Process, Players, and Applications
Group therapy is a form of psychotherapy where one or two therapists work with multiple clients simultaneously. The American Psychological Association recognizes it as a unique specialty where the group collaborates to improve each member's symptoms and self-awareness.
Group therapy has proven effective for depression, PTSD, anxiety disorders, schizophrenia, ADHD, OCD, personality disorders, eating disorders, chronic pain, and more.
Different theoretical frameworks guide how therapists structure and facilitate groups:
Based on Harry Stack Sullivan's work, focuses on clients' desire for secure relationships and exploring parataxic distortions from past experiences.
Developed by Wilfred Bion, emphasizes gaining self-insight through unconscious processes and transferential relationships within the group.
Created by Aaron and Judith Beck, highly structured approach examining relationships between thoughts, behaviors, and emotions.
Based on von Bertalanffy's theories, focuses on clients' roles within systems and managing boundaries between subgroups.
Jacob Moreno's approach where clients write and perform dramatic experiences, learning through role-playing.
Irwin Yalom's approach addressing existential anxiety, loneliness, guilt, and feelings of estrangement.
Inclusion factors: High extroversion and conscientiousness predict success. Use screening tools like the Group Therapy Questionnaire or NEO-Five-Factor Inventory.
Relative contraindications: Acute distress, low motivation, noncompliance with rules, or incapacity for connection (unless specifically designed for these issues).
Core mechanism correlating with therapeutic alliance and clinical improvement
Realizing others share similar feelings and problems
Receiving feedback and experimenting with new ways of relating
Helping others fosters better self-image
Observing others' success creates optimism
Re-enacting family dynamics in a healing way
Member behaviors: Seeking approval, sharing superficial information, determining relevance to personal goals
Leader strategies: Establish norms, ensure safety, focus on commonalities and trust-building
Member behaviors: Challenging authority, critical comments, rivalries for attention
Leader strategies: Provide feedback, teach conflict resolution, promote empathy, avoid retaliation
Member behaviors: Increased self-disclosure, trust, cooperation, problem-solving
Leader strategies: Continue leadership, address regression, orient new members
Member behaviors: Utilizing individual differences, personal change, interdependence
Leader strategies: Facilitate more than lead, balance support and confrontation
Member behaviors: Regression, fear of loss, appreciation for others
Leader strategies: Acknowledge progress, facilitate termination, provide referrals
Members naturally adopt various roles that contribute to group functioning:
| Role | Description |
|---|---|
| Initiator-Contributor | Proposes new ideas to address group problems or goals |
| Information Seeker | Looks for clarification of suggestions and facts |
| Opinion Seeker | Seeks clarification of values pertinent to the group's task |
| Information Giver | Offers facts relevant to the group's problem |
| Opinion Giver | Offers beliefs and alternate suggestions |
| Elaborator | Offers rationale for suggestions |
| Coordinator | Clarifies relationships between various ideas |
| Orienter | Defines the position of the group with respect to its goals |
| Evaluator/Critic | Reviews the accomplishments of the group |
| Energizer | Prompts the group toward action |
| Recorder | Writes down suggestions and serves as group memory |
Note: Understanding these roles helps therapists recognize group dynamics and manage potentially problematic patterns like scapegoating or excessive dependency.
Encourager: Offers praise and acceptance
Harmonizer: Mediates differences between members
Gatekeeper: Facilitates participation of all members
Standard Setter: Expresses group standards
Aggressor: Attacks others or deflates their status
Blocker: Negativistic and resistant to group progress
Dominator: Attempts to control group through manipulation
Help-Seeker: Uses group for excessive personal needs
American Group Psychotherapy Association (AGPA)
Practice Guidelines for Group Psychotherapy. Available at: www.agpa.org
Yalom, I. D., & Leszcz, M. (2020)
The Theory and Practice of Group Psychotherapy (6th ed.). Basic Books.
Bernard, H., & MacKenzie, K. R. (1994)
Basics of Group Psychotherapy. Guilford Press.
Consider joining the American Group Psychotherapy Association (AGPA) for access to training, certification programs, and ongoing education in group therapy practice.