Group therapy: history, types and phases

This type of psychotherapy uses group dynamics to intervene on problems and conflicts.

The concept of "group therapy" encompasses a large number of different interventions, which may focus on the management of specific problems, on the acquisition of behavioral and cognitive skills, or on the social benefits of the group experience itself.

In this article we will describe what are phases of group therapy and what types exist.. Also we will synthesize the development of this therapeutic method and the main theoretical orientations in this respect.

History of group therapy

Group therapy as we know it began to develop in the 1920s and 1930s. In the 20s of the last century Pratt applied pioneering group interventions. for the management of tuberculosis, while Lazell did it with schizophrenia patients.

Psychoanalysis, which enjoyed great popularity in the first half of the 20th century, had a major influence on early group therapy. Wender transferred Sigmund Freud's ideas on family functioning to therapeutic groups, while Schilder adopted dream analysis and transference as his methodology.

Moreno's psychodrama was one of the first group therapies to acquire some relevance. Moreno worked group dynamics through dramatic and emotion-centered procedures, close to interpretation. At the same time, in the 1930s and 1940s, Redl began to apply group therapy with children, and Slavson did the same with adolescents.

Group therapy became popular in the United States after World War II. Slavson founded the American Group Psychotherapy Association, while his rival Moreno created the American Society of Group Psychotherapy. Subsequently, other schools and authors had a significant influence on these therapies, such as Gestalt, the neo-Freudians, Ellis or Carl Rogers.

From the 1960s onwards, the different traditions became more specialized and developed. A clear distinction began to be made between therapies focused on the treatment of specific disorders and others closer to what we know today as psychoeducation. Cognitive-behavioral therapies acquired great relevance in the most practical aspect of group therapy.

Types of group

There are many different ways of classifying therapeutic groups. We will focus on some of the most fundamental differentiations, especially those that refer to the composition and structure of the group.

1. Psycho-educational and process-focused

Psycho-educational groups aim to provide their members with information and tools to manage difficulties. They can focus on pathologies, such as psychoeducational groups for family members of people with psychosis or bipolar disorder, or on specific topics, such as emotional education for adolescents.

In contrast, process-focused groups, closer to psychodynamic and experiential traditions, focus on the usefulness of the group relationship itself to promote emotional expression and psychological change in the people who participate.

2. Small and large

A therapeutic group is usually considered to be small when it consists of approximately 5 to 10 members. In these groups, interaction and cohesion are greater, and in many cases close relationships are created. The ideal group size is between 8 and 10 people, according to experts.

Larger groups are more productive, but tend to facilitate the formation of subgroups and the division of tasks. In addition, participants in large groups tend to feel less satisfied than those in small groups.

3. Homogeneous and heterogeneous

The homogeneity or heterogeneity of a group can be assessed on the basis of a single criterion, such as the presence of a single issue or several issues, or on a general level; for example, group members may vary in gender, age, socioeconomic level, ethnicity, etc.etc.

Homogeneous groups tend to function more quickly, to generate more cohesion and to be less problematic. Nevertheless, heterogeneity, especially in specific disorders or difficulties, can be very useful to present different behavioral alternatives.

4. Closed and open

In closed groups the people who are present when the group is created are also present when it ends, while in open groups the members vary to a greater extent. in open groups the members vary to a greater extent, usually because they are active for longer periods of time.In open groups, members vary more, usually because they remain active for a longer period of time.

Closed groups generate greater cohesion but are more vulnerable to members leaving. Open groups are applied, for example, in psychiatric hospitals and in associations such as Alcoholics Anonymous.

Phases of group therapy

In this section we will describe the four phases of group therapy according to Gerald Corey. Although other authors speak of different phases, most classifications of the stages of the group process converge on the key aspects.

1. Initial or orientation stage

In the orientation stage, the therapist's central task is to establish the trust of the group members. to establish the trust of the group members and the rest of the participants. The rules, both explicit and implicit, must also be clear. There is often a clash between the need for autonomy and the need to belong to the group.

2. Transitional stage

After the initial stage it is possible members may have doubts about the benefits about the benefits they can obtain from the group, as well as fear of exposure. It is common for conflicts to arise between members and for the therapist's authority to be questioned.

3. Working stage

According to Corey, in the working stage cohesion among the participants is produced from the and conflicts that arise in the group itself. that arise in the group itself. The therapist can challenge members in order to move toward therapeutic goals.

4. Final or consolidation stage

In the consolidation stage, a recapitulation of the progress made is carried out. recapitulation of the progress made by the membersThe purpose of this stage is to integrate the group therapy experience into daily life.

Participants may feel some sadness and fear of facing new difficulties without the help of their peers and the therapist, so it is advisable to prepare well for the end and to plan follow-up sessions, if necessary.