Group Counseling: What to Expect

Group counseling can be a unique, but beneficial therapy experience that involves a counselor and at least two persons (not equivalent to couples or family counseling). There are various types of group therapy, and the structure and format may vary depending on the client’s presenting issues. Group counseling can address a wide variety of presenting issues, but some of the most common are:

• Grief/ Loss
• Parenting
• Couples Issues
• Substance Use
• Social Skills
• Trauma Recovery
• Anger Management
• Boundaries
• Depression
• Anxiety
• Domestic Violence
• Divorce
• Food and Eating Issues
• Coping Skills
• Stress Management
• Mindfulness

Not every situation or person is appropriate for group counseling, so the counselor may screen participants to assess their suitability. If the counselor believes that someone would be better served individually, he will make that recommendation or referral.

Types of Group Counseling

Psychoeducational

Psychoeducational groups are characterized by a counselor facilitating the group by teaching material in a lesson on a specific topic. The group is invited to participate, but not in the same way as they would in process groups. Too much personal information is not appropriate for psychoeducational groups.

The counselor will follow specific material for the class, and he may have educational handouts, assessments, and videos in the group. Topics often taught in psychoeducational groups are parenting, domestic violence, coping skills, and anger management.

Anything could be taught in this type of group, though, and if a person is looking more to learn about something specific rather than talk in-depth with other group members, a psychoeducational group is the better fit.

Process

Process groups provide group members with a more therapeutic experience than psychoeducational groups. The counselor facilitates group discussion, but members are each given opportunities to share how they are feeling, thinking, or struggling.

These types of groups often promote healthy self-esteem, help clients see that they are not alone in their struggles, and allow them to hear other perspectives. These groups are often focused on a specific presenting issue, like depression, grief, anxiety, divorce, and others. If a person is looking for this type of experience, then a process group would be the right fit.

Structure of Group Therapy

Most groups will meet for one-two hours weekly and are held in a variety of locations. People will meet in a closed, quiet room with chairs facing each other to ensure the privacy of members and facilitate healthy group dynamics. Therapy groups have different structures:

Open

When a group is open, that means that it is always open to new members. Many times, psychoeducational groups are open. This can be beneficial because it allows the group to be able to serve more people and get the information out that is needed.

Closed

When a group is closed, it has a limited number of people allowed in the group. This could be best for process groups so that trust can be established among group members and healthy relationships built. When trust is established, people feel free to be vulnerable with others.

Ongoing

Ongoing groups meet on a regular basis. This could be a group that meets weekly all year round. They could be open or closed, but usually ongoing groups are open groups. Inpatient and Intensive Outpatient groups run on this schedule most of the time and do rotate members often. Some less intensive groups will run on this schedule as well. This allows for flexibility for group members and helps reach more people.

Limited Time Frame

Some groups will run during a specific time frame. Depending on the topic, some will run for many weeks and some will run for only a few. These groups are usually closed, but that is not always the case. This structure makes room for faster progress and helps the client be consistent.

Format

Inpatient

Patients in the hospital or another type of inpatient program for suicidal ideation, eating disorders, substance use, behavior issues, and severe mental illness will have groups as part of therapy. Patients will be in ongoing groups until they are discharged, and members often come and go. Patients report feeling a bit awkward in these groups, but they still share how they can be beneficial at times.

Outpatient/ Intensive Outpatient

These groups are for patients who have been discharged from an inpatient program, but they still need intensive therapy because they are still a bit unstable and unable to return to normal living. Often coupled with individual therapy, these groups will often meet multiple times a week, follow a program, and must be attended for someone to complete an intensive program. These programs are usually for substance use, eating disorders, suicidal ideation, and severe mental illness.

Weekly

Groups that meet weekly in a setting that is not outpatient, like private practices, community-based practices, and churches are meant for people who are more stable, but still in need of regular therapy.

Risks of Confidentiality

One of the biggest risks of group counseling versus individual therapy is the maintenance of patient privacy. A counselor is ethically bound to honor a patient’s privacy, but group members are not. A counselor will usually provide group rules and will ask each person to commit to also maintain group member privacy.

Even if a member signs a contract regarding this, confidentiality cannot be guaranteed. If a counselor learns of any break in confidentiality, there may be consequences to the guilty party such as being removed from the group. While in a group, for it to be effective, members must be willing to abide by the regulations set by the counselor.

Benefits of Group Counseling

Group counseling can be a helpful alternative to individual therapy. Depending on the type and format of the group, a person will be able to learn a good bit of knowledge about his issue in a small amount of time, become more comfortable sharing vulnerably with others, learn how to trust others, see how other perspectives can be welcomed, practice active and reflective listening skills, learn new skills, practice consistency, and know that he is not alone in his struggles.

Therapy groups differ from support groups in that a qualified therapist will be present teaching evidence-based skills. The therapist will also know how to handle difficult emotional experiences in the group and know what appropriate group behavior is. If a person is willing to do the necessary work and participate in appropriate ways, group therapy can be a powerful and healing experience.

What to Look for When Seeking Group Therapy

When looking for a group to be a part of, it is important to ask a few different questions. Someone can ask these by talking with the facilitator or doing some research about the group. Here are some necessary questions to ask:

1. What does this group address? Is that what I need?
2. How long is the group?
3. When is the group?
4. What kind of group is this?
5. What kind of members are in this group?
6. Is the group open or closed? How large is it?
7. Am I comfortable with sharing vulnerably with other strangers if it is a process group?
8. What activities will take place in the group?
9. What other groups are offered?
10. Are there groups elsewhere that may be a better fit?

Counseling in a group setting can feel scary and uncomfortable for people, but it can be worth the risk. If a person is not sure if group therapy would be the right fit for him, he can ask a trusted person or a counselor.

There may be needs that would be better addressed in individual therapy, but people need to consider the benefits. Group counseling could bring healing in unexpected and maybe even uncomfortable ways, but when effective, the effects could last for a long time.