How to run a successful group therapy session

By Ashleigh Knowles on Feb 29, 2024.

Fact Checked by RJ Gumban.

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Group therapy: A powerful treatment modality 

Group therapy is an excellent tool within the psychology realm, and can be just as effective as individual therapy, if not more so. Group therapy allows clients to connect and build support networks, especially among those who face immense mental health challenges and struggle to cope. Typically, members will meet once a week in numbers of around 5 to 15 participants and will discuss a specific topic, with activities incorporated to boost engagement and connection. Group therapy is a fantastic way to develop skills and to adapt positive behavior and outlooks on life. Produce valuable insights when it comes to your clients in encouraging them within a natural, social setting, and witness their increased willingness to engage. Enhance and elevate psychological well-being to ensure that your clients are one step closer to recovery, and an improved state of mind. 

To help you get started, we’ve created this guide with an abundance of tips and activities to ensure that you know how to successfully run a group therapy session.

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Stages of group therapy: How does it proceed?

Group therapy centers around 5 core stages. It's important that you become acquainted with each of these guidelines in order to incorporate them effectively.

Forming

The first stage is referred to as forming, and it involves establishing group familiarity and acceptance. Forming creates the foundation to ensure success for the session and also provides a good starting position to disclose the purpose and focus of the group. Forming is all about facilitating a safe space so individuals feel comfortable sharing their thoughts and feelings, however, it also acknowledges that many group members may feel apprehensive and anxious. During this stage, participants tend to be polite, guarded, and the group is usually dominated by outspoken individuals. Therapists will utilize this stage to build comfort and acceptance.

Storming

In the storming stage, you may begin to see rising competition and conflict amongst group members. Each individual will bring their own ideas, values, feelings, and thoughts to the group, and the storming stage represents their ability to overcome these challenges. The therapist will typically employ conflict resolution to promote acceptance and respect amongst participants and ensure that all members are heard. In the storming stage, you're likely to see emotional reactions and comments made for recognition and attention, as well as attempts by some members to dominate the group.

Norming

Here, we begin to see a sense of unity developing amongst group members. During the norming stage, participants tend to settle in and acclimatize to group dynamics and recognize each individual's differences. Subgroups and clicks tend to disappear when each individual listens to the others, and shares their feelings and ideas without confrontation, contention, or condescension. You may find that quieter individuals begin to contribute more to group discussions, and alternate viewpoints are more commonly accepted. The norming stage creates more openness, and if conducting group activities, members are more likely to achieve high results.

Performing

Performing builds upon the norming stage in elevating the sense of security and belonging to high levels. Members can feel assured in their opinions and ideas, and members begin to relate to each other's views, thoughts, opinions, and feelings. Diversity is now welcomed, and the therapist can continue promoting empathy between members, which works towards greater synergy. Essentially, group dynamics become more established in terms of cohesion, and rich insights can be found here.

Adjourning

In the final stage, group members will begin to disengage. If the session has been successful, many members may feel apprehensive upon closing, and some may experience feelings of sadness and anxiety. In the adjourning stage, members will tend to express their final feelings or circle back to earlier topics to resolve any unfinished business, or there may be a closing evaluation or reflection. Many group therapy sessions will meet regularly, and if that is the case, the therapist will disclose this information. During the final stage, participants will reflect on their experience, before saying goodbye.

Tips to run a successful group therapy session

To effectively run group therapy sessions it's important to keep in mind the following tips and tricks.

Get trained

Although you likely have psychology, counseling, or therapy qualifications, it is still important to gain training in group therapy specifically. The courses don't have to be extensive and can provide essential background information on how to navigate group settings, how to facilitate cohesion, as well as how to address and repair conflict. You can better understand what to expect during the sessions, which is always a plus! 

Learn icebreakers

To no one’s surprise, it can sometimes be pretty awkward for a bunch of strangers to get together and talk about heavy topics that often accompany group therapy sessions. Starting with an icebreaker is a great way to facilitate a safe space where individuals feel comfortable contributing. Icebreakers can be fun, and a great way to break down barriers quickly.

Compile the right group

Getting the group dynamic right is a really important aspect of group therapy, as it can make or break improvements made. Not every client with the same mental health challenges is necessarily an appropriate candidate. Some individuals may be too hostile for certain environments, or they may be likely to drop out. As a result, it is important that you conduct screening evaluations to ensure that you compile the right individuals for your group therapy sessions.

Set out your expectations

Before you begin your group therapy sessions, it is essential that all members of the group are aware of their responsibilities as participants. For example, it is vital that you clearly outline your attendance policy to ensure that each group member contributes fairly, and acknowledges their value within the group sitting. Their absence can affect everyone in attendance, and laying down this groundwork can reduce the number of dropouts. It's also essential that as part of expectations, you set out the goals of group therapy, which may involve asking participants what they want to get out of every session. Going over the basic agenda can help alleviate any stresses clients may have, as well as answer any impending questions. Also, it is advised that you remind clients that group therapy sessions are a safe space, despite the fact that sometimes conflict will arise.

Make non-violence a hard rule

Although it often goes without saying, it is important that you establish nonviolence as a hard rule. Any threatening or intimidating behavior should be prohibited, especially as many clients attending group therapy sessions are dealing with their own traumas and self-esteem issues. Violent behavior can aggravate mental health problems for many clients and can offset any positive progress made. It is advised to outline the consequences of violent behavior, and what the cool-down process involves.

Respect everyone's privacy

Group therapy is a bit like Fight Club, in that whatever happens in group therapy stays in group therapy. Many clients attend the sessions contingent on the fact that they are able to maintain privacy and confidentiality at all times, and they are not required to divulge specific information. The therapist should protect group members at all times to ensure that each member is willingly and consensually sharing information that does not leave the room.

Have fun-filled group activities

Group therapy doesn't have to be a depressing space, which is often depicted in popular media, movies, and TV shows. Group therapy can be a place for members to have fun in a social setting, and enjoy the time spent with others to whom they can relate. Not only this, but having fun group therapy sessions also increases engagement, communication, and the likelihood of participants returning. Many different activities such as games, collaborative projects, icebreakers, and snack events can work towards a positive and welcoming atmosphere.

Don't force, rather encourage participation

Group therapy is always optional, and with participants choosing to sign up, they've already taken a major step in facing their mental health challenges. You don't need to aggravate their feelings any further, and it is important that participants feel valued. As a result, you should never force participation - especially when dealing with clients who may have intense trauma and are not willing to share. As a mental healthcare professional, you should know that forced participation is often a major deterrent to recovery.

Have your legal and ethical foundation in place

To ensure that you are abiding by legal and ethical standards, make sure that you consistently prioritize these throughout your sessions. This may involve including consent forms, confidentiality policies, group rules, signature forms, compulsory reports, attendance requirements, and essential fees.

Set out boundaries

Finally, it is also important to set good boundaries among group members. For example, if there are any off-limits topics or discussion points, make sure these are known to avoid negative emotional responses. Also, ensure that none of your group members know each other and that each participant is aware of the rules and expectations and consents to each and every one. Having boundaries in place means participants know when to stop potentially harmful behavior, and it ensures everyone has a positive experience within your sessions.

Measuring a successful therapy session with data

Once you've completed your group therapy sessions, you may be wondering, how do you measure success? Fortunately, there are multiple ideas to evaluate the success of your sessions by using data measurements.

Pre/Post Surveys

Pre/post surveys are a very common way to measure the success of group therapy sessions. This may be as simple as implementing a form with Likert scales, where group participants rate how they felt about certain aspects, such as discussions, other group members, teamwork during activities, and many other factors. Having the same questions and writing them before and after the therapy session, allows you to evaluate any changes amongst individual group members, or as a whole. This can give you a better idea of where to make necessary adjustments for improvement and can help you acknowledge what you did well as a group therapist.

School Data

Another valid option is to assess school data. if you're working with students and teenagers, you can evaluate their grades or test scores before and after meeting as a group to assess whether there are any improvements. Additionally, you can also evaluate school attendance, and whether group therapy sessions have imparted newfound motivation within clients to return to their school activities. This can also be applied to other contexts, such as universities and work, however, make sure that you are obtaining this information responsibly. You should only access the data if you have the authorization to do so.

Progress Monitoring

Finally, you can also use progress monitoring to evaluate the success of your group therapy sessions. This may involve providing group members with surveys that focus on specific skills, where you can check in periodically with them throughout the sessions. Alternatively, group members could share their experiences through a journal-type format, so you can closely monitor their progress with exact reasoning and judgments for support.

Conclusion

Hopefully, this guide has provided you with the necessary information to successfully implement group therapy sessions within your practice. We hope that you have consolidated your knowledge when it comes to group therapy, in what the five core stages are, as well as the central pillars to success and to how to measure the effectiveness of your sessions for future improvements. Group therapy is a highly effective tool in helping clients overcome mental health challenges. If you know how to navigate them with ease, you can work towards greater health and well-being outcomes without compromise.

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