Therapy is generally defined as the treatment of a physical or mental illness or disorder. Psychotherapy is generally defined as the treatment of issues by discussing them with a trained psychologist or psychiatrist. This article will refer to psychotherapy as simply therapy. The goal of this article is to discuss the difference between individual therapy and group therapy, and to contrast and compare both with regards to their advantages and disadvantages.
This article also makes the supposition that therapy is the process of discussing and working out issues with a professionally trained and certified psychologist, psychiatrist, social worker, or other mental health care worker. Therapy can only occur in this context. Discussing issues with friends, relatives, or other confidences might result in a person changing and feeling better (in other words one might feel it to be therapeutic); however, this is not therapy. The process of therapy requires a trained professional to assist in addressing and treating the person’s issues. The treatment follows some prescribed paradigm or theory.
Thus, while individuals who attend social support groups, such as 12-Step groups like Alcoholics Anonymous, may believe that their participation in these groups is “therapeutic,” these groups do not satisfy the formal definition of therapy as they are typically run by individuals who are not formally trained in therapy and therapeutic techniques.
Individual vs. Group Therapy
Individual therapy can only occur when one person is in therapy with a psychologist, counselor, therapist, or psychiatrist. Group therapy is loosely defined, but group therapy can only occur when more than one person is treated together in a formal therapeutic environment. Thus, any number of people, provided there are at least two, can participate in group therapy.
Either group or individual therapy can be associated with any treatment paradigm, such as psychoanalytic therapy, Cognitive Behavioral Therapy, client-centered therapy, supportive therapy, etc. The theoretical orientation of the therapist is not relevant in deciding whether or not a particular type of therapy is group therapy or individual therapy. Only the number of clients who regularly attend the sessions defines whether the therapy is either group therapy or individual therapy.
Advantages of Individual Therapy
There are several advantages to participating in individual therapy compared to just participating in group sessions.
These advantages include the following:
- The client may feel more comfortable about disclosing personal information that might otherwise be embarrassing. Only the therapist will know the client’s issues, except in a few select circumstances were the therapist is required to break the ethical principle of confidentiality. Typically, if the client is actively suicidal, actively involved in an action that will threaten the safety of others, or involved in child abuse, elder abuse, etc., the therapist is required to notify the authorities.
- No one else has to know that the person is in therapy.
- Individual therapy sessions can be paced according to the needs of the individual. The therapy moves along at a pace that is comfortable for the singular client in therapy.
- The therapist concentrates specifically on the client, and the therapist does not spread attention to other individuals.
- The therapist may more readily uncover comorbid issues (co-occurring disorders) due to the more intimate nature of the therapeutic relationship.
- The therapeutic alliance, which is the cooperative efforts of the client and therapist together toward solving the client’s issues, is much stronger in individual sessions than it is with members of groups.
- As a result of the more intimate nature of the client/therapist relationship, it is easier to explore issues and to develop individualized approaches to treating or dealing with the individual’s issues.
- The client does not have to listen to the problems and issues of other people that may not be relevant to them.
- The client can arrange a time to meet on a regular bases that is convenient. The client does not have to attend group sessions that are most often at fixed times to allow for availability for a number of individuals.
- There is less of an opportunity to model the behaviors of successful individuals with similar problems.
- There is less of an opportunity to learn about others with similar problems and how others address the issues.
- The sole focus of the therapy is on the individual, and for some individuals, this may be difficult. For instance, individuals who have difficulty communicating their feelings or who do not trust others may feel uncomfortable.
- Individual therapy sessions are typically more expensive than group therapy sessions.
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Group Therapy
Open groups are groups that allow new members to join at any time. Members come and go, and the members of the group are at different levels of development or achievement. Closed groups are groups that begin with a certain membership and continue until they reach their goal. These groups do not allow new members and are typically designed for some specific purpose.
The majority of therapy groups are open groups except for specialty groups, like couples therapy, family therapy (although family members may join or leave the group), and groups designed to complete some project.
Groups can offer some advantages that are not readily available in individual therapy sessions. The major advantages of group therapy are:
- Groups are cohesive, and members share a sense of belonging that allows them to come together and address their issues collectively as well as to address the issues of individuals within the group.
- Therapeutic groups are able to communicate the notion that there is a sense of universality in the group members. This means that members realize that they are not alone in their problems, and they share a sense of togetherness. This is extremely important in treating issues such as substance abuse where individuals tend to think that their problems are unique to them.
- Groups share information. Individuals in each group are able to learn from and help each other by sharing their experiences.
- Because groups work as a unit, there is a sense that they are able to give something to all members. Group therapy expert Dr. Irvin D. Yalom terms this group altruism.
- Groups naturally instill hope in members, such that individuals are encouraged by the successes of the more experienced members in the group and feel optimistic that they can address their issues.
- Individuals in groups become more self-aware as a result of the group sessions. They begin to learn about themselves and what drives them to do the things they do as they identify with others in the group who are explaining their own issues.
- Groups help individuals learn to express themselves in an appropriate manner, listen when it’s time to listen to others, and honestly share their experiences without the fear of being ridiculed or shamed.
- Groups foster modeling. Modeling is a method of learning where an individual simply copies what other people are doing. Groups allow individuals to see what works for others and copy that behavior.
- When group members share their experiences to other members who they believe to be caring and interested in them, this leads to a cathartic effect that results in feelings of relief from shame associated with past deeds.
- Group members can learn to identify with both the therapist and other members of the group. This process of identification helps them learn to understand themselves.
- Individuals who work together in therapeutic groups learn to take responsibility for their actions and accept the consequences of their actions as a result of the group process.
- Certain types of groups, such as couples therapy, family therapy, etc., are specifically designed to address relationship problems that occur within a marriage, family system, etc. Individual therapy may not address these particular issues for the members of these groups in the same manner as these specialized groups.
- Many group therapy sessions have more than one therapist. This helps to maximize the benefits of treatment by using the experiences and skills of different therapists.
- The cost of attending group therapy sessions is typically less than the cost of individual therapy.
- There is less opportunity for personal attention.
- Related to the above, there is less opportunity for a single individual to be able to solely focus on personal issues during the therapeutic sessions.
- Many times, issues brought up in groups may not be relevant to other group members.
- The therapeutic alliance between the therapist and any individual member is not as strong as it is an individual session.
- Individuals in group therapy do not have the same level of confidentiality regarding their problems as individuals in one-on-one therapy. Even though group members are bound not to discuss events/issues that occur in the group outside of the group environment, there is no guarantee that this will happen, and there is no ethical standards to hold group members to this.
- Sometimes, group members do not fully participate in the group process. Group efforts are often not equivalent to what would be expected if the sum of all potential individual efforts could be calculated. This phenomenon is known as diffusion of responsibility, and it occurs when individuals in groups do not put forth as much effort as they would in an individual setting because they expect other group members to carry the weight for them.
- Groups rarely divide the total time equally between all members of the group. Thus, some members will spend more time discussing their issues than others.
- The size of the group can make a big difference in its effectiveness. Many times, groups are too large. For maximum efficiency, therapeutic groups should generally contain no more than 8-12 group members, although groups often contain more members. The optimum group size is generally considered to be 8-10 members.
- Some groups are too small to actually receive many of the benefits outlined above. For example, those in couples therapy, where two individuals participate, do not necessarily realize certain benefits associated with group therapy, such as universality, group catharsis, modeling, etc. Couples therapy is a specialized group therapy that typically consists of romantic partners.
- The pace that the group operates at may be too slow or too fast for some group members.
- Certain types of individuals may not be appropriate for group therapy, such as individuals who have difficulty with severe shyness, are mentally challenged, etc.
- Therapeutic groups need strong leaders. If the group does not have an experienced and competent therapist as the leader, it can often become dysfunctional and result in individuals ganging up on others, alliances between individuals aimed at belittling other members of the group, and so forth.
Group Therapy and Individual Therapy in Combination
Research generally finds that the treatment outcomes for individuals in group therapy and individual therapy are generally equivalent; however, as mentioned above, group therapy typically demonstrates a better cost-benefit ratio. There is also evidence that no one particular type of group therapy is superior to other forms of group therapy for the treatment of substance abuse issues.
Certain types of therapy, such as Dialectical Behavior Therapy, use individual and group therapy in combination when treating clients who are diagnosed with particularly hard-to-treat disorders. In general, the findings indicate that there is an advantage to combining group therapy and individual therapy in these cases; however, this combination of treatments can be expensive and also time-consuming. It may not be appropriate for everyone, but when the two therapeutic models are combined, individuals tend to reap the benefits of both types of therapy and do not appear to be at any added disadvantage.
Individuals who are involved in residential treatment programs for substance abuse, severe behavioral issues, and so forth often attend both individual therapy sessions and group therapy sessions. These programs are extremely helpful in helping individuals avoid relapse in the early stages of the recovery. Much of this success is due to the intensive treatment provided by the integration of the two different therapeutic approaches.
One way to get some of the benefits of participating in groups and individual therapy at the same time but to lower the expense is to attend 12-Step groups in conjunction with individual therapy. Even though participation in 12-Step programs do not formally qualify as a form of therapy, these groups offer many of the above mentioned benefits of group participation, such group cohesiveness, modeling, catharsis, and feelings of universality.
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