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Basics of group counseling and psychotherapy

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Basics of Group Counseling and Psychotherapy: An Introductory Guide provides a unique combination of step-by-step basics of group counseling and psychotherapy and considerable depth of understanding of the intricacies of group process. Students learn how to identify what is going on in their groups, what interventions are most likely to be effective, and when to make those interventions. The text provides readers a competent and effective foundation for their study and practice in group work.

The text is divided into three parts: The Core of Group process and Leadership, Pragmatic Considerations, and The Future. Part I offers a thorough introduction to brief, closed groups, guidance through four key phases of group counseling and psychotherapy—preparation, transition, treatment, and termination—and practical advice regarding leadership, therapeutic interventions, the essentials of training, ethical practices, and co-therapy. In Part II, the book dives into more advanced material, specifically addressing how to work with clients with difficult behaviors and offering the reader structured exercises and techniques they can apply in groups. Part III provides a perspective on the current state of group work and its future, touching on diversity, training, research, and more.

Written by counselors and therapists who have conducted group counseling and psychotherapy sessions for decades, Basics of Group Counseling and Psychotherapy is an invaluable resource for individuals who are new to group treatment and for those experienced group therapists looking for a review.

Group therapy is a form of psychotherapy that involves one or more therapists working with several people at the same time. This type of therapy is widely available at a variety of locations including private therapeutic practices, hospitals, mental health clinics, and community centers.

Group therapy is sometimes used alone, but it is also commonly integrated into a comprehensive treatment plan that also includes individual therapy.

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Types of Group Therapy

Group therapy can be categorized into different types depending on the mental health condition it is intended to treat as well as the clinical method used during the therapy. The most common types of group therapy include:

  • Cognitive behavioral groups, which center on identifying and changing inaccurate or distorted thinking patterns, emotional responses, and behaviors
  • Interpersonal groups, which focus on interpersonal relationships and social interactions, including how much support you have from others and the impact these relationships have on mental health
  • Psychoeducational groups, which focus on educating clients about their disorders and ways of coping; often based on the principles of cognitive behavior therapy (CBT)
  • Skills development groups, which focus on improving social skills in people with mental disorders or developmental disabilities
  • Support groups, which provide a wide range of benefits for people with a variety of mental health conditions as well as their loved ones

Groups can be as small as three or four, but group therapy sessions often involve around eight to 12 people (although it is possible to have more participants). The group typically meets once or twice each week, or more, for an hour or two.

Group therapy meetings may either be open or closed. New participants are welcome to join open sessions at any time. Only a core group of members are invited to participate in closed sessions.

Group Therapy Techniques

What does a typical group therapy session look like? In many cases, the group will meet in a room where the chairs are arranged in a large circle so that members can see every other person in the group.

A session might begin with members of the group introducing themselves and sharing why they are in group therapy. Members might also share their experiences and progress since the last meeting.

The precise manner in which the session is conducted, and any group therapy activities, depend largely on the goals of the group and the therapist’s style.

Some therapists might encourage a more free-form style of dialogue, where each member participates as they see fit. Other therapists have a specific plan for each session that might include having participants practice new skills with other members of the group.

Group Therapy Activities

Common group therapy activities can include:

  • Icebreaker activities that help group members get to know one another 
  • Gratitude activities, such as mapping different aspects of their life that they are thankful for
  • Sharing activities, where group members ask one another questions
  • Expressive writing activities to explore experiences and emotions connected to those events
  • Goal visualization activities to help people set goals and make a plan to accomplish them

What Group Therapy Can Help With

Group therapy is used to treat a wide variety of conditions, including:

  • Attention-deficit/hyperactivity disorder (ADHD)
  • Depression
  • Eating disorders
  • Generalized anxiety disorder
  • Panic disorder
  • Phobias
  • Post-traumatic stress disorder (PTSD)
  • Substance use disorder

In addition to mental health conditions, CBT-based group therapy has been found to help people cope with:

  • Anger management
  • Chronic pain
  • Chronic illness
  • Chronic stress
  • Divorce
  • Domestic violence
  • Grief and loss
  • Weight management
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After analyzing self-reports from people who have been involved in the process, Irvin D. Yalom outlines the key therapeutic principles of group therapy in “The Theory and Practice of Group Psychotherapy.”

  • Altruism: Group members can share their strengths and help others in the group, which can boost self-esteem and confidence.
  • Catharsis: Sharing feelings and experiences with a group of people can help relieve pain, guilt, or stress.
  • The corrective recapitulation of the primary family group: The therapy group is much like a family in some ways. Within the group, each member can explore how childhood experiences contributed to personality and behaviors. They can also learn to avoid behaviors that are destructive or unhelpful in real life.
  • Development of socialization techniques: The group setting is a great place to practice new behaviors. The setting is safe and supportive, allowing group members to experiment without the fear of failure.
  • Existential factors: While working within a group offers support and guidance, group therapy helps members realize that they are responsible for their own lives, actions, and choices.
  • Group cohesiveness: Because the group is united in a common goal, members gain a sense of belonging and acceptance.
  • Imparting information: Group members can help each other by sharing information.
  • Imitative behavior: Individuals can model the behavior of other members of the group or observe and imitate the behavior of the therapist.
  • Instills hope: The group contains members at different stages of the treatment process. Seeing people who are coping or recovering gives hope to those at the beginning of the process.
  • Interpersonal learning: By interacting with other people and receiving feedback from the group and the therapist, members of the group can gain a greater understanding of themselves.
  • Universality: Being part of a group of people who have the same experiences helps people see that what they are going through is universal and that they are not alone.

Benefits of Group Therapy

There are several advantages of group therapy.

Support, Safety and Encouragement

Group therapy allows people to receive the support and encouragement of the other members of the group. People participating in the group can see that others are going through the same thing, which can help them feel less alone. The setting allows people to practice behaviors and actions within the safety and security of the group.

Role Modeling

Group members can serve as role models for other members of the group. By observing someone successfully coping with a problem, other members of the group can see that there is hope for recovery. As each person progresses, they can, in turn, serve as a role model and support figure for others. This can help foster feelings of success and accomplishment.

Insight on Social Skills

By working with a group, the therapist can see first-hand how each person responds to other people and behaves in social situations. Using this information, the therapist can provide valuable feedback to each client.

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Group therapy is often very affordable. Instead of focusing on just one client at a time, the therapist can devote their time to a much larger group of people, which reduces the cost for participants.

While costs vary depending on a variety of factors, estimates suggest that group therapy costs, on average, one-half to one-third less than individual therapy. 

Effectiveness of Group Therapy

Group therapy can be effective for depression. In a study published in 2014, researchers analyzed what happened when individuals with depression received group cognitive behavioral therapy (CBT). They found that 44% of the patients reported significant improvements. The dropout rate for group treatment was high, however, as almost one in five patients quit treatment.

An article published in the American Psychological Association’s Monitor on Psychology suggests that group therapy also meets efficacy standards established by the Society of Clinical Psychology (Division 12 of the APA) for the following conditions:

Is Group Therapy for You?

If you or someone you love is thinking about group therapy, there are several things you should consider.

You Need to Be Willing to Share

Especially if you struggle with social anxiety or phobias, sharing in a group might not be right for you. In addition, some types of group therapy involve exercises like role-playing and intense personal discussion, which can be overwhelming for people who are extremely private or uncomfortable around strangers.

You May Need to Try a Few Groups

Just like you might need to shop around to find the right therapist, you may also need to try a few groups before you find the one that fits you best. Think a little about what you want and need, and consider what might be most comfortable or the best match for you.

It’s Not Meant for Crisis

There are limitations to group therapy and not all people are good candidates. If you or someone you love is in crisis or having suicidal thoughts, individual therapy is a better choice than group therapy. In general, group settings are best for individuals who are not currently in crisis.

If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 988 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.

For more mental health resources, see our National Helpline Database.

How to Get Started

If you feel that you or someone you love might benefit from group therapy, begin with the following steps:

  • Consult with a physician for a recommendation of the best type of group therapy for your condition.
  • Consider your personal preferences, including whether an open or closed group therapy session is right for you. You may also choose to explore group therapy online.
  • Contact your health insurance to see if they cover group therapy, and if so, how many sessions they cover per year.

Before joining, think about whether you want to participate in an open or closed group. If you would prefer an open group, you can likely join in at any time. For closed groups, you will likely have to wait until a new session begins. 

It is also important to consider whether group therapy will be sufficient on its own or if you need additional assistance in the form of individual and/or medication. Talk to your doctor or therapist to decide what treatment approach is right for your needs.