One thing for which I wasn’t prepared when attending graduate school for counseling was a Group Counseling with Adults and Children class. Namely, a portion of the course was conducted using a form of group therapy. One source defines this form of psychotherapy thusly:
[T]reatment of psychological problems in which two or more participants interact with each other on both an emotional and a cognitive level in the presence of one or more psychotherapists who serve as catalysts, facilitators, or interpreters. The approaches vary, but in general they aim to provide an environment in which problems and concerns can be shared in an atmosphere of mutual respect and understanding. Group therapy seeks to enhance self-respect, deepen self-understanding, and improve interpersonal relationships. Also called group psychotherapy.
Although I expected to learn about group therapy as a counseling student, I didn’t plan on actually processing cognitive and emotive matters when in school. In all honesty, I begrudgingly participated in the process, because I wanted to graduate, so nonparticipation wasn’t an option.
For context, I’m a person who appreciates intimate settings in which disclosure takes place. Having lived in a children’s home from half of my seventh grade year until the end of my freshman year, and then again for the second half of my senior year, I didn’t enjoy group settings in my youth.
As well, I was a contributing member of a religious youth group that met on Wednesdays and Sundays. Also, I facilitated and co-facilitated group functions for Vacation Bible School at a church congregation and on stateside mission trips.
During that same time in my life, I befriended a number of gang members. However, apart from other reasons, I didn’t officially join a gang. When I say that I don’t like participating in groups, I mean it. Of course, gang membership and group therapy aren’t necessarily comparable.
While I acknowledge that many people enjoy sharing their problems in open forum, I learned from my children’s home experience how displeasing it was for a person who values individual versus collective participation to ally with groups. Although I can tolerate groups, I’m not fond of them.
Additionally, my service in the Marine Corps from 1996 to 2007 taught me an invaluable lesson about group membership. Needs of the whole often overrode exigencies of the parts which comprised the whole.
In the Corps, I was taught that mission accomplishment eclipsed troop welfare. This fact resulted in egregious abuses of authority. Therefore, my prior experience with group participation informed my involvement with groups when in grad school.
I suppose one redeeming feature of being required to repeatedly engage in group dynamics which were unappealing to me was that over time I achieved resiliency—an ability to recover from or adjust easily to adversity or change. Although groups were unpleasant for me, they weren’t awful.
In any case, I understand the value of group therapy for others. For instance, one source states:
Groups can act as a support network and a sounding board. Other members of the group often help you come up with specific ideas for improving a difficult situation or life challenge, and hold you accountable along the way.
Since I began life coaching when residing in the children’s home during the ‘90s, I was typically the person in whom others confided. Rarely, if ever, did I require a support network or sounding board to resolve my issues – and exceedingly rarer, from a group.
Likewise, I never was fond of having someone to challenge me or hold me accountable. As an example, since having begun weight training in my teenage years, I’ve never enjoyed the support of a lifting partner. To this day, I conduct weight training alone. At any rate, a separate source adds:
It is vital to patient success that providers understand the mechanisms that exist in group therapy. These factors are:
1. Universality: Patients realize that others exist who share similar thoughts, feelings, and issues.
2. Altruism: Patients can improve their self-concept by assisting other patients.
3. Instillation of hope: Patients benefit from witnessing the success of other group members and can envision themselves following a similar path.
4. Imparting information: Patients gain knowledge and information from both the group members and the provider.
5. Corrective recapitulation of primary family experience: Patients can benefit from the opportunity to properly recreate family dynamics in a controlled environment.
6. Development of socialization techniques: Patients learn effective and proper ways to interact with others.
7. Imitate behavior: Patients gain new insight and understanding through the observation of other group members.
8. Cohesiveness: Patients experience feelings of support, trust, and belonging to one another.
9. Existential factors: Patients realize that they are responsible for their life decisions.
10. Catharsis: Patients share personal experiences from both the past and present.
11. Interpersonal learning: Patients gain an understanding of their interpersonal impact via feedback from other members as well as create an environment for one another to learn.
12. Self-understanding: Patients understand the covert factors influencing their behavior and emotions.
I have no valid argument against any of the aforementioned points. In fact, I agree that many people significantly benefit from group therapy. Nevertheless, I’m fully aware that there are other people like me, those individuals who don’t profit from group-based interventions.
When in grad school for counseling and voicing this perspective, I was treated as though I had an ear protruding from my forehead. After all, what prospective psychotherapist didn’t enjoy the processing of thoughts and emotions with other people? That’s like an engineer that doesn’t like math.
Many years later, when discussing the matter with a professor who seemed most interested in my educational success, I was told that he realized early on that I wasn’t like anyone else of which he’d known who made it through the counseling program. I knew I wasn’t like my peers.
The professor laughed when telling me he was more curious than anything else to see how my two years in the program would unfold. I recall him saying something to the effect of, “A counselor that doesn’t feel empathy? I never heard a student say such a thing.”
I remain grateful for his curiosity and support. While in school, I had an opportunity to intern at the Lubbock County Detention Center in Lubbock, Texas. There, I was the sole facilitator of group therapy using Rational Emotive Behavior Therapy (REBT) for anger management.
After graduation, I worked for a mental, emotional, behavioral, and developmental health care system that served over 20 surrounding counties. One of my duties was to serve as a liaison for the Potter County Detention Center in Amarillo, Texas.
The criminal justice diversion program afforded me an opportunity to work in an individual capacity rather than serving a group therapy role. Still, my ultimate goal was to work for the Department of Veterans Affairs (VA), though they only hired social workers at that time.
Although I thought I’d left behind group settings, I was once again exposed to an educational form of group therapy when beginning grad school for social work. The cohort of future social workers to whom I was assigned served as a reminder regarding my antipathy for groups.
Unlike in counseling grad school where I had a small cohort of individuals who moved through the program as a unified group, many of my classes in social work grad school were tiny and fragmented groups. This was in addition to the Theories and Methods of Group Intervention class I was required to take.
At one internship site, I co-facilitated a coed group of adolescents experiencing academic and behavioral problems, co-facilitated another group designed for male mentorship, and facilitated a small group targeting teenage boys involved with the criminal justice system.
On any given week, I was involved with at least three separate groups. Rather than self-disturbing about the matter, I simply did what was required of me in order to ultimately graduate and work for the VA.
It’s worth noting that there are different types of groups. Although many people seem to be somewhat familiar with the concept of support or substance treatment and management groups, there are also psychoeducational, skills development, cognitive behavioral, interpersonal processing, and other groups.
The social work cohort group of which I was a member operated like a hybrid of a psychotherapy and support group. As such, we weren’t committed to merely superficial matters regarding grad school; there was actual cognitive and emotive processing that occurred.
Although each group participant likely experienced a unique perspective, and while acknowledging that the memory is reconstructive, I don’t remember the cohort group as a net positive for me. In fact, when encouraged to use open, honest, and vulnerable communication, I didn’t find that it was in my best interest to do so.
At any rate, I graduated and eventually established employment with the VA. There, group therapy was the preferred method of treatment, due to the cost-effectiveness of this intervention strategy. Concerning this element, one source states:
In an ideal world, the cost of mental health treatment would not be the chief factor in determining which modality is appropriate. In the real world, however, this is a vital consideration for many clients who may not be able to afford individual sessions on a regular basis. This is where groups can prove valuable; while they ideally will not be relied on in lieu of traditional, individual therapy, they can provide a cost-effective form of support.
To put matters into perspective, suppose it costs the VA $150 to see a veteran for an individual session that lasts up to an hour. This hypothetical rate is based on an estimated average regarding how much a mental health practitioner may charge in a similar setting outside of the VA.
Not only is there an economic element to consider, there’s the limited resource of time to contemplate. Suppose that one VA mental health practitioner works an eight-hour day, seeing back-to-back clients at $150 per hour. That equals $1,200 to see eight veterans in a day.
However, because less focus on an individual in a group setting will likely occur, the cost per hour is reduced. Suppose that same practitioner solely facilitates a group of six veterans.
The average cost per client is reduced to $80 per hour, given that the facilitator merely manages group processing rather than providing deep insight for a single participant. That equals $480 for seeing six people in a group setting versus $900 for seeing six clients in individual settings.
Now suppose that single practitioner facilitates three groups per day, each consisting of six veterans per group. That’s 18 clients seen for $1,440 versus the $2,700 it would cost to see 18 veterans for individual therapy.
Therefore, the VA gets more bang for its buck by conducting group therapy. Likewise, other non-VA settings which conduct group therapy similarly enjoy cost savings of this sort. Thus, mental health practitioners are ostensibly expected to conduct group versus individual therapy in many settings.
Allow me to reiterate what I proposed about group therapy, “given that the facilitator merely manages group processing rather than providing deep insight for a single participant,” the cost-effective strategy may save a client money though arguably reduces one’s ability to benefit from the sole attention of a practitioner.
Then, there are people like me who are averse to groups. Although I can endure group interaction, it’s not what I’d prefer from treatment for mental, emotional, and behavioral health issues. What then is a client to do when an organization requires group work versus individual therapy?
When working for the VA, I realized that – given my subjective experience with the specific facility at which I worked – systemic focus on saving money overshadowed veteran-centric treatment. The same was true of the caregivers of veterans for whom I co-facilitated groups.
After leaving the VA, I worked for a private practice and was allowed to conduct self-pay psychotherapy that benefitted the client rather than remaining concerned with the organization’s net income. And although employees were encouraged to attend practitioner group sessions, we weren’t required to do so.
When attending sessions for various training and certification, I’ve been obligated to attend mini-group therapy sessions in order to understand the function of different psychotherapeutic modalities. As has been the case since my youth, I’ve tolerated though not enjoyed such participation.
Aside from these intermittent experiences, I don’t partake in group-related events. Likewise, I see clients strictly in an individual setting. This form of facilitation suits my particular wants and needs while clients express that it’s significantly beneficial to them, as well.
Regarding my perspective on group therapy, I acknowledge its utility. All the same, I choose not to participate in that form of care. Nevertheless, if required to do so, I can tolerate the annoyance of groups, because they aren’t all that terrible, horrible, or awful.
Perhaps you’re somewhat like me (and I’m sorry to hear it). Maybe you don’t favor group therapy. Are you looking for a mental health practitioner who understands your unique perspective in this regard and who’s willing to work with you in an individual setting?
If you’re looking for a provider who works to help you understand how thinking impacts physical, mental, emotional, and behavioral elements of your life—helping you to sharpen your critical thinking skills, I invite you to reach out today by using the contact widget on my website.
As a psychotherapist, I’m pleased to help people with an assortment of issues ranging from anger (hostility, rage, and aggression) to relational issues, adjustment matters, trauma experience, justice involvement, attention-deficit hyperactivity disorder, anxiety and depression, and other mood or personality-related matters.
At Hollings Therapy, LLC, serving all of Texas, I aim to treat clients with dignity and respect while offering a multi-lensed approach to the practice of psychotherapy and life coaching. My mission includes: Prioritizing the cognitive and emotive needs of clients, an overall reduction in client suffering, and supporting sustainable growth for the clients I serve. Rather than simply helping you to feel better, I want to help you get better!
Deric Hollings, LPC, LCSW
References:
American Psychological Association. (2019, October 31). Psychotherapy: Understanding group therapy. Retrieved from https://www.apa.org/topics/psychotherapy/group-therapy
APA Dictionary of Psychology. (2018, April 19). Group therapy. American Psychological Association. Retrieved from https://dictionary.apa.org/group-therapy
Hollings, D. (2022, March 15). Disclaimer. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/disclaimer
Hollings, D. (2023, October 12). Get better. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/get-better
Hollings, D. (n.d.). Hollings Therapy, LLC [Official website]. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/
Hollings, D. (2024, January 2). Interests and goals. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/interests-and-goals
Hollings, D. (2023, September 19). Life coaching. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/life-coaching
Hollings, D. (2022, October 22). On empathy. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/on-empathy
Hollings, D. (2024, January 1). Psychoeducation. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/psychoeducation
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Hollings, D. (2022, March 24). Rational emotive behavior therapy (REBT). Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/rational-emotive-behavior-therapy-rebt
Hollings, D. (2024, May 8). Resilience. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/resilience
Hollings, D. (2022, November 1). Self-disturbance. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/self-disturbance
Hollings, D. (2023, February 16). Tna. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/tna
Hollings, D. (2022, November 15). To don a hat. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/to-don-a-hat
Hollings, D. (2024, May 5). XY-Zone. Hollings Therapy, LLC. Retrieved from https://www.hollingstherapy.com/post/xy-zone
Malhotra, A. and Baker, J. (2022, December 13). Group therapy. StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK549812/
Post University. (2023, June 22). The power of group therapy: Who benefits and how? Retrieved from https://post.edu/blog/benefits-of-group-therapy/