Guidelines and Expectations in Group Therapy
While expectations and general guidelines will vary from group to group, the points outlined here are a good example of what to expect when participating in a process group.
About Group Therapy
Group therapy has a long, proven record as a highly effective and useful form of psychotherapy. It is as helpful as, and in some cases more helpful than, individual therapy, particularly when social support and learning about interpersonal relationships are important objectives of treatment. The vast majority of individuals who participate in group therapy benefit from it substantially. Although group therapy is generally highly supportive, you may find it stressful or uncomfortable at times. That is normal and a sign of getting outside your comfort zone to grow. That being said, group should never feel unsafe. Below, you’ll see more about ways we work together to keep the group a safe and respectful place for expression and connection.
Some Goals of Group Psychotherapy
Many individuals seeking therapy feel isolated and dissatisfied in their particular life situation. They may have difficulties establishing and maintaining close, mutually gratifying, and meaningful relationships with others. Frequently they are interested in learning more about how they relate to others.
Group therapy offers an opportunity to:
• Receive and offer support and feedback
• Improve interpersonal relationships and communication
• Experiment with new interpersonal behaviors
• Talk honestly and directly about feelings
• Gain insight and understanding into one’s own thoughts, feelings, and behaviors by looking at
relationship patterns both inside and outside the group
• Gain understanding of other peoples’ thoughts, feelings, and behaviors
• Improve self-confidence, self-image, and self-esteem
• Undergo personal change inside the group with the expectation of carrying that learning over
into one’s outside life
Confidentiality & Privacy
All statements by participants in psychotherapy must be treatment with the utmost respect, privacy, and confidentiality, by both therapists and participants, as much as possible. It is an essential part of ethical, professional conduct by therapists, and it’s what allows for safe and honest participation by members.
Therapists
Group psychotherapists are pledged to maintain complete confidentiality for members, including pertaining to your status as a client and group member, except in one kind of situation: in the case of abuse or neglect disclosed about an elder or minor, or when there is an immediate risk of serious harm to a group member or someone else, when we are legally mandated to report this risk to authorities.
If you are in concurrent individual treatment, it is helpful if you give your permission to communicate with your individual therapist when clinically appropriate. This type of communication typically unfolds in one direction: from group to individual therapists, on a need to know basis.
Clients/Group Members
Respecting others’ privacy is similarly expected of all group members. Group members must respect and uphold others’ privacy to create a safe environment for the work of therapy and to develop trust within the group. Most individuals in therapy prefer to keep the therapy in a private place and refrain from any discussions about it with others. If, however, in discussions with friends or family, you wish at some point to refer to your group therapy work.
If you do, you should speak only about your own experience, never about any other members’ experience or identity, including their identity as a group member. (Using your “I” statements)
What Will We Do in the Group? How Are We Expected to Behave?
There will not be a prescribed agenda for each session. Participants are encouraged to talk about any personal or relationship issues relevant to the problems and goals that led them to therapy.
Participants are encouraged to offer support, to ask questions, to wonder about things said or not said, to share associations and thoughts, and to verbalize what they notice happening inside of them.
There is an emphasis in groups on examining the relationships and interactions between members—that is, in the “here-and-now” (the present moment). Members will often be asked to share their impressions of one another—their thoughts, fears, and positive feelings. The more we work in the here-and-now of the group, the more effective we will be.
Disclosure about oneself is necessary for one to profit from group therapy, but members should choose to disclose at their own pace. We never pressure members for confessions and disclosure.
In order to construct a therapeutic group environment, we ask that members always try to say things to other members in a way that is constructive and respectful. Helpful feedback focuses on what is happening in the here-and-now, does not blame or shame, is relevant, and connects the member receiving the feedback with the member offering the feedback. This kind of direct feedback and engagement is novel: rarely in our culture do individuals speak so honestly and directly. Hence, it may at first feel risky, but it may also feel deeply engaging and meaningful.
Direct advice-giving from group members and therapists is not generally useful. Neither are general discussions of such topics as sports or politics helpful unless there is something about a current event that has particular relevance to one’s personal or interpersonal issues.
Typically, a therapy group is not a place to make friends. Rather, it is a social laboratory—a place in which one acquires the skills to develop meaningful and satisfying relationships. In fact, therapy groups (unlike support or social groups) do not encourage social contact with other members outside the group.
Why? Because an outside relationship with another member or members generally impedes therapy!
How is therapy impeded? To explain this we need first to emphasize that your primary task in the therapy group is to explore fully your relationships with each and every member of the group. At first that may seem puzzling or unrelated to the reasons you sought therapy.
Yet it begins to make sense when you consider the fact that the group is a social microcosm— that is, the problems you experience in your social life will emerge also in your relationships within the group. Therefore, by exploring and understanding all aspects of your relationships with other members and then transferring this knowledge to your outside life you begin the process of developing more satisfying relationships.
If, however, you develop a close relationship with another member (or members) outside the group, you may be disinclined to share all your feelings about that relationship within the group. Why?
Because that friendship may mean so much that you may be reluctant to say anything that might jeopardize it in any way. What happens in a therapy group when openness and honesty are compromised? Therapy grinds to a halt!
Therefore, it is best that members who meet in any way outside the group (by chance or design) share all relevant information with the group. This includes disclosing necessary information about previous relationships with other members. Any type of secrecy about relationships slows down the work of therapy.
At times members develop strong feelings toward other members. We encourage that these feelings be discussed, both positive feelings as well as other feelings such as irritation or disappointment. Group members are expected to talk about feelings without acting on their feelings.
Group Therapists
Your group therapists are not going to “run the show.” Their role is more that of a participant/facilitator rather than of an instructor. Therapy is most productive when it is a collaborative and a shared experience. Keep in mind that the input from other members may often be as important as, or even more important than, the leaders’ comments. The therapists may make observations about group interactions and behavior, or about what particular individuals say or do in the group. They might also comment on progress or obstructions within the group.
When you have something to say to the group therapists, you are encouraged, as much as possible, to do so in the group sessions. However, if there is something urgent or strictly administrative you must discuss with the group therapists outside of group, between sessions, this can be arranged. But it is useful to bring up in the next group meeting what was discussed with the therapists. Even relevant material from your individual or couples therapy with another therapist can be shared. Ideally, the hope is that there will be really no issues that you cannot talk about with the group.
At the same time, we recognize that trust develops only over time and that some personal disclosures will be made only when you feel sufficiently safe in the group.
Length of Commitment
Group therapy does not generally show immediate positive benefit to its participants. It takes time for the dynamics to be established, as well as trust. Because of this fact, participants sometimes find themselves wanting to leave therapy early on if it becomes stressful for them.
We ask that you suspend your early judgment of the group’s possible benefits and continue to attend and to talk about the stresses involved and your doubts about group therapy.
We ask that you make a commitment to attend and participate in the group for a full 12 sessions. By the end, you will likely have a much clearer sense of the helpfulness of the group.
Attendance and Group Cohesion
The group works most effectively if it is cohesive, reliable, and predictable in its structure. Regular attendance is a key part of that, so we request that you make it a priority in your schedule.
Group therapy progresses best when each member values and respects the commitment and work of each participant. Regular attendance and active participation in the meetings is an important way to demonstrate that respect and valuing.
Similarly, arriving on time to each session is important. If you know that you are going to be late or absent, please notify the group therapist(s) as far ahead of time as possible so that they can let the group know at the beginning of the session.
If you know a week or more ahead of time of a necessary lateness or absence, inform the group at an earlier session. We ask that you also inform the group of any vacation plans well ahead of time, if possible. The group therapists will do the same.
There may be times when the group is the last place you want to be, because of uncomfortable feelings. These times may in fact be unusually productive opportunities to do the work of psychotherapy.
In the same vein, you can anticipate that some of the difficulties that you have experienced in your life, especially in other group situations, will express themselves in the group. Don’t be discouraged by this. It is in fact a great opportunity, because it means that you and the group members are tackling the important issues that concern you.
You have decided, by agreeing to participate in a therapy group, to begin a process of giving and receiving support and working toward needed changes in your personal and interpersonal life!
If you are interested in joining a group, you can check out the current groups at Rosebud Psychotherapy on our Group Page or under the Groups Tab.
[above descriptions and points adapted from Theory and Practice of Group Psychotherapy, Yalom & Leszcz, 2005]