How To Facilitate A Group Therapy Session: 12 Key Tips For Therapists

Research has shown that group therapy is as effective as individual therapy for treating various conditions and symptoms. In some cases, it can even be more effective thanks to its ability to reduce stigma and provide solidarity. Yet, group therapy only makes up 5% of treatment. There are many reasons for this discrepancy. For one, group therapy wasn't recognized by the APA until 2018. Secondly, many therapists don't receive education about group therapy in their degree programs. It also often offers lower reimbursement rates when compared to individual therapy.  

However, despite these hurdles, many therapists want to offer group therapy sessions for their patients, but they aren't sure how. If you're a therapist wondering how to facilitate a group therapy session, read on for insight and tips. 

What is group therapy?

Group therapy is a form of therapy that involves one or more therapists working with several people simultaneously. It's conducted in a group setting, typically consisting of 5-15 group members who share common issues or objectives. 

A group therapy session can provide many benefits, such as an opportunity for each group member to share experiences and learn from each other. It can create a supportive environment that allows other group members to offer and receive feedback, insights, and different perspectives on their challenges. Group therapy can also help individuals develop communication skills, improve socialization, and learn coping strategies from peers facing similar problems. 

While group therapy differs from a support group in that a licensed therapist leads it, both settings aim to provide a safe and constructive space for growth and healing. 

Group therapy stages

Group therapy typically progresses through various stages, and each plays a role in the overall effectiveness of the therapy. The established stages are: 

• Forming – In this stage, individual group members meet and get to know each other. This initial phase is often marked by anxiety, curiosity, and polite interactions as members are just beginning to understand the group dynamics. The therapist's role is to cultivate a safe and welcoming environment, setting the tone for open and respectful communication. 
• Storming – This stage is when you may begin to see members of the group testing boundaries, which can lead to conflicts and challenges. This is a critical phase where differences and disagreements might surface. The therapist's role here is to guide members through these conflicts, helping them learn how to communicate respectfully and effectively. 
• Norming – During this stage, group members typically start to resolve their differences, establish group norms, and develop stronger bonds. This stage is crucial for developing trust and group cohesion as members begin to work together and support each other. 
• Working – This stage is where the actual therapy work takes place. By this point, members likely feel comfortable enough to share deeper issues and work on personal growth. The therapist's role is to encourage group members to explore their emotions, behaviors, and thoughts, providing guidance and feedback. 
• Adjourning – In this final stage, the group prepares to disband. This phase involves reflecting on what the group has learned, discussing the ending of the group, and planning for the future. This stage is a time for closure and acknowledging all the progress made since the first group session.  

Each stage requires different strategies and approaches from the therapist to ensure a successful group therapy session. Recognizing and adapting to these stages can significantly enhance the therapeutic experience for all participants. 

Tips to facilitate successful group therapy sessions

Facilitating a group session can be a rewarding yet challenging experience. Each therapy session has its unique dynamics, and as a therapist, it's important to navigate these effectively. Here are 11 tips for helping you successfully manage and lead group sessions. 

1. Get adequate training 

Before leading a group session, you'll want to ensure you have adequate training in group settings and techniques. While you likely already have therapy qualifications, getting specific group therapy training is still important. The courses you take don't have to be extensive, but they can be invaluable in preparing you to manage conflict, foster cohesion, and address individual needs inside a group context. 

2. Assemble the right group

Establishing positive group dynamics can be critical for the overall success of group therapy. You'll likely want to ensure that everyone within the group has similar therapy goals or mental health challenges. However, not every person with the same mental health condition is an appropriate candidate for group therapy. Some people might be too hostile, introverted, traumatized, or likely to drop out. You'll have to use your discretion to ensure you bring the right combination of people together. 

You'll likely want people in the group with different perspectives who may be in different places along their therapy journey. Diversity can enhance the learning and growth of the group and ensure that the sessions are full of varied insights. 

3. Set expectations and boundaries at the beginning

You'll want to clearly outline the expectations, rules, and boundaries. This helps create a safe, structured environment where everyone feels respected and understood. For example, you might outline an attendance policy, establish any off-limits topic areas, and set participation expectations. It may also be valuable to outline typical sessions so everyone understands what to expect and what's expected of them. 

4. Make attendance a priority

You'll likely want to track members' attendance and encourage everyone to be present consistently. As you can see from the group therapy stages, there's a standard build-up where the group advances, learns, and progresses together. If someone constantly misses sessions, they might fall behind and feel like an outcast. The other members might not trust them, and in the end, it could result in them not showing up. 

5. No fraternizing with group members

It's important to always maintain professional boundaries. A therapist-client relationship should stay strictly professional, even in group dynamics. Outside relationships between group members should also be avoided as they can disrupt group cohesion and damage the therapeutic process. For example, if half of the group consistently gathers outside of sessions to socialize, it can result in the other half feeling excluded and less comfortable sharing. It may also result in people progressing at varying speeds and without the guidance of a professional. For that reason, you should discourage all outside relationships between members until the group has finished all its sessions. 

6. Never force participation (but encourage it)  

While active participation is encouraged, it's important to never force group members to share more than they're comfortable with. Instead, focus on creating an environment where everyone feels safe to contribute.

7. Make non-violence a non-negotiable

It's often important that you establish non-violence as a strict rule. Aggression, intimidation, and threats can aggravate existing mental health issues and hurt the positive progress one is making. As a result, you may want to outline the consequences of violence and what the cool-down period entails.  

8. Be straightforward  

As the therapist, you'll set the tone for the sessions. Consequently, it can be important to be clear, honest, and straightforward with your communication. This can help set a tone of openness and integrity within the group. It's also important that you quickly correct members if they make a wrong assumption and direct them to the desired mindset. When offering corrections, you'll want to provide space and empathize with them so they still feel valuable to the group. 

9. Make it fun 

While group therapy sessions can consist of heavy topics and painful emotions, they can also be a place for patients to have enjoyable moments together. Fun activities can encourage attendance and contribute to group cohesion. Some ways to make it fun include: 

• Playing group therapy games 
• Introducing icebreakers for fun conversations 
• Assigning collaborative projects (like writing a story together or painting a mural)
• Having a show-and-tell of hobbies and passions

While having fun may not be the main goal of group therapy, it can make the outcomes more successful. 

10. Measure progress 

It can also be valuable to measure the effectiveness of group therapy so you can improve future sessions and keep track of individual patient's progress. You can measure progress with pre/post surveys, progress monitoring, or school data (if you're working with kids or teenagers). 

11. Mind your mental health

As a therapist, looking after your own mental health can be just as important as caring for your clients. Managing group dynamics can be overwhelming and draining, especially if you're still maintaining individual patients. Regularly visiting a therapist can provide support and insight and help you be more effective at facilitating positive group therapy experiences. 

If attending an in-person session seems impossible due to your busy schedule, consider online therapy instead. With online therapy, you can schedule sessions at a time that works best for you and attend them anywhere you have internet access. It also allows you to find a therapist that matches your needs, preferences, and location. 

Also, research shows online therapy is just as effective as in-person therapy in treating common conditions like anxiety and depression. 

Takeaway 

Facilitating a successful group therapy session requires a nuanced understanding of group dynamics, a strong foundation in counseling theories, and a mindful approach toward both the group and individual needs. With some education and best practices, therapists can lead transformative and supportive group therapy sessions, fostering an environment where each participant can grow. If you feel overwhelmed before, during, or after running your group sessions, consider contacting a therapist for help.