Group therapy may be one of the less explored modes of emotional healing in India, but it is slowly, surely finding its place in the mental health field. This form of therapy involves a group of people—usually between 8-12 in number— gathering under the guidance of one or more trained psychologists, psychotherapists and/or psychiatrists in order to explore particular issue(s).
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While individual therapy focuses on one person’s emotions, thoughts and behaviours, group therapy considers the collective, and leverages the dynamics of the group to facilitate individual learning and growth. If done in a thoughtful and ethical manner, therapists can use the group format to foster immense communal bonding and healing. For, there is a certain transformative power in knowing that you are not alone in your struggles, that other people understand what you are going through, and have possibly experienced a similar array of emotions.
TYPES OF GROUP THERAPY
Psychoeducational Group Therapy: Therapists might create such a group to help elucidate a particular mental health condition. Here, each group member would likely have the same diagnosis and the therapists would focus on helping them understand their symptomatology and giving them coping strategies. The benefit of creating such a space is the sense of universality that likely occurs when you discover how many other people are going through what you are going through. Suddenly, the stigma of the diagnosis is reduced and the individual is possibly able to feel a sense of hope.
Dialectical Behavioural Therapy: In instances where individuals are searching for a space to learn practical and emotional skills, therapists might create a dialectical behavioural therapy (DBT) group. Developed by American psychologist, Marsha Linehan, DBT is broken into four modules: mindfulness, distress tolerance, emotional regulation and interpersonal effectiveness. While DBT in its full form is extensive and complex, combining group skills training with individual therapy as well as phone consultations with the therapist, DBT-informed group therapy uses parts of the four modules and gives the therapist flexibility to decide what aspects of them are most relevant to the group participants.
In DBT groups that I have conducted, the participants struggled with several concerns such as lack of assertiveness professionally or personally, an inability to set clear boundaries with people, anger management, trauma of varying kinds and severity etc. While some group members were diagnosed with conditions such as Borderline Personality Disorder (BPD), others did not have a formal diagnosis and simply attended the group to learn the skills.
Even though DBT was originally created keeping in mind individuals struggling with BPD and/or suicidality, this form of therapy has expanded beyond those bounds. Today, it is used widely to help individuals foster self-esteem, maintain healthy relationships and cope with varying levels of distress.
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Support Groups: Unlike DBT groups that have a certain flow and structure to them, support groups tend to be slightly less rigid. This type of group therapy fosters healing through active peer-to-peer support. For instance, Alcoholics Anonymous (AA) is a type of support group that creates a space for individuals to share stories about their struggles with addiction. Members of AA celebrate each other’s progress while also holding each other accountable in their efforts to stay sober.
Support groups are less about direct treatment and more about community building. They might focus on overcoming substance abuse or other forms of addiction (such as gambling). They might help caregivers of addicts or chronically ill patients find peace, a space where their minds can simply focus on their own healing instead of that of another. Support groups might also help people deal with grief and bereavement after the loss of a loved one, or help individuals living with social anxiety or phobias practice how to interact with others in a safe, non-judgemental environment. These types of groups are unlimited in the scope of topics that they could address. My colleagues and I just ran a support group for individuals facing challenges with moving back to India after living abroad for an extended period of time.
Expressive Art Group Therapy: This form of group therapy employs creative expression and imagination to foster a connection between an individual’s mind and body. It employs narrative practices through drawing, painting, photography, sculpture, writing and poetry alongside movement and sound to help with healing and recovery. Silence is also key to this kind of therapy, as it allows for deeper reflection after the process of artful creation. This gentle form of therapy is easily integrated with the support-group model in order to help those facing chronic conditions such as cancer, Alzheimer’s disease, and other physical ailments as well as mental health conditions.
The forms of group therapy discussed here are only a few of the myriad of types that exist. Group therapy is powerful in its ability to destigmatize mental health strife by engendering a sense of universality among participants and building awareness that people heal in different ways. The process is never linear, giving way to catharsis through active reflection and discussion, and finally instilling hope that the future is an open playing field that does not need to be tackled alone.
Malika Noor Mehta is a psychotherapist and mental health advocate who runs her own private practice in Mumbai.
Therapy Deconstructed is a monthly column that aims to demystify all aspects of therapy.
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