Therapy Group – Some Theory

Why do therapy in a group?

If someone is in distress, or is feeling depressed and demotivated, or is anxious, or overwhelmed, or is struggling to make good connections with the people around them, how can it make any sense to expect them to join a group to work on changing their experience? Doesn’t this just intensify their difficulties?

We live our lives in groups: we are born into a family, we are educated in schools, we work in organisations. Throughout these experiences we encounter other people and form different kinds of relationships with them. Thus, much of our experience is shaped by our relationships with other people.

People seek therapy when their experience of life is not as they wish it to be. Individual psychotherapy offers a private space where you can work through difficulties at your own pace and in your own way. Group therapy offers a confidential space that is shared with other people who are also facing similar difficulties: each person can work through their own difficulties whilst observing how the other group members are working through theirs.

At times in a therapy group a member will recognise aspects of themselves in another group member. On other occasions they will find that they have very different ways of responding to situations and experiences. Either way, being in a shared setting with other group members can help them to understand themselves better and to gain fresh insight into their difficulties and their ways of responding. Thus, a therapy group can offer both recognition and contrast, both support and challenge. Over time members learn from each other and they also discover and learn with each other through their shared experience of being in a group together.

Different types of group

There are many different approaches to providing therapeutic support in a group setting, each of which has its own features and characteristics.

Some groups are focused on a theme, such as an addiction, and follow a structured approach but with little interaction between group members. Often this kind of group is hosted by someone who is also affected by the core theme but who does not have professional training.

Some groups are focused on a particular way of working, such as a CBT group, again often only with minimal interaction between group members. This kind of group is hosted by a trained specialist who runs and directs the group, with group members taking turns to interact with the host.

Some groups do not give a space for dialogue between group members but instead they make use of interactions between group members in a non-verbal way. Examples are Family Constellations or Psycho-Drama groups. Such groups are hosted by a trained specialist who directs and guides what happens in the group. These methods include an exploration of unconscious motivations and influences.

What I offer is a group-analytic therapy group. In a group-analytic group it is the members of the group who learn from each other, challenge each other, and support each other. There is a free-flowing dialogue and exchange between the members. One of my responsibilities as the group’s conductor is to ensure that all group members are engaged in the process. When difficulties arise between members of the group, we work together to explore what this means for each of them, including unconscious motivations and influences, and this often results in valuable learning about oneself in relation to others. In this kind of group, people with diverse life problems can work together effectively: the group thrives on exploring and understanding the similarities and contrasts between its members.

What is distinctive about group analysis?

Foulkes, the pioneer of group analysis in the UK in the 1940s, describes the purpose of this kind of group:

“Its aim and its result should be the greater inner freedom of the individual and the development of his personality.”

Foulkes, “Group dynamic processes and group analysis”, 1968

A defining feature of the group-analytic way of working is that the group members take responsibility for their participation. During the group’s meetings, they have an opportunity to talk and interact with each other in a way that helps them to gain insights and make changes. They support and challenge each other, with the conductor (group therapist) there to help the group to work effectively. As a consequence:

“the group experience becomes emotionally alive for all the members simultaneously, no matter who is actually speaking, and to whom”

Ormont, “The Group Therapy Experience”, 1992

A therapy group is different to a support group

While this therapy group does provide a source of support for its members, it is different to a support group.

Therapy groups place emphasis on the therapeutic purpose and value of meeting in the group. Thus, a therapy group:

  • is hosted by a trained group therapist
  • has a limited number of group members who all attend every session
  • is a long-term group, where members can continue over a number of years
  • provides an opportunity to work at depth, including with unconscious motivations, along with exploring everyday experiences
  • requires that its members only meet in the group and never meet each other outside the group, which helps to maintain a safe and confidential space.

Support groups put more emphasis on the social aspect of meeting in groups. They:

  • are often hosted by someone who has experience of the core theme of the group but who may not have any formal training in working with groups
  • may have a large number of members but some of them only attend the group occasionally
  • are often short-term groups that meet for a fixed number of sessions
  • focus on everyday experiences without considering unconscious influences
  • allow, and may encourage, social contact with other members outside the group’s meetings.