Group Therapy: How It Works, What It Helps, and More

Group therapy is a type of psychotherapy that involves treating multiple people at the same time. One or more therapists can lead this type of therapy. A typical group includes about 5 to 15 participants, and each session lasts about an hour or two per week, according to the American Psychological Association (APA).

Led by a mental health professional, group therapy allows people to interact with others who may be going through similar challenges, share valuable feedback, and work together to solve common problems, notes the American Group Psychotherapy Association (AGPA).

“You can relate other people’s situations to your own,” says Judith Belmont, a former psychotherapist, a current online mental health coach, and the author of 150 More Group Therapy Activities and Tips. “There’s a sense of universality in group therapy. You realize you’re not alone, and you can try out developing skills in a group setting. It’s a very powerful way of learning and growing.”

Many groups are designed to address a specific concern, such as how to cope with depression, anxiety, pain, substance abuse, low self-esteem, loneliness, or grief, says the APA. But a group can offer a safe environment for anyone who is interested in self-development, regardless of whether you have a specific mental health condition, per the AGPA.

“Although most are apprehensive at first and don’t understand why group [therapy] would be helpful, after several sessions they begin to understand the power of connecting to other people as a significant part of the healing process,” says Martyn Whittingham, PhD, a licensed psychologist, a certified group therapist, and the founder of Focused Brief Group Therapy, an eight-session group therapy approach.

Pros and Cons of Group Therapy

There are both benefits and disadvantages to participating in group therapy, depending on your situation.

According to the American Addiction Centers, some pros of group therapy include:

• It typically costs less than individual therapy.
• Participants are exposed to different points of view and can relate to the struggles others face.
• There’s an opportunity to give and receive support from others.
• Individuals learn to improve their communication skills, become more self-aware, and express their feelings.
• Participants can model the successful behaviors and reactions of others who face similar circumstances.

On the flip side, some potential downsides of group therapy are:

• Each individual is not the main focus in the therapy session, and some may have more opportunities to speak than others.
• There’s less scheduling flexibility, as groups usually meet at specific times and must accommodate the schedules of all group members.
• Some may feel uncomfortable sharing personal information in a group.
• Conflicts can happen within the group.
• Although all group members are told that what’s shared to the group is confidential, there’s potential for less patient confidentiality in a group setting than one-on-one.

When it comes to the issue of participant confidentiality, Dr. Whittingham says it’s important to ask about protocols. “Some places, such as Washington, DC, have laws stating that group members cannot break confidentiality, while other states rely on the promise of each group member,” he explains.

There are many types of group therapy and ways to structure the sessions, Whittingham says. “They can sometimes focus on a diagnosis, like depression, but there can also be theme groups, like dealing with grief or managing perfection,” he explains.

Though there are different approaches to group therapy, most models have a common goal of helping people acquire new skills by interacting with each other, says Belmont. “One misconception is that group therapy is not good for learning about yourself, but actually people learn the most about themselves through other people,” she says.

Common models used for group therapy, according to the American Addiction Centers, include:

• Psychoeducational Groups A therapist acts as an educator, teaching participants about their conditions and helping them identify ways to cope.
• Cognitive-Behavioral Therapy Groups In these settings, a therapist uses cognitive behavioral therapy techniques to help individuals identify and change unhelpful thinking and behaviors into more constructive ones.
• Skills Development Groups People learn specific and applicable skills within a group setting.
• Support Groups This model encourages participants to support each other via different strategies, such as group discussions or problem-solving activities.
• Interpersonal Groups A therapist helps participants gain an understanding of and improve their emotional development and behavior by analyzing their social interactions and interpersonal relationships with other group members.

Sometimes these approaches are combined, depending on the needs and goals of the group, per American Addiction Centers.

Additionally, group meetings can be open or closed, according to research. An open session allows new members to join at any time, but closed groups require members to join at the same time.

Group therapy can benefit many people of different ages, races or ethnicities, gender identities, sexual orientations, or cultural backgrounds, according to the AGPA.

Group therapy may be particularly helpful for individuals who experience the following, according to StatPearls and the APA:

• Depression
• Anxiety disorders
• Post-traumatic stress disorder (PTSD)
• Attention deficit hyperactivity disorder (ADHD)
• Trauma
• Eating disorders
• Social or behavioral challenges
• Grief or loss
• Chronic pain
• Obesity
• Substance use disorder

Studies show that group therapy can be an effective tool for a wide range of conditions, and it may work as well as individual therapy, notes the APA.

In a review published in 2021 in The American Journal of Psychotherapy, researchers analyzed data from more than 329 studies that compared group therapy with individual therapy. They found group sessions are effective for helping reduce symptoms associated with these conditions:

• Depression
• Bipolar disorder
• Schizophrenia
• Anxiety and panic disorders
• Obsessive-compulsive disorder
• PTSD
• Eating disorders
• Borderline personality disorder
• Substance use disorders
• Chronic pain

Evidence shows that therapy conducted in a group setting can also save resources and money.

Using group therapy to meet psychological needs in the United States could save more than $5.6 billion and require 34,473 fewer new therapists compared with individual therapy, according to an analysis published in 2023 in the journal American Psychologist, which Whittington co-authored. A persistent shortage of mental health providers is a common barrier to treatment in the United States, per the same study.

Some research suggests that group therapy conducted virtually may be as effective as in-person sessions. In a review of 40 studies, published online in May 2018 in the Journal of Telemedicine and Telecare, investigators found similar outcomes and levels of participant satisfaction between in-person group therapy and teleconference group sessions.

Here’s what you should know before starting group therapy.

What’s a Group Therapy Session Like?

Therapy groups typically meet for an hour or two each week, according to the APA. Group sessions can be conducted in person or online, per the AGPA. The total number of meetings for each group may vary. Short groups addressing specific issues can last from 4 to 20 sessions, whereas others continue long term, according to the AGPA.

The structure of the meetings varies depending on the treatment models used and the group’s overall goals. “It’s not just talking about your feelings. There are lots of structured activities and topics,” Belmont explains.

Although groups usually consist of 5 to 15 participants, therapists often encourage breaking up into smaller subgroups or pairs for activities and then regrouping for a larger discussion, Belmont says. Typically, activities will emphasize ways to improve communication, personal growth, and trust.

“For example, you might try a role-playing situation for how to speak up more confidently, how to assert yourself, or how to handle your anger,” says Belmont. “The beauty of a group setting is that you can practice these skills.”

Participants may attend group sessions exclusively as their main form of treatment, or some may choose to participate in individual therapy along with group therapy, notes the AGPA.

How to Find a Group Therapist

Group therapy is commonly a required component of other types of psychotherapy, such as dialectical behavior therapy, says Belmont. Often, group sessions take place in inpatient settings, hospitals, and community centers. Group therapy is rarely offered at private practices partly because it’s challenging to assemble a larger number of people at one time, adds Belmont.

A mental health professional can provide recommendations for groups in your area, Whittingham says. Additionally, the AGPA provides a directory of certified group therapists in each state.

It’s a good idea to check with your health insurance company to see whether group therapy is covered prior to attending. As noted earlier, group therapy is typically less costly than individual therapy, and most insurance plans will cover both types, per AGPA.

When choosing a potential therapist, per the AGPA, you may want to ask the following questions:

• What is your background, and what educational training do you have?
• How effective do you think group therapy will be for me and my particular situation?
• What credentials do you have for group therapy?
• Do you have any special training to deal with my specific situation?

How to Prepare for a Group Therapy Session

Before attending a group therapy session, Whittingham says, you should ask the therapist:

• What to expect at sessions
• What is expected of you during sessions
• What the rules are about confidentiality
• If your goals align with the goals of the group

“If you are unsure of your goals for group [therapy], that’s perfectly okay, too,” Whittingham notes. “Most people are not sure how they want to get better, only that they don’t feel good and want to change.”

It might also help to write down what you plan to share with the group ahead of time.

Being open and honest is crucial for a positive experience. According to the University of North Carolina in Chapel Hill, you may want to prepare yourself to receive positive and negative feedback from other group members.

Who Shouldn’t Try Group Therapy?

While group therapy can be a beneficial tool for most people, some may do better with individual therapy, notes Whittingham. “For example, if you are in the middle of a severe crisis, such as a very recent, profound trauma that means you struggle to focus on other people, individual therapy can be a good place to find safety first,” he explains.

Group therapy may not be the best fit for people who are very antisocial, impulsive, or passive-aggressive, or who tend to be extremely shy, per American Addiction Centers. Whittingham adds that it’s best to talk with a mental health professional if you are questioning whether group therapy is a suitable option.

That said, if you are more reserved, you shouldn’t immediately discount group therapy, adds Belmont. “If one is starting out not feeling comfortable, they just don’t say as much. You don’t have to share, and some people might not feel ready for quite some time,” she explains. “But in my experience, people are very surprised by how comfortable they are sharing, especially during structured activities.”