Psychotherapy Guide: Group Therapy vs. Individual Therapy
Psychotherapy, or talk therapy, aims to help an individual identify troubling emotions, thoughts, or behavior using a variety of treatment techniques.1 It may be utilized as one part of a complete treatment plan or aftercare program to help individuals with a variety of conditions, including mental health disorders and substance use disorder, a medical condition defined by the compulsive use of substances despite negative consequences.
Essentially, during psychotherapy, a therapist may draw on a wide range of techniques and strategies to help an individual modify their behavior or thinking, how they deal with their emotions, or the way they process significant events or issues.
“Talking cures” date as far back as ancient Greece.2 English physician Walter Cooper Dendy introduced the term psycho-threpeia in the 1850s to describe a type of talking treatment.3 However, Sigmund Freud and Carl Jung are generally acknowledged as the founders of modern psychotherapy.4 Freud developed psychoanalysis near the end of the 19th century, and following his work, many other schools of therapy were formed.
Individual therapy is one type of psychotherapy. It involves a trained professional helping a single individual work through the therapeutic process. Group therapy, on the other hand, involves a group of individuals—all of whom are treated at the same time—by a therapist.
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What Is Individual Therapy?
Individual therapy allows a therapist—who might be a professionally trained psychologist, social worker, counselor, psychiatrist, or marriage and family counselor—to help an individual work through their thoughts, concerns, emotions, and situations. Thus, individual therapy differs from getting advice from friends, family, and acquaintances, since it is a professional service provided by a trained professional.
Individual Therapy and Substance Abuse Treatment
Research indicates that individual therapy can be an effective component in a treatment plan for a substance use disorder.5 Individual therapy helps individuals find the root of their addiction. Individual therapy sessions generally focus on teaching those in recovery the skills needed to navigate a life without drugs or alcohol and include different forms of behavioral therapy, such as cognitive behavioral therapy (CBT), motivational interviewing and contingency management.6 Each of these behavioral therapies utilizes a different strategy to get the desired outcome. CBT, for instance, teaches individuals how to recognize moods, thoughts, and situations that trigger drug or alcohol cravings.6 The therapist, in turn, teaches the individual how to avoid these triggers and replace the negative thoughts and feelings with positive ones. In addition to using individual therapy to help individuals with substance use disorder, it can help a wide range of co-occurring mental health conditions, including depression and bipolar disorder, among others.7
Advantages of Individual Therapy
Individual therapy offers several advantages, including:8-10
- Confidentiality. The information shared during sessions remains completely private.
- One-on-one attention. This allows the therapist to be thorough in understanding the individual’s specific problems and develop an individualized approach to treatment.
- An intense and comprehensive level of analysis and treatment.
- Completely customized to the individual. For example, individuals who can handle more focused and intense interventions may benefit from a quicker therapy pace. On the other hand, individuals who require time to adjust may benefit from a slower-paced therapy.
- A strong therapeutic alliance, which refers to the working relationship between the individual and therapist. Research indicates that the therapeutic alliance is a key component of a successful therapy intervention.
- The development of self-awareness, which comes by discussing issues and getting feedback from the therapist.
- Flexible scheduling. The individual can arrange a time for the therapy sessions that is most conducive to their schedule.
- Quick appointments. Therapy sessions can be arranged rather quickly, if needed.
- The development of better communication skills.
- An effective component in treating a broad range of mental health disorders.
Disadvantages of Individual Therapy
The disadvantages of individual therapy include:
- Cost. It’s typically more expensive than group therapy.
- No peer interaction. It doesn’t allow individuals to identify with others who share similar problems or issues.
- A motivation requirement. Individuals, who are not committed to changing, doing the work, and applying the principles they learn, may struggle in certain situations.
Individual therapy is the most used form of treatment for substance use disorders. However, there is increasing evidence that supports the use of group therapy in substance misuse treatment.11
What Is Group Therapy?
Dr. Joseph Hersey Pratt began group therapy sessions to instruct individuals in the care of tuberculosis.12 Pratt found that through shared experience and support, the members in the group benefitted emotionally. He began referring to his sessions as group psychotherapy. Group psychotherapy increased in popularity following World War II when therapists treated groups of combat veterans together and observed the positive effects from the group sessions.
Group therapy means more than one individual is being treated at the same time by at least one therapist. Some groups may have more than one therapist. Group sizes vary depending on the type of therapy. For instance, couples therapy, a type of group therapy that typically treats romantic partners, consists of two individuals; whereas, other groups, such as substance misuse groups, may include 10 to 12 people in one session. Researchers who study the effectiveness of group therapy generally recommend 6 to 12 individuals in a group.13
Group Therapy and Substance Abuse Treatment
We are social creatures, and as social creatures, our need to congregate can be a powerful therapeutic tool. Formal therapy groups can be persuasive and supportive. Groups organized around substance misuse can offer individuals insight, guidance, and comfort. Under a therapist’s guidance, groups can foster healthy attachments as well as teach individuals new social skills. While group therapy is as effective in the treatment of substance misuse as individual therapy, there is mounting evidence that suggests that group therapy might be even more beneficial.14
Individuals who engage in group therapy tend to be more committed to maintaining abstinence.14 Research suggests that group therapy can help with co-occurring mental health disorders, such as depression, anxiety, and personality disorder, too.14
Types and Models of Group Therapy
Therapists might use a variety of group treatment models to meet the needs of the group during the many phases of recovery. The five group models that have proven to be effective in the treatment of substance misuse include:14
- Psychoeducational groups. The primary focus of these groups are to educate and inform individuals generally about substance abuse, mental health, related behaviors, and the consequences of those behaviors.
- Skills development groups. This model is flexible. The therapist can adapt the the teaching of skills based on the needs of the individuals in the group. Skills focus on maintaining abstinence from drugs or alcohol and involve more interaction among the group members.
- Cognitive-behavioral therapy groups. The therapist works to identify the problematic thinking and behaviors that contribute to the substance misuse and teaches group members new thinking and behavior patterns. These groups focus on relapse prevention training as well.
- Support groups. Just as the name suggests, this model provides support and care for the members while teaching them interpersonal skills through group discussion, shared experiences, and collaborative problem-solving.
- Interpersonal process groups. In this model, the therapist observes group interactions, functionality, and performance. The therapist helps members with their emotional development and addresses their childhood concerns that may lead them to poor decision-making and impulsive tendencies.
These models are fluid. Therapists can employ them based on the needs and goals of the group and can even shift from one model to another in a single group therapy session.
Goals of Group Therapy
Applying what is learned in group therapy to life outside of therapy is the main goal. This means individuals are able to make behavior corrections, implement the interpersonal skills they learned to new and existing relationships, and utilize the preventative measures and coping skills when necessary to avoid relapse.15
Advantages of Group Therapy
There are a number of advantages to group therapy, including.16-17
- The assurance that individuals aren’t alone. Other individuals share similar problems and struggles. Psychotherapist and author Dr. Irvin David Yalom, a longtime advocate of group therapy, terms this the principle of universality.
- The opportunity to receive and give support. Both of these notions are important in treatment. Receiving support from others is part of the bonding or therapeutic alliance that occurs in groups; whereas, giving support to others allows for growth and learning.
- A broader therapeutic alliance, which allows for the incorporation of different points of view.
- The development of communication and socialization skills, which allows individuals to learn how to express their issues and accept criticism from others.
- The development of self-awareness, which comes from listening to others with similar issues.
- The therapeutic nature that accompanies sharing one’s experiences with others who have similar problems.
- The feeling of having a broad safety net for individuals who may otherwise be hesitant to discuss their feelings and perceived weaknesses.
- The ability to model the successful behaviors of other individuals who have gone through similar experiences. Modeling is a form of learning where individuals learn by copying or imitating the actions of others.
- Cost. Group therapy is typically less expensive than individual therapy.
Disadvantages of Group Therapy
The disadvantages individuals may experience in group therapy include:17
- Not being the center of attention. In many groups, the old adage “the squeaky wheel gets the grease” seems to apply. Thus, the level of intervention is not as focused and intense for any single person as individual therapy.
- Less confidentiality. Although group members are generally instructed that the information and events that occur in the group are to be held confidential and only to be shared with group members during therapy, the potential for a breach of confidentiality is greater.
- The potential for social loafing. Some individuals in groups do not actually make changes but simply ride on the success of others. Groups may allow unmotivated individuals to hide their issues and avoid accountability.
- A less focused therapeutic alliance.
- Less flexibility. Groups typically meet at specific times. There is less opportunity to fit the therapy into one’s personal schedule.
- Not the right fit. Group therapy may be inappropriate for certain types of individuals, such as individuals who are extremely antisocial, extremely shy, impulsive, and passive-aggressive.
Sometimes, certain alliances form in groups, and these subgroups target and denigrate other group members. An experienced and competent therapist is able to avoid such alliances that are detrimental to the overall group; however, it is inevitable that certain individuals in the group will identify more strongly with one another and not identify with other members.
Is Group and Individual Therapy Covered by Insurance?
Group and individual therapy, when used as one component of a formal rehab treatment plan, may be covered by insurance. This depends on the provider and the specifics of the plan. Use our online verification form below to see if insurance may be able to cover the cost of treatment.
Group vs. Individual Therapy Effectiveness
The answer to the question, “Which is better: group or individual therapy?” is actually relatively straightforward: “Neither.” It really depends on the individual and what’s best suited for them and their needs.
In general, research finds that both group therapy and individual therapy are relatively equivalent in their effectiveness in addressing substance use disorder and a broad range of mental health disorders, too.14
If it’s an option, try both to see what feels right for you.
Nonetheless, both formats of therapy have advantages and disadvantages. Deciding which one to engage in is a personal choice that depends on an individual’s needs, goals, and the types of therapies available.