By Jen Kohlenberger
Oftentimes when people start a Partial Hospitalization Program or Intensive Outpatient Program, they are surprised by the amount of time that is devoted to group therapy and may even be skeptical of this approach. New patients tend to believe one-on-one therapy will be more effective and may even think group seems like a waste of time. The truth of the matter is that group therapy provides a lot of benefits that individual therapy does not, and is an essential component of a successful treatment plan.
Safe Space. Many people with mental illness do not speak openly about their experience with other people– especially people they don’t know well. They often don't even speak about it with people in their close circle like their family and friends. Group therapy can provide the space to begin to open up about these things and garner support, which will build confidence in having these types of conversations and interactions in the future in other aspects of your life. Sometimes it actually feels safer to share in the therapy group first, rather than to people with whom you share a stronger personal connection outside of the group. Oddly enough, it may be easier to open up to a perfect stranger than your spouse, sibling, child, or parent.
Transitioning. Communicating in a group setting allows a patient to acquire new ways of thinking, feeling, and behaving. Moreover, you have the opportunity to practice these new behaviors in the group as preparation for interactions that will occur in real life. Role playing is an incredibly effective exercise, in which patients can act out real life scenarios and plan for several possible outcomes from the other involved party. This exercise helps you prepare for those scenarios in real life situations.
Accountability. Meeting with a group, whether it’s multiple times a day or once a week, holds you accountable to the things you have decided to address and work on in your life. Having other people check in with you and ask how you’re feeling, or discuss what you are doing each day to stick to your treatment plan, is the best way to stay on track. The best part of this accountability is that it comes from other people who are on a similar path and benefit from you keeping them accountable as well.
Accountability can feel accusatory or even condescending, depending on who in your life is inquiring about your behaviors. Therefore, it’s important that you have people who can check in with you out of genuine concern and even graciously challenge you when necessary. Being challenged and receiving feedback from peers can be extremely constructive and help you work through difficult things.
Perspective. Group therapy can help you see your situation in a new light. Hearing the stories of other individuals allows you to gain perspective. It’s not about comparison or ranking whose problems are worse, but about knowing you are not alone in your struggle. There are many circumstances in our life where people portray themselves in a way that suggests they don’t have any problems. The more we believe that others don’t struggle, the more we feel like something is wrong with us. When we gather with people who are willing to be vulnerable and honest about things they are dealing with, we can feel validated and like we belong.
Outside Points of View. A group allows for you to receive third-party advice– and not just from a professional. This setting provides a wide range of unbiased perspectives. While advice from a therapist is incredibly important, helpful, and necessary, advice from peers can sometimes seem more genuine, organic, raw, and you can accept it without questioning the motive.
For example, it is common for patients to have concerns about their therapist, be skeptical about why they ask certain questions, whether they are listening, or doubt the sincerity of their feedback. However, when patients talk with each other in a facilitated setting, it can be more comfortable to assume that another patient does not have any reason behind their questions or input other than just to relate and support you.
Gain Confidence in Providers. For those who do have concerns about therapists, the aforementioned interactions with other patients can also create safety in a setting where a therapist or other provider is present. A good provider will facilitate the discussion and build trust with the patients. When you are able to have honest conversations in the group and be gently guided by a facilitator, you will be more confident in their ability and desire to help you. The group settings also allow you to observe how providers communicate with other patients, which can improve your communication with them as well.
Motivation. Hearing about what great things others are doing in life can be overwhelming and unrealistic if you don’t feel you are capable of doing the same things– especially if you face barriers due to your mental illness. On the other hand, hearing how poorly others are doing who face similar challenges as you may also make you feel defeated and as if there’s no hope. Having a peer support group with people who face similar situations to yours but are working toward becoming healthy can help you to have a more realistic understanding of attainable goals.
In group therapy, some patients have been in treatment longer than others. Everyone’s treatment timeline is different, and therefore, some people are further along in their healing. A person who just started therapy may be experiencing a lot of distress. Knowing that others feel more stable and regulated, and are accomplishing things they weren’t able to do prior to therapy, can give a new patient hope that they can get there too. Hearing about others’ success is empowering and motivating.
Empathy. Empathizing with others makes us better. Helping others and giving support often builds our confidence and self-esteem. It allows us to get outside of ourselves and our own thoughts and circumstances and put energy toward supporting someone else. Caring for other human beings gives us a sense of purpose. Research also shows that it reduces stress, increases social connection, and makes us feel good— which all contribute to our mental wellness.
Community. Perhaps one of the most important reasons why group therapy works is because, as humans, we are designed to live in community with one another. When we are not mentally well, there is a tendency to pull away, shut down, and isolate. Isolation negatively impacts our mental health. This becomes a vicious cycle— we isolate because we are struggling, and the more we isolate, the more we struggle. This is also why when we begin our mental health journey, group therapy sounds both challenging and unappealing. But it is exactly what we need. The good news is that the cycle can be reversed— when we start to engage with others, we begin to feel better, and the better we feel, the more we want to engage.
Taking the first step and participating in a group is difficult, but group therapy may very well be the most important aspect of your healing journey.