Why Group Therapy Works
Well Staff WriterIf you are looking for new skills or a new perspective, Group Therapy works and may be just what you need!
Too often when we think of “psychotherapy” we imagine an individual alone in a room or over a video-chat speaking with an individual therapist. This conception, however, ignores the potential benefits of psychotherapeutic groups, which can provide an effective space for growth and diminishment of identified problems specifically through communal interaction with other group members and a qualified therapist. Like many other groups outside of a therapeutic context (including support groups that aren’t therapist-led — and even groups in the workplace responsible for specific tasks), therapeutic groups exist primarily as a means for growth through connection, but they did not always exist in that context. So, how did group therapy emerge, and why is it beneficial?
Where Group Therapy Came From
Many mistakenly believe that Sigmund Freud, a foundational figure in early psychology, was the “inventor” of group therapy — indeed, he did write Group Psychology: The Analysis of the Ego in 1922 while simultaneously hosting Wednesday night meetings with his students in Vienna. Long before these educational and perhaps-therapeutic groups for his students, however, American physician Joseph Pratt was thinking through and publishing on his use of what he called “thought control classes” for his Tuberculosis patients as far back as 1905. This means that while Freud was getting experimental with his students, Pratt was already using what is believed to be the beginnings of group therapy to actually treat his medically ill patients.
Many mistakenly believe that Sigmund Freud, a foundational figure in early psychology, was the “inventor” of group therapy — indeed, he did write Group Psychology: The Analysis of the Ego in 1922 while simultaneously hosting Wednesday night meetings with his students in Vienna.
Of course, not all groups are the same, and though making connections and forging a community is an important undercurrent of most, there exist a variety of groups with a variety of goals. What Pratt was initially doing is what we would call “psychoeducational groups,” groups aimed to allow members to grow together in becoming more informed about a specific problem or concern — here, the medical diagnosis of Tuberculosis, though these groups can also focus on things like life transitions, which exist outside of a diagnostic framework — while being supported as a group with strong interpersonal bonds. Collective learning can be helpful, as the group setting helps alleviate any concerns about stigma or isolation, and diversity within groups, even with a shared diagnosis or life event, reminds members that there is no one correct way to cope with and apply the information outlined in these educational settings.
As he continued working with patients, Pratt began to recognize that the groups were adding more benefits than simply educational ones; he became impressed with the “power” interactions between group members worked to allow for growth, as members learned and engaged with each other. As a result of these observations, Pratt became the trailblazer for how we think about the benefits of communal therapy beyond didactic outcomes. These elements are crucial, because for most of us, when we think of group therapy, we think not about educational groups but instead about what is called “psychotherapy groups.” These can be arranged around a particular concern, life event, or diagnosis (like Pratt’s pioneering groups around Tuberculosis), but can also be heterogeneous and oriented around process since the underlying goals working in a group are to use interpersonal dynamics to “promote psychological growth” and “ameliorate psychological problems” by engaging with both a therapist (or therapists) leading the group and also other group members. Groups support us as individuals and, by creating connections, help to facilitate a safe space for growth and reflection. As Irvin D. Yalom and Molyn Lesczcz (2005) have noted, well-formed groups foster behavioral interaction, notions of altruism, and elements of collective hope and positivity that rely specifically on bonding and community, and allow clients to grow individually while not being alone.
But Does Group Therapy — and Group Telehealth Therapy — Actually Work?
But how do we know that group therapy is effective? When studying how group therapy works, scholars in the field look for outcomes both in the decreased regularity of diagnostic-specific symptoms as well as more general categories (for example, patient-reported self-esteem). By attending to these measures over time and comparing the evidence to a control group or groups — patients not engaging in the therapy of any kind, and/or those engaging in individual rather than group therapy, with all also controlled for medication use — we can actually measure how group therapy impacts its members. What have these studies shown? Group therapy has been shown to be effective in treating a number of disorders and life experiences, and is a promising way to treat a host of others when compared to individual therapy (or medication alone).
Even before COVID-19 limited our ability to meet in person, there existed an interest in telehealth groups, often studied in contexts where in-person group therapy could not happen. In many rural areas, for instance, people often have no access to the type of specialist who might lead a group in larger cities, and travel to these cities is inconvenient (if possible at all). Similarly, telehealth groups can forge cultural connections in spaces where ones might not exist regionally, allowing increased access, for example, for LGBTQ+ clients, disabled clients, aging clients, or those of particular racial and ethnic groups. Telehealth groups free us from the limitations of our immediate context, and, much like in-person groups, studies have shown that telehealth groups are beneficial not just in reducing the occurrence of symptoms, but also in one’s general sense of self. In addition to treatment outcomes, the existence of these groups is itself a huge benefit: telehealth groups increase access by making therapy that can be hard to find more accessible to those unable or unwilling to seek such treatment in-person. By broadening access, telehealth groups widen the possibilities for treatment, making specialists more accessible and freeing group make-up from regional constraints. What’s so beneficial about group telehealth? You have more options for community-building and treatment beyond what is immediately and physically accessible to you, allowing you to find the best possible treatment for your needs rather than limiting what is possible.
