INTRODUCTION

• HUMAN BEINGS ARE COMPLEX CREATURES WHO SHARE THEIR ACTIVITIES OF

DAILY LIVING WITH VARIOUS GROUPS OF PEOPLE. HEALTHCARE
PROFESSIONALS NOT ONLY SHARE THEIR PERSONAL LIVES WITH GROUPS OF
PEOPLE BUT ALSO ENCOUNTER MULTIPLE GROUP SITUATIONS IN THEIR
PROFESSIONAL OPERATIONS. TEAM CONFERENCES, COMMITTEE MEETINGS,
GRAND ROUNDS, AND IN-SERVICE SESSIONS ARE BUT A FEW. IN PSYCHIATRY,
WORK WITH CLIENTS AND FAMILIES OFTEN TAKES THE FORM OF GROUPS.
WITH GROUP WORK, NOT ONLY DOES THE NURSE HAVE THE OPPORTUNITY TO
REACH OUT TO A GREATER NUMBER OF PEOPLE AT ONE TIME, BUT THOSE
INDIVIDUALS ALSO ASSIST EACH OTHER BY BRINGING TO THE GROUP AND
SHARING THEIR FEELINGS, OPINIONS, IDEAS, AND BEHAVIOURS. CLIENTS
LEARN FROM EACH OTHER IN A GROUP SETTING.
DEFINITION:

• GROUP: A GROUP IS A COLLECTION OF INDIVIDUALS WHOSE ASSOCIATION

IS FOUNDED ON SHARED COMMONALITIES OF INTEREST, VALUES, NORMS,
OR PURPOSE. MEMBERSHIP IN A GROUP IS GENERALLY BY CHANCE (BORN
INTO THE GROUP), BY CHOICE (VOLUNTARY AFFILIATION), OR BY
CIRCUMSTANCE (THE RESULT OF LIFE-CYCLE EVENTS OVER WHICH AN
INDIVIDUAL MAY OR MAY NOT HAVE CONTROL).
GROUP THERAPY:

• A FORM OF PSYCHOSOCIAL TREATMENT IN WHICH A NUMBER OF CLIENTS

MEET TOGETHER WITH A THERAPIST FOR PURPOSES OF SHARING,
GAINING PERSONAL INSIGHT, AND IMPROVING INTERPERSONAL COPING
STRATEGIES.
AIM / GOALS OF THE GROUP
THERAPY:
• TOASSIST EACH INDIVIDUAL IN EMOTIONAL GROWTH AND PERSONAL
PROBLEM SOLVING.
• TOHELP INDIVIDUALS BETTER UNDERSTAND THEMSELVES IN THE
CONTEXT OF THEIR RELATIONSHIPS SO THAT THEY CAN MAKE MORE
KNOWLEDGEABLE, HEALTHY, AND ADAPTIVE CHOICES BASED ON A
DEEPER AWARENESS OF THEIR FEELINGS, INTERPERSONAL
BEHAVIOURS, REACTIONS AND PATTERNS.
• RESEARCH SHOWS THAT GROUP THERAPY IS ACTUALLY THE TREATMENT
OF CHOICE FOR MANY RELATIONAL ISSUES SUCH AS CERTAIN FORMS OF
DEPRESSION, ANXIETY, ISOLATION, ANGER, SHYNESS, INTIMACY
CONCERNS, FRIENDSHIP TROUBLES, AND WORK ISSUES.
PRINCIPLES OF GROUP
THERAPY:

• YALOM'S THERAPEUTIC FACTORS (ORIGINALLY TERMED CURATIVE

FACTORS BUT RENAMED THERAPEUTIC FACTORS IN THE 5TH EDITION OF
'THE THEORY AND PRACTICE OF GROUP PSYCHOTHERAPY').
• UNIVERSALITY
THE RECOGNITION OF SHARED EXPERIENCES AND FEELINGS AMONG
GROUP MEMBERS AND THAT THESE MAY BE WIDESPREAD OR UNIVERSAL
HUMAN CONCERNS, SERVES TO REMOVE A GROUP MEMBER'S SENSE OF
ISOLATION, VALIDATE THEIR EXPERIENCES, AND RAISE SELF-ESTEEM.
• ALTRUISM
THE GROUP IS A PLACE WHERE MEMBERS CAN HELP EACH OTHER, AND THE
EXPERIENCE OF BEING ABLE TO GIVE SOMETHING TO ANOTHER PERSON
CAN LIFT THE MEMBER'S SELF-ESTEEM AND HELP DEVELOP MORE
ADAPTIVE COPING STYLES AND INTERPERSONAL SKILLS.
• INSTILLATION OF HOPE
IN A MIXED GROUP THAT HAS MEMBERS AT VARIOUS STAGES OF
DEVELOPMENT OR RECOVERY, A MEMBER CAN BE INSPIRED AND
ENCOURAGED BY ANOTHER MEMBER WHO HAS OVERCOME THE PROBLEMS
WITH WHICH THEY ARE STILL STRUGGLING
• IMPARTING INFORMATION

WHILE THIS IS NOT STRICTLY SPEAKING A PSYCHOTHERAPEUTIC PROCESS,

MEMBERS OFTEN REPORT THAT IT HAS BEEN VERY HELPFUL TO LEARN
FACTUAL INFORMATION FROM OTHER MEMBERS IN THE GROUP. FOR
EXAMPLE, ABOUT THEIR TREATMENT OR ABOUT ACCESS TO SERVICES
• CORRECTIVE RECAPITULATION OF THE PRIMARY FAMILY EXPERIENCE

MEMBERS OFTEN UNCONSCIOUSLY IDENTIFY THE GROUP THERAPIST

AND OTHER GROUP MEMBERS WITH THEIR OWN PARENTS AND
SIBLINGS IN A PROCESS THAT IS A FORM
OF TRANSFERENCE SPECIFIC TO GROUP PSYCHOTHERAPY. THE
THERAPIST'S INTERPRETATIONS CAN HELP GROUP MEMBERS’ GAIN
UNDERSTANDING OF THE IMPACT OF CHILDHOOD EXPERIENCES ON
THEIR PERSONALITY, AND THEY MAY LEARN TO AVOID
UNCONSCIOUSLY REPEATING UNHELPFUL PAST INTERACTIVE
PATTERNS IN PRESENT-DAY RELATIONSHIPS
• DEVELOPMENT OF SOCIALIZING TECHNIQUES
THE GROUP SETTING PROVIDES A SAFE AND SUPPORTIVE ENVIRONMENT
FOR MEMBERS TO TAKE RISKS BY EXTENDING THEIR REPERTOIRE OF
INTERPERSONAL BEHAVIOUR AND IMPROVING THEIR SOCIAL SKILLS
• IMITATIVE BEHAVIOR

• ONE WAY IN WHICH GROUP MEMBERS CAN DEVELOP SOCIAL SKILLS IS

THROUGH A MODELLING PROCESS, OBSERVING AND IMITATING THE
THERAPIST AND OTHER GROUP MEMBERS. FOR EXAMPLE, SHARING
PERSONAL FEELINGS, SHOWING CONCERN, AND SUPPORTING OTHERS
• COHESIVENESS

• IT HAS BEEN SUGGESTED THAT THIS IS THE PRIMARY THERAPEUTIC

FACTOR FROM WHICH ALL OTHERS FLOW. HUMANS ARE HERD ANIMALS
WITH AN INSTINCTIVE NEED TO BELONG TO GROUPS, AND PERSONAL
DEVELOPMENT CAN ONLY TAKE PLACE IN AN INTERPERSONAL CONTEXT. A
COHESIVE GROUP IS ONE IN WHICH ALL MEMBERS FEEL A SENSE OF
BELONGING, ACCEPTANCE, AND VALIDATION
• EXISTENTIAL FACTORS

• LEARNING THAT ONE HAS TO TAKE RESPONSIBILITY FOR ONE'S OWN LIFE
AND THE CONSEQUENCES OF ONE'S DECISIONS
• CATHARSIS
• CATHARSIS IS THE EXPERIENCE OF RELIEF FROM EMOTIONAL DISTRESS
THROUGH THE FREE AND UNINHIBITED EXPRESSION OF EMOTION. WHEN
MEMBERS TELL THEIR STORY TO A SUPPORTIVE AUDIENCE, THEY CAN
OBTAIN RELIEF FROM CHRONIC FEELINGS OF SHAME AND GUILT
• INTERPERSONAL LEARNING

• GROUP MEMBERS ACHIEVE A GREATER LEVEL OF SELF-

AWARENESS THROUGH THE PROCESS OF INTERACTING WITH OTHERS IN
THE GROUP, WHO GIVE FEEDBACK ON THE MEMBER'S BEHAVIOUR AND
IMPACT ON OTHERS
• SELF-UNDERSTANDING

• THIS FACTOR OVERLAPS WITH INTERPERSONAL LEARNING BUT REFERS TO

THE ACHIEVEMENT OF GREATER LEVELS OF INSIGHT INTO THE GENESIS
OF ONE'S PROBLEMS AND THE UNCONSCIOUS MOTIVATIONS THAT
UNDERLIE ONE'S BEHAVIOUR
• INDICATION
• WHILE GROUP THERAPY CAN TECHNICALLY BE APPLIED TO A VARIETY OF
APPROACHES AND A VARIETY OF CONCERNS, THERE ARE CERTAIN AREAS
THAT MAY PARTICULARLY BENEFIT FROM A GROUP DYNAMIC. THE
FOLLOWING TOPICS ARE EXAMPLES
• ADDICTION

• HAVING A STRONG SUPPORT NETWORK IS KEY WHEN IT COMES TO

OVERCOMING ADDICTION. FOR SOME PEOPLE, THIS KIND OF NETWORK ISN'T
AVAILABLE AT HOME AND THEY MAY BENEFIT MORE FROM THE SUPPORT OF
OTHERS WITH AN ADDICTION. HEARING HOW OTHERS COPE, LEARNING
INTERPERSONAL SKILLS AND UNCOVERING HOW YOUR BEHAVIOURS CAN
IMPACT OTHER PEOPLE CAN ALL HELP YOU ON YOUR JOURNEY TO
OVERCOMING ADDICTION
• ANXIETY

• FOR PEOPLE SUFFERING WITH ANXIETY, GETTING OUT AND INTERACTING

WITH THOSE WHO UNDERSTAND CAN BE HELPFUL. KNOWING YOU AREN'T
ALONE IN YOUR FEELINGS AND HEARING HOW OTHERS MANAGE THEIR
ANXIETY CAN BE INVALUABLE. YOU ARE ALSO LIKELY TO DEVELOP
BETTER SOCIAL SKILLS, WHICH CAN HELP IF YOU SUFFER FROM SOCIAL
ANXIETY
• DEPRESSION

• THOSE DEALING WITH DEPRESSION MAY FIND THEMSELVES FEELING

VULNERABLE AND ISOLATED. GETTING OUT OF THE HOUSE AND TALKING TO
OTHERS IS ALWAYS USEFUL AND IN A GROUP THERAPY SESSION IT CAN BE
EVEN MORE SO. REACHING OUT TO OTHERS GOING THROUGH SIMILAR
ISSUES AND DISCUSSING COPING MECHANISMS CAN HELP YOU TO HELP
YOURSELF. YOU MAY ALSO FIND THAT IMPARTING YOUR OWN ADVICE HELPS
TO BOOST YOUR SENSE OF SELF-ESTEEM
• EATING DISORDERS

• FOR SOME PEOPLE, THE SUPPORT NETWORK CREATED BY GROUP

THERAPY CAN AID RECOVERY FROM AN EATING DISORDER. FOR OTHERS
HOWEVER, IT CAN BE COUNTERPRODUCTIVE. IF YOU FIND THAT YOU ARE
COMPARING YOURSELF TO OTHERS IN THE GROUP (FOR EXAMPLE THEIR
WEIGHT/SIZE) IT MAY BE WORTH SEEKING INDIVIDUAL THERAPY INSTEAD
• OBSESSIVE COMPULSIVE DISORDER
• BEING ALONE WITH YOUR OWN THOUGHTS DURING TIMES OF ANXIETY
CAN TRIGGER SYMPTOMS WHEN YOU SUFFER FROM OBSESSIVE
COMPULSIVE DISORDER. SPEAKING TO OTHERS WHO UNDERSTAND YOUR
FEELINGS AND BEHAVIOURS CAN HELP YOU UNDERSTAND YOUR
CONDITION BETTER. TOGETHER YOU CAN SUPPORT ONE ANOTHER AND
LOOK TO FIND WAYS OF COPING
• RELATIONSHIP DIFFICULTIES

• IF YOU FIND IT DIFFICULT TO FORGE AND MAINTAIN RELATIONSHIPS,

ATTENDING GROUP THERAPY COULD HELP. BEING AROUND OTHER
PEOPLE ON A REGULAR BASIS CAN HELP YOU TO DEVELOP
INTERPERSONAL AND SOCIAL SKILLS THAT YOU CAN GO ON TO PRACTICE
OUTSIDE OF YOUR SESSIONS
• SCHIZOPHRENIA

• GROUP THERAPY FOR THOSE WITH SCHIZOPHRENIA CAN BE BENEFICIAL,

DEPENDING ON THE SEVERITY OF THE CONDITION. IT CAN BE HELPFUL TO
REACH OUT TO OTHERS WHO EXPERIENCE SIMILAR SYMPTOMS TO YOURSELF,
AND LEARNING MORE ABOUT THE DISORDER CAN HELP YOU UNDERSTAND
YOUR OWN THOUGHTS BETTER. IF YOU FIND YOU ARE FEELING UNSAFE OR
PARANOID DURING GROUP THERAPY SESSIONS HOWEVER, IT IS IMPORTANT
TO DISCUSS YOUR FEELINGS WITH YOUR THERAPIST
• SELF-HARM

• MEETING WITH OTHERS WHO STRUGGLE WITH SELF-HARM CAN HELP YOU
FEEL LESS ALONE. HEARING HOW OTHERS COPE WITH THEIR PROBLEMS,
INCLUDING PRACTICAL TIPS YOU MAY NOT HAVE THOUGHT OF, CAN ALSO
BE INCREDIBLY HELPFUL
CONTRAINDICATION
• ANTISOCIAL PERSONALITY DISORDER
• ACUTE OR SEVERE ILL CASES LIKE SUICIDAL TENDENCY WHERE INDIVIDUAL
ATTENTION IS REQUIRED
• CLIENTS WITH DELUSIONS.
• OLDER AGE.
• LOW INTELLIGENCE.
• UNWILLINGNESS
• LACK OF ADEQUATELY TRAINED STAFF.
ADVANTAGES
• MORE CLIENTS CAN BE TREATED AT ONCE, FOSTERING COST EFFECTIVENESS.
• MEMBERS BENEFIT BY HEARING OTHERS DISCUSS SIMILAR PROBLEMS; FEELINGS OF
ISOLATION, ALIENATION, AND UNIQUENESS OFTEN DECREASE, ENCOURAGING MEMBERS TO
SHARE PROBLEMS.
• GROUP THERAPY ALLOWS CLIENTS TO EXPLORE THEIR SPECIFIC STYLES OF
COMMUNICATION IN A SAFE ATMOSPHERE WHERE THEY CAN RECEIVE FEEDBACK AND
UNDERGO CHANGE.
• MEMBERS LEARN FROM OTHERS MULTIPLE WAYS TO SOLVE PROBLEMS, AND GROUP
EXPLORATION MAY HELP THEM TO DISCOVER NEW WAYS.
• MEMBERS LEARN ABOUT THE FUNCTIONAL ROLES OF INDIVIDUALS IN A GROUP.
SOMETIMES, A MEMBERS SHARE THE RESPONSIBILITY AS THE CO-THERAPIST. MEMBERS
BECOME CULTURE CARRIERS.
• THE GROUP PROVIDES FOR ITS MEMBERS UNDERSTANDING, CONFRONTATION, AND
IDENTIFICATION WITH MORE THAN ONE PERSON.
•
DISADVANTAGES
• A MEMBER’S PRIVACY MAY BE VIOLATED, SUCH AS WHEN A CONVERSATION IS
SHARED OUTSIDE THE GROUP. THIS BEHAVIOUR OBSTRUCTS
CONFIDENTIALITY AND HAMPERS COMPLETE AND HONEST PARTICIPATION.
• CLIENTS FROM VARIOUS DIAGNOSTIC GROUPS MAY DIFFER BASED ON
NEUROBIOLOGICAL FUNCTIONING.
• CLIENTS MAY EXPERIENCE DIFFICULTY EXPOSING THEMSELVES TO A GROUP
OR BELIEVE THAT THEY LACK THE SKILLS TO COMMUNICATE EFFECTIVELY.
• GROUP THERAPY IS NOT HELPFUL IF THE THERAPIST CONDUCTS THE GROUP
AS IF IT IS INDIVIDUAL THERAPY. SUCH A THERAPIST MAY SEE DYNAMICS AND
GROUPS.
CONCLUSION
• THE USE OF GROUPS ORGANIZED FOR PSYCHOTHERAPY DEVELOPED IN THE
20TH CENTURY ALONG WITH THE POPULARIZATION OF PSYCHOANALYTIC
THEORY. THERAPY GROUPS HAVE BEEN USED AS A MECHANISM FOR BOTH
INTRA-PSYCHIC AND INTRAPERSONAL CHANGE. THE SIGNIFICANCE AND
MEANING OF EXPRESSION AND EXPOSURE OF THE INDIVIDUAL IS SEEN IN
TERMS OF THE CONNECTIONS AND BONDS MADE AMONG THE GROUP
MEMBERS. A NUMBER OF SOCIAL TRENDS ARE CONTRIBUTING TO THE
INCREASED USE AND RELEVANCY OF THE GROUPS. ONE PURPOSE OF GROUP
THERAPY IS TO INTERVENE IN MENTALLY DISORDERED BEHAVIOUR,
THINKING, AND FEELING. GROUP THERAPY OFFERS MULTIPLE STIMULI TO
REVEAL, EXAMINE, AND RESOLVE DISTORTION IN INTERPERSONAL
RELATIONSHIPS