaviours can impact other people can all help you on your journey to overcoming addiction.

To find out more about group therapy for addiction, read ‘12 Step Treatment and Group Therapy for People with Addictions.’

Anxiety

For people experiencing anxiety, getting out and interacting with those who understand can be helpful. Knowing you aren't alone in your feelings and hearing how others manage their anxiety can be invaluable. You are also likely to develop better social skills, which can help if you suffer from social anxiety.

Depression

Those dealing with depression may find themselves feeling vulnerable and isolated. Getting out of the house and talking to others is always useful and in a group therapy session, it can be even more so. Reaching out to others going through similar issues and discussing coping mechanisms can help you to help yourself. You may also find that imparting your own advice helps to boost your sense of self-esteem.

Eating disorders

For some people, the support network created by group therapy can aid recovery from an eating disorder. For others, however, it can be counterproductive. If you find that you are comparing yourself to others in the group (for example their weight/size), it may be worth seeking individual therapy instead.

Obsessive-compulsive disorder (OCD)

Being alone with your own thoughts during times of anxiety can trigger symptoms when you suffer from obsessive-compulsive disorder. Speaking to others who understand your feelings and behaviours can help you understand your condition better. Together you can support one another and look to find ways of coping.

Relationship difficulties

If you find it difficult to forge and maintain relationships, attending group therapy could help. Being around other people on a regular basis can help you to develop interpersonal and social skills that you can go on to practice outside of your sessions.

Schizophrenia

Group therapy for those with schizophrenia can be beneficial, depending on the severity of the condition. It can be helpful to reach out to others who experience similar symptoms to yourself, and learning more about the disorder can help you understand your own thoughts better. If you find you are feeling unsafe or paranoid during group therapy sessions, however, it is important to discuss your feelings with your therapist.

Self-harm

Meeting with others who struggle with self-harm can help you feel less alone. Hearing how others cope with their problems, including practical tips you may not have thought of, can also be incredibly helpful.


Group therapy activities

Some therapists like to incorporate group therapy activities into their sessions. The purposes and types of these activities used will depend on the nature of the concerns being explored and are often tailored to suit the needs of the members.

The following activities are popular in group therapy:

Icebreakers

Icebreakers are activities that help members of the group get to know each other and feel more comfortable. In some cases this simply involves going around the circle, introducing yourself and explaining why you are attending group therapy. Some therapists will introduce games and activities to help you feel relaxed and to introduce alternative ways of thinking.

Example activity: The game 'categories' requires you and other members of the group to organise yourselves into small groups according to certain categories such as favourite colours, hobbies, month of birth, etc.

Trust building activities

These types of activities are designed to help you develop mutual respect, empathy and understanding. These can be particularly helpful if you find it hard to form relationships or have difficulty trusting others.

Example activity: In the game 'minefield' objects are scattered on the floor and, working in pairs, you have to guide your teammate around the objects blindfolded. You then swap and your teammate guides you, attempting not to step on the objects.

Psychological exercises for insight and self-awareness

Exercises of this kind are designed to help you think in different ways and understand why you, and others, think or behave a certain way.

Example activity: 'Mirror image' requires you to work in pairs and involves one of you mirroring the other's movements.

Support groups and self-help groups

Group therapy is facilitated by a professional therapist who monitors the behaviour and progress of the members. In contrast to this, support groups and self-help groups may not involve a therapist. Typically support groups are made up of people who are experiencing the same issue or concern and meet up to provide each other with emotional support. Group therapy activities may not be involved and the focus is usually on discussion and providing empathy.

Self-help groups normally involve the exchange of information and advice regarding the concern in question. You may discuss outside resources or you may simply discuss your own experiences. Support groups and self-help groups can be particularly helpful for issues such as bereavement or terminal illness. If you think you require the kind of therapy that could help you change your thoughts or behaviours, you may benefit from a group therapy session instead.

Seeking support from others can be invaluable when you are having emotional difficulties and it is important to find an approach that works for you. Speaking to a professional such as your doctor or a counsellor can help you decide if you would benefit from group therapy or support/self-help groups, or find out more about the differences between group therapy and support groups

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