What are the Differences Between Individual and Group Therapy?
Group therapy was originally conceived by a physician who attempted to instruct groups of individuals regarding the care of tuberculosis. This physician, Dr. J. H. Pratt, noticed that individuals in groups began to support one another, and he actually began referring to his educational sessions as group psychotherapy. Group psychotherapy became increasingly popular after World War II when groups of combat veterans were treated together.
In essence, individual therapy occurs when one or more therapists work with a single individual in the same session, versus group therapy which is defined by treatment delivered by one or more therapists to one or more individuals in the same session.
Group Therapy: Advantages and Disadvantages
As mentioned above, group therapy consists of a number of different conditions where one or more therapists treats at least two individuals in the same session. Typically, the number of therapists running group sessions is one or two; however, some special cases may require more therapists or assistants to run particular types of groups. The size of the group being treated will vary, depending on the type of therapy being delivered and on several other factors. For example, most often, marital therapy (a type of group therapy where spouses are being treated) typically consist of only two clients. Group therapy for substance use disorders may consist of 10 or more individuals, depending on the therapist. In general, research indicates that the most effective groups typically have a maximum number of 6-12 clients; however, depending on the nature of the group, there may be more than 20 individuals.
Group therapy offers some specific advantages that make it attractive for both the therapist and the clients being treated. According to scholarly sources, such as The Handbook of Group Counseling and Psychotherapy, these are benefits of individuals working together in groups and do not necessarily indicate that group therapy is superior in any way to individual therapy (see below).
According to Dr. Yalom, there are various benefits that can occur as a result of group processes:
- Individuals begin to understand that they are not alone in their issues, and other people have similar issues and struggles. This results in the development of a sense of identity, belongingness, and the release of tension and stress.
- The therapeutic alliance refers to the bond between the therapist and the client that allows them to address the client’s issues effectively. This is an extremely important factor in positive therapeutic outcomes. According to Dr. Yalom, the therapeutic alliance occurring in group therapy is broader than the alliance that occurs in individual therapy.
- Individuals in group therapy receive support from other people and are also able to give support to other members. Receiving and giving support develops a broader therapeutic alliance and a shared sense of goals that fosters improvement.
- Individuals in group therapy find that they often have fewer reservations about discussing their issues with others because they can identify with the members of the group.
- Individuals in groups develop insight into their own issues and greater self-awareness by listening to others who have similar problems.
- Being in a group fosters the development of communication abilities, social skills, and results in individuals being able to learn to accept criticism from others.
- Group therapy sessions are generally more affordable than individual therapy sessions.
- Individuals in groups often make lifelong connections with other members of the group.
One of the most accomplished researchers and writers of how group processes contribute to group therapy outcomes is the psychiatrist Dr. Irvin D. Yalom who published extensively regarding group processes in therapy and about the advantages of having clients working in groups.
While there are some advantages to the group therapy process, there are also some weaknesses associated with the group therapy.
- The attention of the therapist is spread across the members of the group. This means that individuals will not receive focused treatment, and some individuals may take up disproportionate amounts of time with their own issues.
- People in group therapy sessions risk having other confidential issues spread by other group members outside the group. Although it is continually emphasized that what is discussed in the group needs to remain in the group, there is no guarantee that some individuals will adhere to this confidentiality.
- Even though the therapeutic alliance in the group therapy environment is broader, it is not as focused on any single individual.
- Because group therapy sessions must accommodate many individuals, there is less opportunity to fit the therapy sessions into one’s personal schedule.
- Some individuals in groups may not be motivated to participate and will simply let the others in the group contribute.
- Whenever there are groups of people, there is the chance that certain subgroups will form within the larger group. If the therapist does not check this, the development of small alliances within the group can impede the group’s progress.
- Certain individuals are not appropriate for group therapy. Often, individuals who are extremely manipulative, aggressive, shy, impulsive, or suffering from active psychosis are not appropriate for groups. In addition, some individuals are not appropriate for certain types of groups. For instance, a blue-collar worker may feel out of place in a group full of physicians and college professors.
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As mentioned above, individual psychotherapy occurs when there is one individual being treated by one or more therapists. There are several advantages to participating in individual therapy sessions.
- The client receives the full attention of the therapist and is able to work with the therapist on a one-on-one basis. This results in a very focused and intense therapeutic experience.
- The client gets direct feedback on their progress from the therapist, and the therapist has a more complete understanding of the client’s progress.
- The therapeutic alliance is strongest in individual sessions.
- The client can be assured that the therapist will maintain the confidentiality of the treatment sessions and that no one else will learn about their issues.
- Treatment in individual sessions is much more comprehensive and intense.
- The pace that the therapist and client work at can be tailored to suit the needs of the specific client. This cannot be achieved in group sessions because the pace is often adjusted to meet the needs of the slowest members.
- Meeting times for therapy sessions can be arranged to fit the client’s schedule and can be adjusted depending on specific circumstances, whereas this is not the case for group sessions.
Some of the relative weaknesses of individual psychotherapy follow:
- Individual sessions are typically more costly than group sessions.
- While being the sole focus of attention can be considered an advantage to individual sessions, it can also be disadvantageous to some individuals. Some people may wish to have a little “camouflage” initially until they can adjust to the therapeutic environment.
- Some individuals who have issues with motivation may struggle when they are the sole focus of attention.
- The client only gets the viewpoint of the therapist and does not get multiple viewpoints.
The Effectiveness of Individual Therapy vs. Group Therapy
In general, the majority of the research suggests that individual therapy and group therapy are effective for treating nearly every type of problem, psychological disorder, or issue that is addressed within a therapeutic or counseling environment. Some individuals may be more suited to working in groups based on the above discussion of the strengths of group therapy, whereas others may be more suited to working in individual situations. In addition, a number of different therapeutic paradigms, such as Dialectical Behavior Therapy, use both group and individual therapy, and individuals benefit from both.
The choice to become involved in group or individual therapy will depend on a number of different factors, including affordability, one’s comfort level with discussing problems in front of other individuals, and the type of intervention being used. Neither form of therapy is “better” than the other, but both represent different approaches to reaching the same goal.