Why Group Therapy Can Be As Good (If Not Better) Than Individual Therapy
To access counseling services at a university counseling center where I worked, students would first go through an intake where they talked through why they were seeking services. At the end of this intake, we would collaborate on connecting them with the most appropriate resource for their needs. Services we offered included individual therapy, group therapy, psychiatry, and workshops. Overwhelmingly, students wanted individual therapy. However, it was also my job to recommend what I perceived to be the most appropriate services based on the students’ presenting concern.
With this in mind, I often recommended one or multiple of the various group therapies that we ran each semester. These groups ranged from support groups (e.g., a grief group) to interpersonal process groups (i.e., unstructured groups where people learn more about themselves and how they relate to others). For the most part, students balked at my suggestion. Many discussed their discomfort at talking in front of people. Others wondered how the group would work. I tried to explain the structure of the different groups and why they would be helpful for their specific concern. However, most wanted to stick with good ol’ fashioned individual therapy. So, I would schedule them with one of our therapists, wondering about the growth that they might be missing out on that only a group can offer.
To be clear, I understand why joining a group feels more daunting than starting individual work. When picturing therapy, almost everyone imagines a one-on-one setting with a therapist. All the professional attention is on them, and they have full autonomy to talk about whatever they want to talk about. A group is more complicated than that. The “safe space” everyone refers to in therapy seems a bit riskier with the presence of a bunch of strangers, none of whom are trained in mental health. Rather than just worrying about how the therapist may respond to their vulnerabilities, there is a room full of people who might have their own reactions or judgments. And that same room of people have their own issues that they want to discuss. For many, this does not sound therapeutic.
However, much of what makes a group anxiety-provoking is precisely what makes it so rewarding. In hearing others’ concerns, people often feel less alone. Stigma about mental health has declined recently, but people still tend to try to portray their best self to the world (Ask anyone, “How are you?” and I almost guarantee they will say, “Good!”). As a result, the mere fact that we are struggling can feel isolating. Hearing others go through something similar or just going through something in general can alleviate this sense of isolation.
There is more to this than just learning that someone is struggling. Listening to others’ difficulties and how they are navigating them can offer perspective on our own struggles, maybe even provide guidance on how to address them. On the flip side, we might be able to provide our own guidance, feedback, or support that is instrumental to helping someone else. The act of helping another human being is therapeutic itself. To feel appreciated by someone else connects us. To have the ability to enact positive changes in another person empowers us.
Similarly, it is impactful to be heard by others when sharing our own struggles. People have many reasons for bottling their emotions, such as not feeling like they have people in their life who will listen or not wanting to burden others with their problems. Oftentimes, we worry that people will not understand what we are dealing with, so we choose not to talk about what is going on. This, in turn, ensures that people do not understand and leaves us feeling alone. A group consists of people who are similarly motivated to listen and support other group members. Having our struggles heard by members can also decrease our loneliness. Our sense of worthiness, inversely, increases, as we experience care and validation from other members. These members might be able to offer feedback that we have not thought of before; having more people in a group compared to individual therapy offers more opportunity for different perspectives. While I think an individual therapist can provide significant help (not surprising coming from a therapist who mainly does individual therapy), helping and being helped by peers has its own powerful effects that can sometimes be more meaningful.
An important mechanism of change in groups, especially interpersonal process groups, is that groups act as a microcosm for what happens in “real life.” By this, I mean that what people are struggling with in their day-to-day will make its way into the group. For example, if someone has difficulty managing their anger, then it is likely that their anger will make its presence known in the group. And in the group, this anger can be responded to and processed in a different, therapeutic way. To do this, groups focus on two unique aspects that are often lost in our day-to-day interactions: the here-and-now and the process.
To focus on the here-and-now, group members are encouraged to be aware of their thoughts and emotions during the session and communicate these to the group. Oftentimes, people do not take the time to really reflect on what is going on for them in the moment during their daily lives. Instead, we react to what is going on around us in familiar patterns that have become ingrained in us. By mindfully paying attention to our moment-to-moment experience, we can become more aware of our patterns and make the choice where we want to continue engaging in those patterns. In individual sessions, people often talk about their experiences with other people before the session. This can still be helpful, but in the group, the emotions and reactions to others are processed during the group, which can be more impactful.
Engaging with the here-and-now not only increases self-awareness for group members, but it also allows them to get feedback from other members. So often, we wonder what people are thinking – are they judging me? Do they like me? We do not ask these questions, maybe due to social norms at asking such direct questions or wanting to avoid the potential answer. In a group, however, where people are united in their desire to help each other and therapists make sure to maintain a safe space, the curtain can be pulled back and there is no need to wonder these questions. To get group members more comfortable with the here-and-now, the therapists will often ask members what their reaction was to something that happened in the group (e.g., what they were feeling when a group member said something).
The second unique focal point is process, which is where the interpersonal process group gets its name from. This differs from the content, which is what is directly said or what happens. Process, on the other hand, is the underlying meaning and messages behind our overt actions. For example, a group member might not contribute at all in a group session. This silence is the content. The process is the underlying message behind the silence. Are they scared of being judged if they contribute? Perhaps they think they are better than the others in the group and do not need to participate? The group therapist might make a process comment, asking that group member if they could share their thoughts to the group on what their silence means. These types of questions/comments are common in a process group, whether they are directed to an individual or to the group itself. For example, the therapist might pose a question to the group about whether they are also feeling a lack of energy in the group that day. Bringing the process to light and getting past content offers the opportunity to engage in more authentic communication that then allows for greater self-awareness and deeper connections.
Group is a more vulnerable venture than individual therapy in many ways, but it is this increased vulnerability that can result in a different type of growth that is unique to group therapy. Oftentimes in therapy, if there is something that you are avoiding talking about, that probably means it is worth talking about and processing. If joining a therapy group evokes anxiety in you, that just might be the sign that a group could be good for you
To start group therapy in Dallas, TX, follow these steps:
1. If you are at all interested, I encourage you to email Dr. James Ramarushton, PhD at james@sunrisecounselingdallas.com to set up a free, 30-minute virtual meeting where he can tell you more about the group, talk through what you want to get out of the group, and determine whether you would be a good fit.
2. The plan is to start a group in March or April, in-person, and at our office in Dallas, TX once we have enough participants. The meeting time will be dependent on the group members’ and therapist’s availability - the time with the most overlap in availability will be chosen.
3. The group will then meet weekly for 90-minute sessions.
Other Mental Health Services in Dallas, TX
Group Therapy is only one of the mental health services we offer at Sunrise Counseling. We provide a variety of services to clients from our Dallas TX-based therapy office and the surrounding areas. Other mental health services we provide at Sunrise Counseling include: