group therapy revisited

May 11th, 2018

“Since I joined group, I don’t feel so alone anymore—now I know there are others who want the best for me.” I hear this sentiment over and over again from clients who commit to weekly group therapy—a place to both learn about oneself while helping others learn about themselves. Clients typically come to group because they have longings for deeper contact, and group is where they get to take risks, be vulnerable, and as a result, experience deeper connection.

In the early ‘80s, my dad was part of a men’s therapy group in Philadelphia. I was in high school at the time and didn’t really understand why he attended these mysterious meetings. Because we lived in a somewhat sheltered suburb in South Jersey, it seemed quite revolutionary that he would travel into the city every Tuesday night to meet with a diverse group of men. All I knew is that he was devoted to this weekly ritual, and he returned home with a more optimistic outlook. After five years of going to his men’s group, my father built up the courage to separate from my mother and start a new life for himself. Discovering his true voice allowed him to make a bold decision after thirty years of marriage, and this was a formative event in the history of my family and my life.

In the late ‘80s I started graduate school at UCLA to study clinical social work, and in 1992 I became an associate in a busy private practice in Los Angeles where I was asked to lead a men’s psychotherapy group. How ironic—I was now leading a men’s group after my dad’s influential experience as a group member just a few years earlier. Although I felt as if I was treading water at times, I slowly built up clinical muscle and returned every Wednesday night for eight more years—and this turned out to be one of my most significant growth experiences both personally and professionally.

Through the course of my career, I’ve led several long-term therapy groups, and today, I call them interpersonal process groups with an emphasis on here-and-now relationships in the room. As a former group leader of many types of groups, I firmly believe in the therapeutic nature of the group experience, but nowadays, I view the groups in my practice through a process group lens.
With that said, here are some of the typical themes that emerge during a group session:
• Relationship Challenges
• Trauma
• Anxiety and Depression
• Addictions and Codependency
• Career and Money
• Shame and Loneliness
• Sex and Sexuality

When I meet a client for the first time, I’m already assessing his eventual appropriateness for group. Once a client has identified and started to explore the issues that brought them into therapy, it may be time to introduce the possibility of joining a group. There’s no cookie-cutter approach to the timing of a client considering group therapy, but I always hold this possibility for the client if my instincts tell me that they would benefit from a group experience. Because most of my individual clients know that I lead groups, they may initiate interest, or I may plant a seed about future group membership. Although I may be eager to transition a client into group, I always need to check in with myself to make sure that the client wants group more than I want it for them.

Here are a few questions that may reveal whether a client is ready to participate effectively in a group:
• Is the client able to offer empathy and attunement?
• Is the client able to receive empathy and attunement?
• Does the client appear enthusiastic about a group experience?
• Is the client interested in developing more honest, satisfying relationships with others?
• How does the client respond to conflict and/or anger?
• Is the client willing to comply with group guidelines?

In order to foster longevity in therapy groups, the following ingredients will promote greater trust and safety:
• Cultivating honest relationships with the members of the group and the group therapist.
• Giving and receiving clear, honest feedback.
• Understanding one’s impact on others.
• Accessing and articulating one’s internal world.
• Exploring deeper longings and desires.
• Assessing sexuality and sexual expression.
• Expressing anger safely and productively.
• Acknowledging and processing shame.

Bringing together a therapy group requires perseverance from the group therapist, but it can also be one of the richest clinical experiences. Clients learn how to be more fully themselves with one another—a rare transformation that far transcends the challenges group formation requires. Having led therapy groups since 1992, I remain deeply grateful for the opportunity to learn and grow along side my clients. As my dad shared with me many years ago, “my group helped me reclaim my life.”

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