Group therapy sometimes gets short shrift. Viewed by some patients as second best to individual therapy and by some mental health professionals as intimidating to run, groups are mostly found in outpatient agencies and hospitals, where they are used to treat people with severe or acute conditions. In private practice, group therapy makes up at most 5% of treatment, with 95% of resources going into individual therapy.
But group therapy is as effective as individual therapy for a wide range of symptoms and conditions, and it is more efficient, allowing a single therapist to reach many people at once. In many cases, groups can be even more effective than individual therapy, thanks to the stigma reduction and solidarity that people experience in the presence of their peers.
The benefits are substantial enough that some psychologists are now calling for every private practice to offer at least one group. Meeting the unmet psychological need in the United States with group therapy would save more than $5.6 billion and require 34,473 fewer new therapists than individual therapy, according to research to be published in February in American Psychologist. If just 10% of this need was met by group instead of individual therapy, 3.5 million more people could be seen. The demand for therapy is high and rising, with 79% of psychologists reporting an increase in patients with anxiety disorders in 2022 and 64% reporting increases in patients seeking help for trauma- and stressor-related disorders, according to APA’s 2022 COVID-19 Practitioner Impact Survey. Two thirds report seeing patients with an increasing severity of symptoms compared with previous years.
“Given that group therapy is a triple-E treatment, which means it’s effective, it’s equivalent to individual therapy for most conditions, and it’s efficient, offering at least one extra group or beginning to run a group, particularly in private practice, would create enormous efficiencies in the system,” said Martyn Whittingham, PhD, a licensed psychologist in Ohio and the developer of Focused Brief Group Therapy, who led the work.
There are barriers to launching new groups, not least poor reimbursement rates for group versus individual therapy. But another key barrier is training. Group therapy was only recognized as a specialty by APA in 2018, and many psychology graduate programs offer limited instruction on group therapy skills. Psychologists can expand their skills with resources from the American Group Psychotherapy Association (AGPA) or from APA’s Division 49 (Society of Group Psychology and Group Psychotherapy).
Candidates for a group
Group therapy is as effective as individual therapy for an array of symptoms and conditions. In a recent series of 11 meta-analyses encompassing 329 studies comparing group with individual therapy, group therapy was found effective for depression and bipolar disorders, schizophrenia, anxiety disorders, social anxiety disorder, panic disorders, obsessive-compulsive disorder, posttraumatic stress disorder, eating disorders, borderline personality disorder, substance use disorders, and chronic pain (Rosendahl, J., et al., The American Journal of Psychotherapy, Vol. 74, No. 2, 2021).
Groups can be particularly fruitful for people of marginalized identities, offering support and solidarity from others with similar experiences. For instance, a meta-analysis of group interventions for trauma and depression in refugee adults and children led by Maryam Rafieifar, PhD, a social worker now at Montclair State University in New Jersey, found reduced symptoms of posttraumatic stress and depression (Research on Social Work Practice, Vol. 32, No. 1, 2022). Research has also found that group therapy can help LGBTQ+ patients cope with universal stressors and stressors stemming from coping with bias as well as other challenges related to their minority status (Craig, S. L., et al., BMC Psychology, online, 2021).