Participation in a therapy group provides an opportunity for support and feedback from others as you learn more about yourself and the issues that feel difficult, especially internal conflicts that may impact your interactions with others. Being in a therapy group can also help you appreciate areas of strength and resilience.

This guide to group psychotherapy will give you an idea of what to expect if you join one of my groups.

My Approach as a Group Leader

My approach to Group Therapy uses the interpersonal model which assumes that personality develops, beginning in infancy, through interactions with others. In the group, you have an opportunity to learn how you and others impact one another as you freely interact and share feedback about these interactions.

My work as group leader also draws upon psychodynamic theory. That means that I pay attention to understanding the ways in which old patterns from the past, and roles learned in one’s families of origin, continue to be replayed over and over in interactions with others. What is especially useful about a therapy group is that these roles will naturally recur in the group itself where there will be an opportunity to learn more about them. As such, the group becomes a “laboratory“ in which members learn more about their patterns of relating — how they get close to others and how they push others away, and what triggers the feelings and behaviors that leave them feeling stuck.

Group Agreements

Group ground rules or group agreements are designed to facilitate that work. When honored, they lead to a growing trust and intimacy. They are as follows:

Confidentiality: To make the group a safe place to share personal information and to protect the privacy of members, members agree to keep names and identifying information about other group members to themselves. While you might want to talk to a close friend, partner, or your therapist about what happens in the group and what you are learning about yourself, it is expected that you will do so in a way that will not reveal the identities of other members.

Engagement in the Group Process: Members of the group commit to giving honest, responsible feedback and to use the feedback from others to learn new ways of relating. In this process, members learn to appreciate not only what gets in the way for them but also their strengths.

Boundaries: Group members are expected to use the group for therapeutic rather than social ends. By limiting relationships to interactions inside the group, a safe container is created in which everyone is on the same page. If there is any contact outside the group (e.g. bumping into each other in a supermarket), it is expected that this will be shared in the next group session. Sharing about outside of group “sightings,” (including those involving the group leader) are always of interest and members’ reactions when sightings occur can be of value to the work of the group.

Tenure in the Group: Members make a minimum of a one-year commitment to the group, with the caveat that, if you are feeling early on that the group does not feel like a good enough fit for you, you will give it at least three months before finalizing the decision to leave.

Endings are Important: At any point when considering leaving the group, it is important to share your decision process with the group. This helps others understand what is going into your decision and will be useful to your own work, as well. Sometimes when people express a wish to leave it is the right time. At other times, especially when confronting a challenging moment in the group, you may feel the urge to leave quickly to relieve your anxiety. But this could undermine an important opportunity to work. Enlisting the perspective of others can help you sort this out. In any case, it is important to give the group several weeks notice in order to have an opportunity to sort it out, to say goodbye if that is what will ultimately be happening, and to bring relationships to as much closure as possible.

Attendance: Members are expected to make attendance a priority and to attend sessions on time. Should you be planning to be away, it is helpful to give as much notice as possible, as well as telephoning as soon as you know if you will be late or absent due to sickness or some other unforeseen life complication.

Financial Agreement: The group fee is per session whether you attend a particular meeting or not. Patients are expected to make payment on the last group of the month. If receipts are needed for insurance, I can give those to you at whatever frequency would be useful. As with all topics pertaining to the group, if there are any problems regarding payment, it is expected that these will be discussed in the group.

How the Group Works

The group can be of value to you in many ways. You can find support from other members and can, in turn, offer support. You can practice communicating in ways that help you to feel better understood and that can help you more clearly address your needs. Being in a group can also help you to feel less isolated and alone.

In addition to these supportive aspects of group therapy, there are also some techniques which I will use to heighten the group’s ability to do therapeutic work. These techniques are useful in intensifying engagement in the group and also in identifying patterns which have interfered with your ability to fully connect with others elsewhere. These techniques include: moving the group into “the here and now,” making connections to childhood experience, exploring what is happening in the group as whole, practicing reactive and receptive communication, paying attention to deviations from the group ground rules, and enlisting the group’s perspective about what is happening in the room.

Moving the Group into the Here and Now: Although there are no rules about what is OK to share, often the most growth enhancing work comes out of your ability to stay in the present, focusing on feelings about your own experience of what’s currently happening within the group and inside of you. As you are discussing a difficult encounter with a family member, a problem at your job, or a question that has been on your mind from a previous group, I may help connect these experiences to what may be currently happening within the group room. Examining dynamics as they are occurring within the group can increase members’ understanding of the ways that life unfolds outside the group, as well.

Connecting to Past History in Your Family of Origin: We may also explore how events that we are talking about may connect to your earliest relationships in your family origin. And along with this, we will pay attention to possible ways that old familiar patterns are being replayed in your reactions to certain members or to situations that are occurring in the group.

Understanding Group Phenomena in Terms of the Group as a Whole: Often, especially at painful junctures in the group, the group as a whole may develop protective strategies — perhaps actively avoiding something important that is happening in the group, coming late, or creating distractions through ‘social talk’, humor, or joining together to bicker. I will help the group understand what is happening and what is being avoided.

Practicing Reactive and Reflective Communication: Communication within the group is a balance between spontaneous reaction and more thoughtful reflection. You can practice both reaction and reflection, and you can work at finding a healthy balance of both of these in your relationships in the group.

In the reactive mode you can practice spontaneity and honesty. You can go with your gut feeling, owning your own reaction as valid, worth expressing, and worth understanding. A useful way to own your own reaction is by saying, for example: “I’m feeling… in reaction to what you were saying when you said…” Or, “When you do…, I feel….” You will gain the most from the group when you allow yourself to take risks in honestly describing your own experience.

In the reflective mode you can practice understanding your reactions, asking yourself, “What feelings are being triggered in me?” “Is this feeling familiar?” “When I have felt this way before?” “What am I repeating in this?” “Which of my old buttons are getting pushed and why now?”

Paying Attention to Deviations from the Ground Rules: Members are encouraged to put feelings into words not actions. That is why we pay attention to any behavior that is different from what has been agreed to in the ground rules.

Thus, when members are late, miss sessions, or forget payment, I may explore possible feelings that are being expressed in actions rather than in words. For example, if a member is late, might he be avoiding something that is happening in the group, or perhaps feeling inadequate and sacrificing his time because he feels unworthy of full membership? We might also look at the ways might the group might be colluding by ignoring his lateness.

Enlisting the Group’s Perspective about What is Happening in the Room: Though I will try to identify dynamics in the group’s development, I will not be the only one with useful perspective and insight. There will often be diverse perspectives, all of which provide unique and useful contributions to understanding what’s happening in the group.

Additional Relevant Resource

Groups Led by Dr. Vannicelli

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This guide has been adapted from a useful handout prepared in the late 90s by an esteemed colleague, Dr Steven Cadwell, Ph.D.