Psychotherapy Guide: Group Therapy vs. Individual Therapy
The American Psychological Association offers this formal definition of psychotherapy:
“Psychotherapy is the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable.”
Essentially what this means is that of psychotherapy involves the use of psychological principles applied by an individual who is formally trained in the use of these principles to assist others in modifying their behavior or thinking, or in dealing with their emotions or with other significant events/issues.
References to using various types of talking cures have been found as far back as ancient Greece. English psychiatrist Walter Cooper Dendy introduced the term psycho-threpeia in the 1850s to describe a type of talking treatment. The person that is generally acknowledged as the founder of modern psychotherapy (just referred to as therapy in this article) is Sigmund Freud. Freud developed psychoanalysis around the beginning of the 20th century, and following his work, many other schools of therapy were formed.
What Is Group Therapy?
Group therapy is generally acknowledged as beginning when the physician J. H. Pratt began group sessions to instruct individuals in the care of tuberculosis. Pratt found that the groups benefited the members emotionally due to supporting one another in shared experiences. Pratt eventually began referring to his sessions as group psychotherapy. Group psychotherapy began to increase in popularity following World War II when groups of combat veterans were treated together, and specific benefits from these group sessions were observed.
What Is Individual Therapy?
Individual therapy consists of a therapeutic situation where one individual (termed the client for purposes of this article) is involved in the therapeutic process with at least one therapist. A therapist can be anyone professionally trained in the use of therapy, including a psychologist, social worker, counselor, psychiatrist, marriage and family counselor, etc. For the purposes of this article, we will define the therapist as someone who has received formal training in therapy and is licensed by the state they practice to do therapy. Thus, therapy differs from getting advice from friends, family, acquaintances, etc., as it is a professional service provided by a trained professional.Individual therapy offers several advantages:
- The confidentiality of the client’s issues is most easily maintained in individual therapy.
- The client receives one-on-one attention from the therapist, and this allows the therapist to be very thorough in understanding the specific problems of the client and in developing an individualized approach to helping the client.
- The level of analysis and treatment can be much more intense and comprehensive in individual therapy compared to group therapy.
- The pace of the therapy can be tailored to the specific client. It can be sped up in cases where clients can handle more focused and intense interventions, or it can be slowed down in cases where clients need time to adjust and move slowly.
- The therapeutic alliance, which refers to the working relationship between the client and therapist, is strongest in individual therapy. Research investigating the components of effective therapy have consistently pointed out that the therapeutic alliance is a key component of a successful therapy intervention.
- Individual therapy allows for the development of self-awareness by discussing issues and getting feedback from the therapist.
- The client can arrange a time for the therapy sessions that is most conducive to their schedule.
- Therapy sessions can be arranged rather quickly, if needed.
- Individual therapy allows for the development of communication skills in individuals who need help with these skills.
A couple of relative disadvantages of individual therapy include:
- Individual therapy is typically more expensive than group therapy.
- Some clients may have a strong need to identify with other individuals who share similar problems/issues. This need can be best addressed in a group situation.
- Clients in individual therapy need to be motivated and are obviously in the spotlight. Clients who are not committed to changing, doing the work, and applying principles learned in therapy may struggle when they are the center of attention.
- The research supports the notion that individual therapy is generally effective for treating most nearly every different psychological disorder, condition, and problem that is generally addressed in a therapeutic environment.
Group therapy is loosely defined as having more than one client treated at the same time by at least one therapist. Some groups will have more than one therapist; if this is the case, most often, there are two therapists addressing the group at the same time and very rarely more than that. Group sizes can vary depending on the type of group therapy being employed. For example, couples therapy, a type of group therapy that typically treats romantic partners, consists of two clients (most often), whereas certain types of groups, such as substance abuse groups, may feature 10-12 clients in a session. Researchers who study the effectiveness of group therapy generally recommend that the ideal maximum number of clients in a group is somewhere between 6 and 12; however, some groups have even larger numbers of clients in them.
There are a number of advantages to being involved in group therapy. However, it is important to note that many of these advantages represent actual strengths of the group process as opposed to trying to make and evaluate a comparison that group therapy is better than individual therapy.
Some of the advantages that occur in group therapy include:
- Group therapy assures individuals that they are not alone and that other individuals share similar problems and struggles. The famous psychiatrist Dr. Irvin David Yalom, one of the acknowledged gurus of group therapy, terms this the principle of universality.
- Group therapy offers the opportunity to both receive support from others and to give support to others. 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.
- The therapeutic alliance that occurs in groups is broader than the alliance that occurs in individual therapy. This allows for the incorporation of many different points of view.
- Group therapy helps individuals develop communication skills and socialization skills, and allows clients to learn how to express their issues and accept criticism from others.
- Group therapy allows individuals to develop self-awareness by listening to others with similar issues.
- Sharing one’s experiences with others with similar problems is often itself therapeutic.
- Group therapy provides a broad safety net for individuals who may otherwise be hesitant to discuss their feelings, perceived weaknesses, etc.
- Individuals in group therapy can 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.
- Group therapy is typically less expensive than individual therapy.
Several disadvantages to group therapy are:
- The client is not the focus 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.
- The level of confidentiality in groups is far less secure than it is an individual therapy. 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 far greater in group therapy.
- The notion of social loafing is a problem with all group efforts. 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.
- Although the therapeutic alliance is broader, it is not as focused and strong in group therapy as it is in individual therapy.
- Groups typically meet at specific times. There is less opportunity to fit the therapy into the one’s personal schedule.
- Group therapy may be inappropriate for certain types of individuals, such as individuals who are extremely antisocial, extremely shy, impulsive, passive-aggressive, psychotic, etc.
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.
The answer to the question, “Which is better: group or individual therapy?” is actually relatively straightforward: “Neither.” Both have advantages and disadvantages that are suited for specific types of individuals and for specific problems.
In general, the research finds that both group therapy and individual therapy are relatively equivalent in their effectiveness in addressing a large number of issues. Thus, there is no real answer to the question of which is better.
This is an individual choice that can be made by clients who are able to try both types of therapy and decide for themselves which is best for them.
The best-case scenario is to try and get involved in both types of therapy at the same time. Unfortunately, this can be relatively expensive and time-consuming for some individuals.
Nonetheless, both formats of therapy have advantages and disadvantages. Deciding on which one to engage in is a personal choice that depends on one’s personal issues, goals, and the types of therapists/groups that are available.