How to attend group counseling

How to attend group counseling

Group therapy is a form of psychotherapy that aims to help people manage mental health conditions or cope with negative experiences and behaviors.

This article will discuss what group therapy is, its potential benefits, and what to expect during treatment sessions.

How to attend group counseling

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Group therapy is a form of psychotherapy that involves one or more mental health practitioners who deliver psychotherapy to several individuals in each session.

Group therapy can reduce wait times and give more people access to mental healthcare.

Some people attend individual therapy sessions in addition to group therapy, while others only use group therapy.

Anyone can attend a group therapy session. However, group therapy can be especially helpful for people with limited access to mental healthcare, such as those living in rural or low income areas where healthcare clinics are understaffed or scarce.

One of the goals of group therapy is to bring people who share similar experiences together.

Group therapy usually focuses on a specific mental health concern, such as social anxiety or depression. Some other examples of conditions a group may focus on include:

Group therapy can also help people with:

  • grief
  • obesity
  • chronic pain
  • weight loss
  • anger management
  • domestic violence
  • cultural trauma
  • chronic illness

In his book The Theory and Practice of Group Psychotherapy, Irvin D. Yalom outlines 11 principles of group therapy, which he refers to as “the 11 primary factors.”

The following sections of this article will outline these 11 principles from the book.

Instillation of hope

Therapists can instill hope in group members by acknowledging when current and former members progress toward their goals.

Groups usually consist of people at different stages of treatment.

According to The Theory and Practice of Group Psychotherapy, watching people who are currently experiencing or recovering from a similar problem gives other group members hope that they will also have positive treatment outcomes.

Universality

Group therapy brings people who have similar experiences together.

Meeting other people recovering from or working through similar issues helps people realize that they are not alone, according to The Theory and Practice of Group Psychotherapy.

The book also states that understanding the universality of their experiences can help people overcome physical and emotional isolation.

Imparting information

Group members and therapists can help each other by sharing information and offering advice.

Altruism

Group members can support, reassure, and help each other improve throughout the treatment.

According to The Theory and Practice of Group Psychotherapy, this helps improve their self-esteem and confidence.

The corrective recapitulation of the primary family group

The Theory and Practice of Group Psychotherapy states that therapy groups often resemble family groups, with one or two parental authority figures and some peer siblings.

Within group therapy sessions, people can confront their early childhood experiences and dynamics with these “parents and siblings.”

They can learn how these early experiences shaped their personality and identify which behaviors and beliefs are unhelpful or destructive in their lives.

Development of socializing techniques

According to The Theory and Practice of Group Psychotherapy, group members can give and receive corrective feedback that can help them engage in social interactions outside the group.

Imitative behavior

Members of the group may imitate the behaviors they observe in more senior members or therapists.

As a result, group members can gain a better understanding of themselves, according to The Theory and Practice of Group Psychotherapy.

Interpersonal learning

The therapy group reflects the individual’s social universe, according to The Theory and Practice of Group Psychotherapy.

Through feedback and self-observation, group members can gain awareness of the strengths and limitations of their interpersonal behavior.

Group cohesiveness

As part of a group with a common goal, members can gain a sense of belonging, according to The Theory and Practice of Group Psychotherapy.

The author says that members may feel more comfortable opening up to the group as a result. They may also be more willing to implement the behavioral changes they learn as part of the treatment.

Catharsis

Sharing their feelings, experiences, and pain with a group can help people release anger and pent up emotions.

According to The Theory and Practice of Group Psychotherapy, this process can lead to sudden insights that shift the ways in which people perceive and respond to life.

Existential factors

Group therapy sessions provide space and time for people to explore uncomfortable existential factors, such as loss and death, according to The Theory and Practice of Group Psychotherapy.

Group members can also develop a stronger sense of self-reliance by learning to understand that they are ultimately in control of their behaviors, actions, and choices.

There are several different types of group therapy, and treatment models vary from group to group.

The following sections will outline five of the most common types of group therapy.

Psychoeducational groups

Psychoeducational group therapy focuses on educating members about their conditions and providing them with new coping strategies.

These groups usually focus on a specific condition, such as substance use disorder, anxiety, or phobias.

Skills development groups

Skills development groups focus on introducing and improving the skills that members need to cope with certain mental health conditions.

These groups may incorporate aspects of psychoeducational groups.

Still, the overall goal involves strengthening the members’ behavioral and cognitive resources to help them make positive choices and avoid harmful situations.

Cognitive behavioral groups

Cognitive behavioral group therapy attempts to restructure the beliefs a person has that lead to negative or harmful behaviors.

For example, cognitive behavioral groups that focus on substance use disorder begin by identifying situations and environments that trigger addictive behavior.

With this understanding, members can develop management strategies that support reduced use.

Support groups

Support groups can help people cope with significant life changes, such as the loss of a loved one.

In support groups, members give and receive unconditional acceptance.

The group also encourages its members to reflect on their personal beliefs and behaviors.

Interpersonal process groups

The interpersonal process group model uses the psychodynamic approach to promote positive change. Psychodynamics is a school of psychology that views a person’s early life experiences and subconscious beliefs and feelings as the foundation of their personality and behaviors.

Interpersonal process groups focus more on interpersonal group dynamics and less on individual psychology.

Being attentive means the counsellor is giving the client their full focus, paying attention to what the client is saying, doing, the tone of voice used and body language.

Key aspects of attending:

  • Eye contact
  • Body language
  • Gestures
  • Facial expressions
  • Tone of voice

How to attend group counseling

Attending – Effective counselling skills

Attending is the first skill a trainee counsellor learns. It is the base that other skills can be built on and used.

Good attending will show the client that they are respected and encourage them to talk about their thoughts and feelings.

It also shows they are being listened to and taken seriously.

There are several key elements in attending. These are:

  • Eye Contact: Looking directly at someone demonstrates they have your full attention and you are listening to them. Be thoughtful not to stare intently, as this can make a person feel uncomfortable. Just be natural and yourself. Be mindful that in some cultures eye contact can be seen as disrespectful.
  • Body language: Be considerate of your posture. Being relaxed is a great way to invite someone to talk about themselves! Leaning slightly forward in the chair demonstrates that you are giving your full attention, actively listening to what your client is saying.
  • Gestures: You communicate so much in your body movements. For example, sitting with your arms and legs crossed, hunched up, can give the impression that you have put a barrier up and are not listening or interested. Waving your arms about can also be very distracting.
  • Facial Expressions: A good listener will be thoughtful of their facial expressions. Frowning or raising eyebrows can transmit revulsion or judgment which may shut the client down, while smiling at appropriate times demonstrates human warmth which helps build trust and develops rapport.
  • How you speak: Attending is not all about listening; sometimes you may need to ask clarifying questions or paraphrase back what the client has said. When you respond, be thoughtful and precise in the words you use. Try to avoid any misunderstanding or confusion.

When using the skill of attending it is useful to remember: We have one mouth and two ears so we can listen twice as much as we speak’.

How to Attend

To begin and maintain attendance in counselling, a counsellor must first welcome the client warmly, making him/her feel comfortable in the counselling environment.

This will make the client feel more relaxed about disclosing personal information about their emotions, feelings and thoughts.

Depending on the nature of your problem, group therapy can be an ideal choice for addressing your concerns and making positive changes in your life.

How to attend group counseling

If you’re considering psychotherapy, several options are available. One of those options is group therapy. Depending on the nature of your problem, group therapy can be an ideal choice for addressing your concerns and making positive changes in your life.

What should I expect?

Group therapy involves one or more psychologists who lead a group of roughly five to 15 patients. Typically, groups meet for an hour or two each week. Some people attend individual therapy in addition to groups, while others participate in groups only.

Many groups are designed to target a specific problem, such as depression, obesity, panic disorder, social anxiety, chronic pain or substance abuse. Other groups focus more generally on improving social skills, helping people deal with a range of issues such as anger, shyness, loneliness and low self-esteem. Groups often help those who have experienced loss, whether it be a spouse, a child or someone who died by suicide.

Benefits of group therapy

Joining a group of strangers may sound intimidating at first, but group therapy provides benefits that individual therapy may not. Psychologists say, in fact, that group members are almost always surprised by how rewarding the group experience can be.

Groups can act as a support network and a sounding board. Other members of the group often help you come up with specific ideas for improving a difficult situation or life challenge, and hold you accountable along the way.

Regularly talking and listening to others also helps you put your own problems in perspective. Many people experience mental health difficulties, but few speak openly about them to people they don’t know well. Oftentimes, you may feel like you are the only one struggling — but you’re not. It can be a relief to hear others discuss what they’re going through, and realize you’re not alone.

Diversity is another important benefit of group therapy. People have different personalities and backgrounds, and they look at situations in different ways. By seeing how other people tackle problems and make positive changes, you can discover a whole range of strategies for facing your own concerns.

More than support

While group members are a valuable source of support, formal group therapy sessions offer benefits beyond informal self-help and support groups. Group therapy sessions are led by one or more psychologists with specialized training, who teach group members proven strategies for managing specific problems. If you’re involved in an anger-management group, for instance, your psychologist will describe scientifically tested strategies for controlling anger. That expert guidance can help you make the most of your group therapy experience.

Joining a group

To find a suitable group, ask your physician or your individual psychologist (if you have one) for suggestions. Also check with local hospitals and medical centers, which often sponsor a variety of groups.

When choosing a group, consider the following questions.

Is the group open or closed?

Open groups are those in which new members can join at any time. Closed groups are those in which all members begin the group at the same time. They may all take part in a 12-week session together, for instance. There are pros and cons of each type. When joining an open group, there may be an adjustment period while getting to know the other group attendees. However, if you want to join a closed group, you may have to wait for several months until a suitable group is available.

How many people are in the group?

Small groups may offer more time to focus on each individual, but larger groups offer greater diversity and more perspectives. Talk to your psychologist about which choice is better for you.

How alike are the group members?

Groups usually work best when members experience similar difficulties and function at similar levels.

Is group therapy enough?

Many people find it’s helpful to participate in both group therapy and individual psychotherapy. Participating in both types of psychotherapy can boost your chances of making valuable, lasting changes. If you’ve been involved in individual psychotherapy and your progress has stalled, joining a group may jump-start your personal growth.

How much should I share?

Confidentiality is an important part of the ground rules for group therapy. However, there’s no absolute guarantee of privacy when sharing with others, so use common sense when divulging personal information. That said, remember that you’re not the only one sharing your personal story. Groups work best where there is open and honest communication between members.

Group members will start out as strangers, but in a short amount of time, you’ll most likely view them as a valuable and trusted source of support.

Thanks to Ben Johnson, PhD, for contributing to this article.

1. Confidentiality

Anything said between any two or more group members at any time is part of the group and is confidential. I understand that everything said in group is confidential. I agree to keep secret the names of other members of the group and what is said in the group. I agree to keep secret anything which occurs between or among group members. I understand that there is an exception to this confidentiality which applies to the group leader. If the group leader believes that someone is in danger, the leader has a professional obligation to take direct action in order to keep everyone safe.

I agree not to keep secret from the group anything which occurs within the group. Anything which occurs between or among any members is part of the group is kept secret from anyone outside of the group but is not kept secret from the group. This also applies to any individual meetings you may have with a group leader. I understand that if I violate this confidentiality I could be removed from the group.

2. Privacy (The Stop Rule)

No group member is ever required to answer any question, to participate in any activity, or to tell anything. If I am asked questions or asked to participate in an activity which makes me feel uncomfortable, I understand that I have the right to pass, that is, the right to refuse. I agree that will never pressure other group members to participate in any discussion or activity after the member has passed or refused. I understand that the group leader is obliged to protect this right. I also understand that I will benefit more from group the more I am able to take risks in sharing and participating.

3. Dignity

No group member is ever humiliated, hazed, or abused in any way. I agree to avoid this destructive behavior.

4. Violence or intimidation

Violence or intimidation toward other group members is never tolerated. I understand that I must never be violent or intimidating toward other group members and that if I threaten to harm persons or property I will be asked to leave the group.

5. Alcohol and Other Drugs

Group members cannot participate in the group under the influence of alcohol or other mind altering drugs. When under the influence of chemicals, persons do not have access to their emotions and have less control over their behavior. I understand that if the leader believes that I am under the influence of alcohol or other drugs, I will be asked to leave the group.

6. Exclusive relationships

Dating and other exclusive relationships between or among group members are not a good idea. The relationships can make other group members feel left out. When a couple breaks up, for example, this can be most painful and may make it impossible for these people to continue in the group. Since anything which occurs between or among group members is part of the group, members who are dating or in very exclusive relationships may be embarrassed when their intimate moments are discussed in the group.

7. Gossip

Gossip and secret grudges can be very destructive in a group. I agree that if I have something to say to another group member, I will try to say it to the member directly rather than talk about him/ her behind his/her back.

8. Attendance

I agree that I will attend every meeting unless an emergency arises. If an emergency should arise I will notify the group leader prior to the meeting to tell him or her that I will be unable to attend. I understand that the group leader will tell the group what has happened. I understand that if I have three unexcused absences, my continued group membership will be discussed.

9. Internet Connectivity

I feel very strongly that the members of the group should form and participate in an online group limited to the group members. Of course, the same cautionary notes apply to the internet communications in terms of both confidentiality and inter-group sharing. (I have used this model very successfully, and it significantly enhances a healthy form of interconnection.)

10. Responsibilities

I understand that it is the group leader’s responsibility to enforce these procedures and guidelines. The group may, when it wishes, propose other procedures and guidelines which will be up to the group to monitor.

11. Termination

Usually, group members decide, within the group, with the leader, when it is time to leave the group. Sometimes it is necessary for a group member to leave the group unexpectedly. This can cause group members to wonder if they have harmed the leaving member. I promise that if I must leave the group unexpectedly, I will come to a last group meeting and tell the members that I am leaving and say goodbye. I agree to announce this at the beginning of the last meeting so that the group has time to ask questions and say goodbye. If I decide to leave the group the group members may express their concerns but also respect the decision of the person wishing to leave.

I have read the procedures and guidelines for group and agree to be bound by them while I am a member of the group

_____________________ ____________
Group Member Date

I promise to faithfully enforce procedures and guidelines for this group.

It’s hard to watch someone you care about struggle with their mental health. It’s even worse when you know they could benefit from professional help. Approaching an individual and encouraging them to seek therapy can be a tricky situation. If done the wrong way, you could aggravate the person or turn them against the idea entirely. However, there is an effective way to have this conversation.

Here are some steps you can take to tell your loved one about the benefits of seeking therapy.

Show Support

Misconception about mental health and therapy has intensified stigma in society. Your loved one may be aware that they need help, but may be afraid to seek it if they think you will judge or treat them differently. Therefore, it is essential to use non-stigmatizing language when talking with them about their mental health. Assure them that you will support them through the therapy process.

Demi Lovato is one of the most vocal celebrities about her mental health issues. She mentioned on multiple occasions how important it was for her to have people around that really care about her wellbeing. She credits her support group for being able to go through everyday life. Demi asks for advice from her loved ones and asks them to let her know when they feel something’s off: “So whether it’s with my management team or with my friends, every choice that I make, I run by people. And that’s what’s really helped me—vocalizing what you need.”

Be Sensitive to Timing and Place

Talking to someone about mental health requires emotional sensitivity as well as physical sensitivity. The “where” and “how” the topic is presented may determine how a person reacts to your suggestions. Your loved one may not be as bold as Kesha when she shared her condition and struggles with the world while receiving an award.

Don’t start this delicate conversation in front of other people or where others can hear as this may cause discomfort. And avoid grouping up in an intervention-style conversation as people do on TV shows. Allow the person struggling to decide whether they want others to know. This way, they feel respected and in control of their own treatment.

Also: Avoid talking to someone when they are in a bad mood, tired, have tight deadlines at work or if they’re doing something important. They may dismiss you or disregard the weight of the topic. Approach the person when they’re in a good mood, relaxed and undistracted. Try as much as possible to keep the conversation private, friendly and relaxed.

Prepare for Resistance

Not all people who hear about therapy will be willing to try it out. You need to be prepared to make your case if your loved one resists your suggestion. Here are some ideas that you can use to highlight the importance of therapy:

  • Try to use your relationship as leverage, in a loving way. Whether you’re their sibling, friend, spouse or relative, tell them how important your relationship with them is to you. And how it could benefit from their seeking therapy. However, avoid giving an ultimatum as it can cause emotional distress.
  • Name their admirable qualities. It’s easier to appeal to someone by pointing out what you like about them. When you point out someone’s positive qualities, they will be motivated to take the necessary steps to better themselves even further.
  • Explain specific areas of problematic behavior. Most people who refuse therapy may claim that they don’t have a problem. By pointing out specific problems without coming off as judgmental, you can help them see the need for seeking professional help.

Offer to Help

You can try to embolden someone to go to therapy, but unless you are willing to offer meaningful support, it’s not going to encourage them. Some people do not know where to start when seeking help. Guide them in finding a suitable therapist in the area, depending on their preferences. You can contact offices on their behalf or research various professionals, their credibility and reviews.

Some people are scared of seeing a therapist alone or signing up for group therapy. Offer to go with them until they’re comfortable. You can sit in the waiting room during their first few sessions. Make sure to assure them that you won’t ask prying questions about the counseling unless they want to share.

Seeking therapy is one of the best steps that a person with a mental health condition can take. However, it’s an effort that requires great strength and courage. Share your suggestions as openly as possible and leave them to make the decision that best suits their needs. Above all things, assure them of your continued love and support throughout the process.

Mike Jones, owner, and contributor at Schiz Life, is fighting against mental illness stereotypes. He has immersed himself into the schizophrenia community and is offering advice regularly on specific treatments, tips for diagnosis, and differences between this condition and other mental disorders. Mike is passionate about fitness, clean eating and sudoku. You can follow Mike on Twitter @mike_jones35

It’s hard to watch someone you care about struggle with their mental health. It’s even worse when you know they could benefit from professional help. Approaching an individual and encouraging them to seek therapy can be a tricky situation. If done the wrong way, you could aggravate the person or turn them against the idea entirely. However, there is an effective way to have this conversation.

Here are some steps you can take to tell your loved one about the benefits of seeking therapy.

Show Support

Misconception about mental health and therapy has intensified stigma in society. Your loved one may be aware that they need help, but may be afraid to seek it if they think you will judge or treat them differently. Therefore, it is essential to use non-stigmatizing language when talking with them about their mental health. Assure them that you will support them through the therapy process.

Demi Lovato is one of the most vocal celebrities about her mental health issues. She mentioned on multiple occasions how important it was for her to have people around that really care about her wellbeing. She credits her support group for being able to go through everyday life. Demi asks for advice from her loved ones and asks them to let her know when they feel something’s off: “So whether it’s with my management team or with my friends, every choice that I make, I run by people. And that’s what’s really helped me—vocalizing what you need.”

Be Sensitive to Timing and Place

Talking to someone about mental health requires emotional sensitivity as well as physical sensitivity. The “where” and “how” the topic is presented may determine how a person reacts to your suggestions. Your loved one may not be as bold as Kesha when she shared her condition and struggles with the world while receiving an award.

Don’t start this delicate conversation in front of other people or where others can hear as this may cause discomfort. And avoid grouping up in an intervention-style conversation as people do on TV shows. Allow the person struggling to decide whether they want others to know. This way, they feel respected and in control of their own treatment.

Also: Avoid talking to someone when they are in a bad mood, tired, have tight deadlines at work or if they’re doing something important. They may dismiss you or disregard the weight of the topic. Approach the person when they’re in a good mood, relaxed and undistracted. Try as much as possible to keep the conversation private, friendly and relaxed.

Prepare for Resistance

Not all people who hear about therapy will be willing to try it out. You need to be prepared to make your case if your loved one resists your suggestion. Here are some ideas that you can use to highlight the importance of therapy:

  • Try to use your relationship as leverage, in a loving way. Whether you’re their sibling, friend, spouse or relative, tell them how important your relationship with them is to you. And how it could benefit from their seeking therapy. However, avoid giving an ultimatum as it can cause emotional distress.
  • Name their admirable qualities. It’s easier to appeal to someone by pointing out what you like about them. When you point out someone’s positive qualities, they will be motivated to take the necessary steps to better themselves even further.
  • Explain specific areas of problematic behavior. Most people who refuse therapy may claim that they don’t have a problem. By pointing out specific problems without coming off as judgmental, you can help them see the need for seeking professional help.

Offer to Help

You can try to embolden someone to go to therapy, but unless you are willing to offer meaningful support, it’s not going to encourage them. Some people do not know where to start when seeking help. Guide them in finding a suitable therapist in the area, depending on their preferences. You can contact offices on their behalf or research various professionals, their credibility and reviews.

Some people are scared of seeing a therapist alone or signing up for group therapy. Offer to go with them until they’re comfortable. You can sit in the waiting room during their first few sessions. Make sure to assure them that you won’t ask prying questions about the counseling unless they want to share.

Seeking therapy is one of the best steps that a person with a mental health condition can take. However, it’s an effort that requires great strength and courage. Share your suggestions as openly as possible and leave them to make the decision that best suits their needs. Above all things, assure them of your continued love and support throughout the process.

Mike Jones, owner, and contributor at Schiz Life, is fighting against mental illness stereotypes. He has immersed himself into the schizophrenia community and is offering advice regularly on specific treatments, tips for diagnosis, and differences between this condition and other mental disorders. Mike is passionate about fitness, clean eating and sudoku. You can follow Mike on Twitter @mike_jones35

Group therapists are responding to COVID-19 by rapidly transitioning from in-person to online therapies.

How to attend group counseling

Research shows that group therapy is as effective, and in some cases, can be more effective, than individual therapy. At a time when social isolation is occurring in unprecedented ways, the role of groups as a protective factor is an important one. Online groups also offer therapists an efficient and effective way to support the mental health of the larger community during the COVID-19 epidemic.

Treatment types and billing codes for online groups

There are two specific code sets for telehealth group therapies under the emergency guidelines for Medicare:

  • Group Psychotherapy by Telehealth (CPT Code 90853), which, as of March 30, 2020, was added to the temporary emergency provision of services rules changes for Medicare.
  • Health Behavior Assessment and Intervention Group codes (96164 and 96165).

Maintaining an ethical practice

Group telehealth requires competency in two areas — group therapy and telepsychology. Group therapy has been infrequently used in telehealth, so the applicable ethical and legal framework is still emerging. Before starting a telehealth group, psychologists should refer to the APA Ethics Code and to the APA Practice Guidelines for Telepsychology.

Establishing privacy and confidentiality

APA Ethics Code 10.03 states that in group therapy psychologists should “describe at the outset the roles and responsibilities of all parties and the limits of confidentiality.”

While the group leader must maintain confidentiality, a group member (in most states) is under no such legal or ethical imperative. While potentially beneficial, video platforms are more hazardous than in-person groups, placing the client’s confidentiality at greater risk.

Potential breaches to confidentiality may include, but are not limited to:

  • A group member attending group in a non-secure location where a nonmember (such as a family member or roommate) can see or hear the group.
  • A member recording or taking a screenshot of the group members.
  • A member using recorded material to share the identity of or blackmail the group or a specific member.

The consequences to a group member whose privacy is compromised may be significant to them individually and to the therapeutic nature of the group as a whole. That’s why it’s important for group psychologists to alert all members to the greater risks of teletherapy via a more prolonged informed consent process. Group members may then be presented with several treatment options, including but not limited to:

  • Showing their faces during the session.
  • Wearing a disguise or blocking their faces using non-threatening, pre-approved masks that still allow for speech to be heard. (Note: Psychologists will not be reimbursed if a patient blocks the video feed of his or her face; this service would be considered telephone therapy, which is not reimbursable).
  • Using a fictitious name or only an initial as on-screen identification.
  • Temporarily leaving the group.
  • Finding another treatment modality.

The therapist should present the potential benefits of the group and contrast them with the potential for harm.

Group leaders should have clients read and sign informed consent forms for group telehealth before the first session, so they are aware of the risks, benefits and limits to confidentiality. It is the group leader’s responsibility to adhere to and uphold the highest privacy standards possible for the group.

Using a HIPAA compliant video platform

Privacy is a central concern in the ethical and legal provision of group therapy via telehealth. While privacy guidelines have been more relaxed due to COVID-19, and though the Health Insurance Portability and Accountability Act (HIPAA) requirements do not guarantee confidentiality, clinicians are strongly encouraged to utilize a HIPAA compliant platform to provide the highest level of security for the group whenever possible.

The federal government has waived penalties for HIPAA violations by providers in connection with the “good faith” provision of telehealth for the duration of the public health emergency.

Improving treatment with pre-group screening appointments

Group leaders should continue to conduct group screening appointments. Reviewing the informed consent and established group guidelines is critical to reducing group dropout rates, setting expectations, clarifying goals and maintaining the fidelity of the telehealth treatment.

Setting guidelines for group telehealth

Group leaders are encouraged to ask members to:

  • Be in a space free of distractions, where the patient is alone and can speak freely. Inform others in the location that they should not be disturbed during this time.
  • Wear appropriate clothing commensurate with attending group in person.
  • Have the technological means to attend the group. This includes being on a secure internet connection, rather than public or free Wi-Fi. Keep the video steady and at eye contact level. Phones or computers should be put on airplane mode to minimize interruptions. Wearing headphones or keeping the volume low can prevent sound from travelling to another room.
  • Follow any group-established policy regarding if a member, or the entire group, gets disconnected. If the group agrees, this may include having a member call in for the remainder of the session. Adhere to the group policy about how to handle a breach in confidentiality, such as a nonmember bystander witnessing the group or someone walking into a room while the group is meeting.

Practicing across state lines

Therapists must pay attention to state and federal guidelines for practicing across state lines if they are not licensed in the state where group members are receiving telehealth. Consult with your state licensing board regarding interstate practice policies.

Note: At press time (April 10, 2020) telephone therapy was not a billable service; however therapists should check for updates on billing and reimbursement on the Practice Resources in Response to COVID-19 webpage.

Depending on the nature of your problem, group therapy can be an ideal choice for addressing your concerns and making positive changes in your life.

How to attend group counseling

If you’re considering psychotherapy, several options are available. One of those options is group therapy. Depending on the nature of your problem, group therapy can be an ideal choice for addressing your concerns and making positive changes in your life.

What should I expect?

Group therapy involves one or more psychologists who lead a group of roughly five to 15 patients. Typically, groups meet for an hour or two each week. Some people attend individual therapy in addition to groups, while others participate in groups only.

Many groups are designed to target a specific problem, such as depression, obesity, panic disorder, social anxiety, chronic pain or substance abuse. Other groups focus more generally on improving social skills, helping people deal with a range of issues such as anger, shyness, loneliness and low self-esteem. Groups often help those who have experienced loss, whether it be a spouse, a child or someone who died by suicide.

Benefits of group therapy

Joining a group of strangers may sound intimidating at first, but group therapy provides benefits that individual therapy may not. Psychologists say, in fact, that group members are almost always surprised by how rewarding the group experience can be.

Groups can act as a support network and a sounding board. Other members of the group often help you come up with specific ideas for improving a difficult situation or life challenge, and hold you accountable along the way.

Regularly talking and listening to others also helps you put your own problems in perspective. Many people experience mental health difficulties, but few speak openly about them to people they don’t know well. Oftentimes, you may feel like you are the only one struggling — but you’re not. It can be a relief to hear others discuss what they’re going through, and realize you’re not alone.

Diversity is another important benefit of group therapy. People have different personalities and backgrounds, and they look at situations in different ways. By seeing how other people tackle problems and make positive changes, you can discover a whole range of strategies for facing your own concerns.

More than support

While group members are a valuable source of support, formal group therapy sessions offer benefits beyond informal self-help and support groups. Group therapy sessions are led by one or more psychologists with specialized training, who teach group members proven strategies for managing specific problems. If you’re involved in an anger-management group, for instance, your psychologist will describe scientifically tested strategies for controlling anger. That expert guidance can help you make the most of your group therapy experience.

Joining a group

To find a suitable group, ask your physician or your individual psychologist (if you have one) for suggestions. Also check with local hospitals and medical centers, which often sponsor a variety of groups.

When choosing a group, consider the following questions.

Is the group open or closed?

Open groups are those in which new members can join at any time. Closed groups are those in which all members begin the group at the same time. They may all take part in a 12-week session together, for instance. There are pros and cons of each type. When joining an open group, there may be an adjustment period while getting to know the other group attendees. However, if you want to join a closed group, you may have to wait for several months until a suitable group is available.

How many people are in the group?

Small groups may offer more time to focus on each individual, but larger groups offer greater diversity and more perspectives. Talk to your psychologist about which choice is better for you.

How alike are the group members?

Groups usually work best when members experience similar difficulties and function at similar levels.

Is group therapy enough?

Many people find it’s helpful to participate in both group therapy and individual psychotherapy. Participating in both types of psychotherapy can boost your chances of making valuable, lasting changes. If you’ve been involved in individual psychotherapy and your progress has stalled, joining a group may jump-start your personal growth.

How much should I share?

Confidentiality is an important part of the ground rules for group therapy. However, there’s no absolute guarantee of privacy when sharing with others, so use common sense when divulging personal information. That said, remember that you’re not the only one sharing your personal story. Groups work best where there is open and honest communication between members.

Group members will start out as strangers, but in a short amount of time, you’ll most likely view them as a valuable and trusted source of support.

Thanks to Ben Johnson, PhD, for contributing to this article.