Individual vs. Group Psychotherapy: how is the therapeutic process different ?
Nancy Wesson, PhD, Licensed Psychologist, Certified Group Psychotherapist
Individual and group psychotherapy are both considered effective and highly therapeutic forms of psychotherapy. However there are differences in how the therapeutic process works in the two modalities of psychotherapy. In this article group psychotherapy will refer to group psychotherapy with a special emphasis on interpersonal group psychotherapy as defined by Yalom & Leszcz (2005) Individual psychotherapy will be defined as the one on one therapeutic process between a client and an individual psychotherapist.
- Different therapeutic alliance: in individual psychotherapy the therapeutic alliance is between a client and a psychotherapist. In group psychotherapy the therapeutic alliance is with the group.
- Individual psychotherapy is a one on one therapeutic relationship with a The group psychotherapist has a different role in the therapeutic process. The group psychotherapist leads a group through the therapeutic process.
- Different therapeutic factors (elements of the change process) are at work in group psychotherapy than in individual psychotherapy.
- Unlike individual psychotherapy, group psychotherapy is a team approach.
Different Therapeutic Alliance
There is considerable evidence which links therapeutic alliance (engagement in a therapeutic bond ) with psychotherapy outcome for a “wide range of diagnoses and populations. (Klein et al, 2013). Individual psychotherapy is a place for clients to work through psychological issues within the context of a one on one therapeutic alliance. In group psychotherapy the therapeutic alliance is with the group comprised of group members and the group psychotherapist. The “group psychotherapy alliance can be understood as the perception of the emotional bond held by an individual group member for the group. (Tasca, Balfour, Ritchie,and Bissada, (2007 p 1).
Different role of the psychotherapist
In contrast to individual psychotherapy which is a one on one protected therapeutic relationship with a psychotherapist, the role of the group psychotherapist is quite different. The group psychotherapist leads group members in an exploration of relationship issues and maintains the group process in the group.
The therapeutic change process in group psychotherapy is different for group psychotherapy clients than in individual psychotherapy. Group psychotherapy client interacts with a group of peers, and interpersonal skills are learned through several relationships. The group psychotherapist and group members observe interactions as they take place within the group and encourage feedback. This is a very different change process than in the on one relationship of individual psychotherapy.
Different therapeutic factors (components of the change process) are at work in individual and group psychotherapy
Different therapeutic factors are at work in group psychotherapy than in individual psychotherapy. Holmes & Kivlighan, (2000) compared individual and group therapy and concluded that there are different factors that reflect different processes in individual and group treatment. The factors of emotional awareness-insight and problem definition-change were more important to the process of individual treatment. They found that the factors of relationship-climate and other versus self-focus were emphasized more in group psychotherapy. In their review of the literature. Yalom & Leszcz (2005) identified 12 therapeutic factors of group psychotherapy. Of the 12 factors identified, interpersonal input (feedback from others) was found to be the most valuable to group members. This is a substantially different therapeutic process involving different therapeutic factors than individual psychotherapy.
Unlike individual psychotherapy, group psychotherapy is a team approach.
Individual psychotherapy requires a focus on the individual client and resolution of their psychological issues through the therapeutic process. In psychotherapy, group members experience in-vivo closeness with each other, trust each other, and develop as a “team” also known as “group cohesiveness.” (Wesson, 2007).
Relationships between group members and the therapeutic bond between them are the most important aspects of the therapeutic process. In group psychotherapy clients become part of a community which is like a healthy family and clients have the opportunity to experience multiple positive and healthy relationships. Yalom & Leszcz (2005) have referred to this group experience as the “corrective emotional experience.”
For many of our clients relationships have been painful and difficult. As psychotherapists we work to improve the relationships in the client’s life. According to interpersonal theory (Sullivan, 1953), in group psychotherapy a client demonstrates the very interpersonal behavior which is causing problems in his/her relationships. This dysfunctional relationship behavior creates feeling reactions in other group members and is described and reflected to the client through feedback. Clients become aware of their unhealthy interpersonal behavior through the eyes of peer group members and how this behavior interferes with closeness and support. They then have the opportunity to develop healthy interpersonal skills and practice them within the group. Clients learn how to develop meaningful and close relationships through this process.
The healing power of psychotherapy exists in individual and group psychotherapy. Involvement and engagement in healthy relationships with peer group members is an important aspect of the therapeutic process in group psychotherapy which is different than the one on one focus of individual psychotherapy. In both forms of psychotherapy clients learn about the “work” and “joy” of in relationships which have honesty and emotional depth.
Nancy Wesson, Ph.D., CGP, a Licensed Psychologist (psy9621), Certified Group Psychotherapist (CGP). She is the founder of the Center for the Study of Group Psychotherapy (CSGP.org), a nonprofit group psychotherapy training center which offers group psychotherapy training courses. Dr. Wesson has studied group psychotherapy for over 27 years. She has been trained by Dr. Irvin Yalom and the American Group Psychotherapy Association. She has 17 years teaching group therapy courses and has led two weekly psychotherapy groups for 27 years. DrNWesson@CSGP.org.
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