I Think I Want To Try Group Therapy: The Basics

I thought I’d do a series of entries talking about my experiences with various types of group therapies. As a part of your individual therapy, it’s usually encouraged (both by paid and public) to attend groups as a part of your treatment plan. To start the series of posts, I thought it important to do a basic entry explaining generalities.

What’s consistent with groups is that:

  • On average, you have two clinicians who lead the group (who may be trained similarly, but bring different opinions about a practice).
  • It’s weekly (sometimes multiple times a week) and are a minimum an hour long (not a therapeutic hour).
  • You’ll have a minimum of 5 other people who are dealing with similar issues.
  • It can help you figure out issues that are causing you to become stuck in individual therapy.
  • You’ll always learn something new.
  • If you participate, you gain social skills on top of dealing with your issues.

Sometimes groups are hard to find, and from personal experience, asking your GP isn’t the best option. If you have a therapist/social worker/psychologist, that’s your first best bet. They usually know what groups that may be suitable for you, and if they don’t, you can ask them to ask other professionals if they’re aware of anything, and get back to you.

Another way to find out if there’s any groups, and you have no treatment team, is to find a local mental health office and either drop in, or give them a call. A list can be found here. Explain you don’t have a GP and are looking for group and/or treatment options. Another way to do this is by calling 211 (this is in Nova Scotia only).

Should I join an open group, or a closed group?
Both have their pros and cons.

Open groups are the easiest as anyone can join and leave as they please. It’s a great way to see if that type of environment will be beneficial to your recovery. Even though they may limit your time, it’s a great non-judgmental sounding board. The downside to this is that it’s harder to build a trusting rapport with other members (due to the volume of people, and the lack of dependability the same people will show up). It can also be discouraging as if you don’t go a few times: one bad experience can turn a person off of the concept. You may also see people you know: anonymity is one of the rules, but seeing someone can be both good or bad depending on your stage of recovery.

Close groups usually have set weeks, and will always dwindle down to roughly five to seven people after the third session. Anonymity is pretty much guaranteed unless it’s agreed by both parties to socialize outside of group, so many find it easier to open up. Downside here is that most of the time, you’ll be on a waiting list, and it’s not flexible (set date/time). The practitioners (most likely) have been doing that particular group for a good period of time, so if you go off script, there can be butting of heads. In some cases, there’s non-negotiable rules, so be sure you know the ins-and-outs.

How much should I share?
Confidentiality is important, and is the main ground rule of any group. However, you have no guarantee of privacy, so use discretion. It’s important to find a healthy balance of being open, but not spilling guts. My latest tactic is during the first few sessions, I’m quiet and listen, and get the vibe of the group. Say what you want to say in general terms, only using specific details if requested by the facilitator. What I also find helpful is to write down any question or thought that’s popped into my brain, and if it’s a pretty full group, wait until the end and approach the facilitator with my question. I’ve seen people do this who weren’t feeling comfortable enough to share with everyone.

In both open and closed groups (public and private – I find more public), you’ll have your busy-body members: you owe them nothing. If someone is making you uncomfortable, tell the facilitator immediately in private. It’s also up to you how much you want to interact with others outside of group. All public groups will discourage mingling outside group setting. There is reason: the possibility of co-dependency is quite high, and people not being at the same stages of acceptance in their treatment.

Remember that holding things in is worse that blabbing it out to someone who’ll nine times out of ten forget it (and you) by tomorrow morning.

In some cases, expect to pay. Cash only.
In both publicly funded and private groups, there’s sometimes a fee to participate. The reason for this is to cover costs of photocopies, rental of the space, supplies, and other amenities such as tea/coffee. It can range from a toonie to ten dollars. You have the right to ask where your money is going, and if you can’t afford the fee, speak with the facilitator. The only times I had to pay when it was publicly funded situation was art-therapy related for supplies, and one private group that needed money to rent the space.

Keep an eye out for bad practice in private, closed groups.
Due to these style of groups being self-regulated, you can run into some bad practice that is hurtful, not helpful, and in some cases illegal. I’ve run into one situation where if the facilitator had a PhD, it would have been my other therapist’s duty to report the person to CPSNS. When in doubt, and if something isn’t sitting with you, you have every right to contact them to see what your options are.

The facilitator should not be getting therapy from clients or becoming friends, you shouldn’t be forced to join other activities at the risk of exclusion, you’re repeatedly encouraged to buy extra anything, you’re repeatedly encouraged to get new members, trying to impose any sort of religious, spiritual, political or social beliefs, not giving you basic respect for your beliefs or background, the facilitator and/or group encourages you to blame others for your problems, or the facilitator becomes too defensive when faced with feedback or criticism. That’s a very small list.

These groups are in the minority. If you find yourself in one, the easiest option is to get out and start over. It’s up to you if you want to report: if you think it would cause you more strife, don’t worry about it.

Do the damn homework!
If you’re assigned a therapeutic task to do in-between sessions, do it. There’s nothing more frustrating than being the only person (or one of two) who does the work, and you can’t get any human feedback due to other’s lack of participation. Facilitator feedback isn’t the same than someone who’s similar to me going through their plight, and may have faced the challenge differently. It’s fine not to share, but why go to these things if you don’t want to change? Change requires work. At minimum, give feedback to others when invited. Participation is important.

That’s all I can really think of, for now. I may do an updated version of this list, or you may see some additional tips in my future posts about types of groups. I believe everyone should give groups a try, and don’t give up in the first go. I wouldn’t make it my primary resource for treatment, but added to your treatment plan, you may find all (the bad and the good) learning experiences for yourself, and how you may change/stay the same.

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