What it is: Much of what drives people to seek out therapy can be traced back to relational difficulties. Interpersonal group therapists (what most people think of as generic group therapists) believe that it’s important to practice communicating in a safe environment. Both therapists and fellow group members offer constructive feedback, which encourages both awareness and a level of frankness that friends and family might not offer.
“We all have blind spots, and most people aren’t that honest with us,” says Victor Yalom, Ph.D., a psychologist in San Francisco. “What you can get in groups that you can’t get in individual therapy is a lot of feedback and valuable information on how you relate to other people.”
In well-run groups, the therapist encourages clients to interact with each other, not just with the therapist. This allows the therapist, as well as the other people in the group, to see the client in action: is she confrontational? Does he always interrupt people? Is she narcissistic? Is he passive, shying away from conflict? Once these patterns are identified, the group provides a safe place to practice communicating in healthier ways.
“Once you practice it in a group and develop some new skills, the goal is that you start applying that in the world, in your real relationships, and that’s exactly what happens,” Yalom says. Group members might tell a people-pleaser that, if he shared more of himself, it might allow them to know him more fully and feel closer to him. Or they might turn to a self-involved member and ask, “What about the rest of us?”
“Group therapy, by its very nature—being interactive and experiential—can encourage you to take risks and try out new behaviors that individual therapy doesn’t always accomplish,” Yalom says.
How it works: Before joining a group, the client meets with the therapist who leads it to make sure it’s the right fit: interpersonal dynamics are vital here. In this initial meeting, the therapist gets a detailed history of the issues the client is dealing with and shares information about how the group is run. (In some cases, such as in Yalom’s group, prior or concurrent individual therapy is actually required for participation.) Groups are usually ongoing, with clients joining and leaving as suits their needs, and tend to have between six and 10 participants.
Sessions are free-form, with the therapist encouraging dialogue between members. Joe might tell his group, for example, that women tend to reject him after a first date. The therapist might turn the question to the other members, asking what their experiences of Joe have been and if there’s anything that might be relevant to this problem. “You’re always interrupting people,” someone might point out—unlike in a support group, there’s no requirement that feedback be positive here. Ideally, Joe would practice listening rather than interrupting in both the group and on future dates, reporting back on how it’s going for him.
But it’s not all about being brazen and coming to the group with your problems: the therapist also draws out quieter members. “If someone dominates the group and other people are letting them dominate the group, we’ll confront both of them,” Yalom says. Besides that, watching others communicate can be edifying. “You learn through observing as well as through participating,” Yalom says.
Who it fits: People looking to improve their relationships, whether romantic, familial, friendly or professional. “If you want to improve the quality of the relationships in your life and you’re willing to be open and to receive some feedback on how people experience you, then it’s much more likely to be helpful for you,” Yalom says. Discussing your problems with a group can be nerve-wracking, so you also have to be willing to tolerate that anxiety. “If you’ve never been in therapy and the idea of a group seems terrifying to you, you might be better starting off in individual therapy,” Yalom says.
Shown to treat: Any problem that can be traced back to relational difficulties. “I think group therapy can be useful for really any type of psychological problem. The question is finding the right type of group to match your problem,” Yalom says.
Duration: A year or more. Groups usually meet for about 90 minutes, weekly.
Where to find a group therapist: See the American Group Psychotherapy Association for a list of state and local group therapy societies.
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