Introduction
Through the years of clinical practice, group psychotherapy proved to be a practical intervention tool for various chronic and psychiatric disorders, including acute cases. Group therapy could benefit individuals and improve their progress in other significant areas besides therapy, such as building social skills and reducing the frequency of multiple psychiatric symptoms. Moreover, group therapy generally leads to favorable outcomes in cases where treatment is troubled by other co-morbidities.
While group psychotherapy is helpful for practitioners as it allows a simpler treatment process, patients also benefit from group therapy. According to a study conducted by Ezhumalai et al. (2018), the efficiency of group therapy can be compared to effects from individual therapy in many patient cases. The study proves that patients can positively influence each other when placed in groups and cause changes in other patients, which is not present in individual therapy. As in psychotherapy, patients tend to trust peers and their guidance more than therapists group therapy can be more effective than individual therapy. This paper will evaluate the efficacy of group therapy and provide recommendations of some group therapy session strategies for clinical practice.
Evaluating Efficacy
In order to evaluate the efficacy of group therapy, one should thoroughly examine its nature and dynamics. The main principle of group therapy is creating a friendly setting where the group will feel safe to share their experience, challenge themselves and others to change, and rehabilitate. Being a part of a group provides the individual an opportunity to view his experience in a different light and gain additional insight into their disorder and the struggles that it causes. An example of such behavior was displayed in Interpersonal group therapy for addiction recovery demonstration (Cats Cats, 2016), where the therapist established appropriate communication between the patients and respectfully managed their engagement, providing positive reinforcement. In addition to creating a positive setting, group therapy also fulfills the essential human need for belonging in offering support and suppressing feelings of loneliness.
Furthermore, there are two major categories of group therapy: process-oriented and psychoeducational. Process-oriented therapy focuses on interactions between group members, implying that members recover during therapy through their participation in discussing and sharing their experiences. On the other hand, the psychoeducational type of therapy is based on the principle of providing the members with valuable knowledge from other members’ experiences that can be used to overcome their struggles.
Even though many types of group therapy can be separated into two categories based on their primary focus, all types of group therapy utilize similar elements. Principles of altruism and universality, use of social skills, providing a sense of support, and instilling hope as group therapy elements allow establishing a connection between members and encourage their participation (Yalom & Leszcz, 2005). For example, one of the common elements in different types of group therapies, catharsis, is highly effective in the treatment of substance use (Ezhumalai et al., 2018). The therapist’s role in group therapy is to support the member’s engagement in therapy and guide them in gradually connecting the adverse outcomes with their disorder or behavior, such as substance use. Therefore, the efficacy of group therapy is based on fulfilling people’s essential need of belonging, providing support of their engagement, and gradually guiding them towards connecting personal experiences with the disorder.
Strategy Recommendations
Based on the evaluation of group therapies’ efficacy in their nature and mechanics, this research recommends following several strategies that can be used to ensure successful completion of group therapy and group members’ treatment progress. First, in dealing with troublesome events or behaviors during group therapy, it is recommended to use preventive methods and employ the universality principle in defining the group therapy’s guidelines with members prior to the first session. Next, as group therapy is supported by communication and exchange of experience with peers, it is necessary to build trustful relations between members to increase their engagement and prevent inappropriate behavior. Another effective strategy is defining the group leader, who could resist the offender and engage in valuable discourse on the topic without the offender’s removal (Gladding, & Binkley, 2007). Even though the use of such a strategy can negatively influence the course of the session and friendly climate, it is more effective for establishing trustful connection within the group than removing the offender.
Next, defining the group’s leader can be helpful in other situations besides conflicts or inappropriate behavior. A common feature in group therapy is members’ insecurity and unwillingness to engage in discussion due to introvert tendencies. In this case, a conversation between the leader and troubled member can resolve the situation and build his confidence and engagement in the therapy session. According to Gladding & Binkley (2007), modeling strategy can also be used to encourage those individuals who are afraid that they lack knowledge on the subjects or experience insecurity. Moreover, it helps to detect members who experience trouble connecting with other people and provide additional focus in therapy to develop their social skills.
Lastly, a helpful strategy for building the positive climate of group therapy is dividing the session into separate stages and providing additional measures specific for each stage. According to Ezhumalai et al. (2018), the group therapy session can be separated into stages of forming, storming, norming, performing, and adjourning. Applying different measures connected to each stage, such as allowing the members to know each other in the forming stage, can ease the establishment of valuable connections (Hinz, 2014). Therefore, the effective strategies for group therapy sessions include utilizing universality principles, defining the group leader, and dividing the course of the session into separate stages.
Applying Current Literature to Clinical Practice
The existing body of knowledge in current literature acknowledges the benefits of group therapy for improvements in other valuable areas besides the initial disorder, such as developing interactional skills and trustful connections. Moreover, group activities are widely used to overcome personal or societal challenges (U.S. Department of Health and Human Services, 2013). However, the existing literature on group therapy admits that not all people experience the positive effects of group therapy at the same rate. Thus, admission to group therapy might require preliminary evaluation of possible members, which can be performed through consultations and observation of each member.
The preliminary evaluation helps identify possible risks prior to the therapy session and establish a plan for therapists to encourage group members’ engagement in therapy. Alternatively, in cases where group therapy is most likely to be unsuccessful for the patient, the therapists can take additional measures in educating them about group therapy and its goals or use other treatment programs. Besides preliminary evaluation, current literature also recommends documenting the course of group therapy sessions to gather information about the dynamics in the group and potential issues for the rehabilitation process.
Conclusion
Group therapy is an effective intervention tool for treating chronic and acute psychiatry disorders. Group therapy creates trustful connections between the members and a positive climate that provides people with support from peers. However, while group therapy can be more effective than individual therapy in most cases, many people do not suit this type of therapy. Therefore, admission to group therapy requires preliminary examinations. Moreover, even though group therapy sessions have positive outcomes in most cases, some experts suggest that all psychotherapeutic interventions could have adverse outcomes (Strauss, 2021). Therefore, group therapy sessions should be performed by experienced professionals with the use of video documentation.
References
Cats Cats. (2016). Interpersonal group therapy for addiction recovery demonstration [Video]. YouTube. Web.
Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. Indian journal of psychiatry, 60(Suppl 4), S514–S521. Web.
Gladding, S. T. & Binkley, M. A. (2007). Advancing groups: Practical ways leaders can work through some problematic situations. American Counseling Association. Web.
Strauss, B. (2021). “You can’t make an omelet without breaking eggs”: Studies on side effects and adverse events in group psychotherapy. International Journal of Group Psychotherapy, 71(3), 472–480. Web.
Hinz, L. (2014). Stages of group development. Web.
U.S. Department of Health and Human Services. (2013). Substance abuse treatment: Group therapy inservice training: Treatment improvement protocol series (TIP 41). Lulu.com.
Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). Basic Books.