Patrick Turbiville, LMSW
Individual, couple & group psychotherapist...
Supervised by Louis Laves-Webb, LCSW, LPC-S
About Group Therapy
Group therapy is a unique experience. Having multiple group members in the room, specifically strangers who have had some similar experiences, offers benefits that may be absent or less apparent in individual therapy. I currently offer one group, a Personal Exploration Group for Adults.
The idea of starting group therapy may be daunting. It is hoped that learning more about how groups work, and how they can help people heal and grow, will relieve some of the anxiety experienced by those considering group therapy. If you have any specific questions about group therapy or the group I offer, feel free to contact me. To learn more about groups in general, and how they can promote well-being, continue reading.
Types of therapy groups
In recent years, many therapists and researchers have come to view group therapy as a primary treatment method for a variety of concerns. Group therapy can be a powerful supplement to individual therapy or provide an opportunity to continue personal growth once individual therapy ends. However, one therapy group may operate very differently from another, depending on its purpose, size, timeframe, membership policies, and the person facilitating the group.
Groups come in many sizes. A group can have as few as two members. Some groups resemble classes, and may have 20 or more members. I prefer groups with three to eight members, because they usually provide a sufficient variety of personal experiences for members to benefit from both similarities and differences, while maintaining a level of intimacy that might be lost in larger groups.
Groups have different purposes. A support group offers individuals with similar experiences a regular opportunity to share their stories in a safe environment while receiving and giving support that may be lacking elsewhere. An interpersonal process group, like my Personal Exploration Group for Adults, gives members a space to practice interacting with others while receiving honest, encouraging feedback, developing personal insight, and learning about relationships and the world. Psychoeducational groups focus on imparting information about topics relevant to members, while skills-based groups focus on learning and practicing specific behaviors related to a common concern or interest. Most therapy groups are facilitated by a licensed mental health professional. Self-help groups focus on a specific topic and may be facilitated by unlicensed individuals who are also group members, and who may have various levels of education, training, and experience. Task-oriented groups focus on accomplishing a common goal, such as the implementation of a community service project. Often, a group that falls into one of these categories shares characteristics with other types of groups.
Some groups last longer than others. Some groups are time-limited; they last for a specified number of sessions, but may start again at a later date, usually with different members and sometimes with different facilitators. Other groups, like mine, are open-ended; they have no set end-date and will last as long as there is adequate membership and attendance, or until external circumstances bring the group to an end. Additionally, session length may vary by group, but is usually one to two hours.
Groups have different membership policies. Some groups are closed; once the group starts, or after a specified number of sessions, the group will no longer accept new members. This allows for consistency and the development of more intimate connections between individual members and the group as a whole. Other groups, like mine, are open; the group will periodically introduce new members, usually when group membership falls below a certain threshold. This encourages active and well-attended group sessions, exposes members to a wider variety of people and experiences that may prove beneficial, and gives more individuals the opportunity to benefit from group. This may also be a more accurate reflection of life outside of group, with people coming and going, sometimes unceremoniously, and other times having substantial impact on remaining members. Some groups allow drop-in membership, and are open to anyone who arrives at the appointed place and time. Other groups, like mine, require a pre-group interview, consultation, or information session to ensure that the group and the potential member will be mutually beneficial to each other, that the group facilitator has answered any questions the potential member may have, and that the potential member is aware of any important group norms or expectations.
No two facilitators are alike. Each group facilitator will have a unique personality, identity, education, experiences, theoretical orientation to therapy, and style. Some may rely on a narrow range of structured and strictly defined interventions, while others may incorporate a wide variety of strategies. Some will take a more active role in group, while others prefer to let the group unfold naturally and intervene only at key moments. A therapist may even change how they facilitate a group over time. Sometimes, a group will have two facilitators, and interactions between them contribute to the unique experience in the group. The most important job of the facilitator may be to maintain a sense of safety among group members. Often, authentic interaction with and connection to other group members is far more beneficial than any particular action of the group facilitator, and the facilitator’s job is to nurture an environment that encourages this (and then get out of the way).
How groups promote healing and growth
Irvin D. Yalom, in The Theory and Practice of Group Psychotherapy, identifies 11 “therapeutic factors” which are either unique to group therapy or work differently than they might in individual therapy. These are mechanisms by which healing and growth are achieved in group. They represent the group's ability to respond to both collective and individual needs, allowing individual members to benefit in ways that are most relevant to them. Each of these factors overlaps with the others while maintaining individual significance. These factors apply most directly to interpersonal process groups, but are usually present to some extent in every therapy group. For a more specific review of possible benefits of my Personal Exploration Group for Adults, click here. Yalom’s 11 therapeutic factors are:
Instillation of hope: Hope in the present encourages progress toward personal goals and well-being in the future. Observing several group members who are actively working to better themselves and their lives. Some group members may have been where you are now and act as living examples that things can improve.
Universality: For some, no amount of consolation from loved ones, or reading about others' experiences of a particular problem, or empathy from a highly-skilled therapist can overcome the dread of feeling isolated. Group therapy allows us to witness others working through experiences similar to ours live and in-person, shaking the foundation of loneliness that accompanies some of life’s most challenging problems.
Imparting information: At times, a facilitator may offer psychoeducation, advice, or information about a resource that is relevant to a group discussion. As with other therapeutic factors, however, the contributions of group members may outshine those of the facilitator. When a variety of members share about their perspectives, coping strategies, ideas, and resources for support, each member has the opportunity to identify which of these might work for them.
Altruism: Helping others can encourage group members to embrace their own value, power, and identity. When group members express appreciation for each other, they emphasize how others have been valuable to them. This also illuminates the power members have to take action toward positive change, for themselves as well as others. Furthermore, coming to view oneself as a helpful person can open the door to acknowledging other positive aspects of one's unique identity.
The corrective recapitulation of the primary family group: As members become more comfortable participating in group, they shed the masks they wear in unfamiliar social situations and begin to act out the roles, habits, defenses, and skills that are usually more apparent in closer relationships. Members may act like the parent, the helpless one, the wise one, the loner, the competitive one, etc. Members become aware of roles they play in relationships and can try out other roles, if they choose.
Development of socializing techniques: Group therapy offers an opportunity to observe, in the moment, whether the outcome of an interaction is what we expected. Or, if our words or actions communicated something we did not intend, we can receive real-time feedback about what went wrong. The group environment encourages us slow down, take stock, and recognize our social patterns. We can then do more of what we like and try new behaviors to replace ones we don't like.
Imitative behavior: Observing others in the concocted, but safe and supportive situation of group therapy provides a menu of behaviors that one can try on and then apply to outside relationships. Imitative behavior can be a conscious activity, but it can also occur naturally and subconsciously when we observe others behaving in ways that we appreciate or admire.
Interpersonal learning: The meaningful and authentic relationships that develop in group allow members to test long-held, sometimes subconscious, and often counterproductive assumptions about themselves and the world. The richness of these relationships provides an ample canvas for creating a new and deeper understanding of ourselves and what positive, supportive relationships can look like.
Group cohesiveness: Within the safety of the group, members often come to accept, support, and protect one another. This encourages members to take risks by sharing in vulnerable ways. This can take the form of sharing a difficult, embarrassing, painful, or even overwhelming thoughts, experiences, or emotions. As vulnerability is rewarded with insight, connection, and personal growth, members are motivated to deepen connections, which promotes further insight and growth.
Catharsis: When a group member is able to express painful, pent-up, and intense emotions openly, they may experience substantial relief. And, when one member experiences catharsis in this way, other members may feel safe enough to do the same. Taking the time to investigate and reflect on the meaning of a cathartic release of emotion, especially in cooperation with others, can help members to better tolerate difficult emotions and retain some of this relief more permanently.
Existential factors: As members share their painful and heartfelt stories, a group inevitably faces some difficult realities. Though grim, approaching these truths head on, and coping with them individually and collectively, can reveal previously unrecognized strengths. Accepting that life is unjust, painful, and temporary, and that we must choose to either engage in or retreat from it, is a heavy task, but one that can instill us with the hope, courage, and motivation to create a better future.
For many, the thought of showing up to group––let alone sharing about personal experiences or grappling with harsh existential realities––can be a daunting and anxiety provoking. This speaks to the powerful healing potential of group. A group member’s first risk is showing up. Using the power of human relationships, we build on this first act, layer upon layer, until members have the emotional strength, skills, and confidence to take on larger, more difficult challenges. The unique and mutually supportive environment of group therapy offers opportunities for growth that are rarely found in other situations. The richness of group therapy provides fertile ground for developing insights about ourselves, relationships, and our view of the world.
Click this link for detailed information about my Personal Exploration Group for Adults.