Group therapy: history, types and phases

The concept of "group therapy" encompasses a large number of different interventions, which can be focused on managing problems concrete, in the acquisition of behavioral and cognitive skills or in the social benefits of the group experience itself herself.

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

• Related article: "Types of psychological therapies"

Group therapy history

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 so with schizophrenia patients.

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

Moreno's psychodrama it was one of the first group therapies to acquire some relevance. Moreno worked on group dynamics through dramatic and emotion-centered procedures, close to interpretation. Around the same time, in their 30s and 40s, Redl began applying group therapy to 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. Later, other schools and authors notably influenced these therapies, such as Gestalt, Neo-Freudians, Ellis or Carl rogers.

From the 1960s on, the different traditions 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 now know as psychoeducation. Cognitive-behavioral therapies they acquired great relevance in the more practical aspect of group therapy.

• Related article: "The psychodrama of Jacob Levy Moreno: what does it consist of?"

Group types

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

1. Psychoeducational and process-focused

The psychoeducational groups aim to contribute to their members information and tools to handle difficulties. They can focus on pathologies, as is the case with psychoeducational groups for family members of people with psychosis or bipolar disorder, or on certain topics, such as emotional education for teenagers.

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

2. Small and big

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

Larger groups are more productive, but they tend to make subgroup formation and division of tasks too easy. Furthermore, 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 based on a single criterion, such as the presence of a single problem or of several, or at a general level; For example, the members of a group may vary in gender, age, socioeconomic status, ethnicity, etc.

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

4. Closed and open

In closed groups, the people who are present at the creation of the group are also present when it ends, while in open groups members vary to a greater extent, usually because they stay active for a longer time.

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

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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 phase the central task of the therapist is establish the trust of group members towards him and towards the rest of the participants. The rules, both explicit and implicit, must also be clear. There is frequently a clash between the needs for autonomy and those for belonging to the group.

2. Transition stage

After the initial stage it is possible that the members feel doubts about the benefits they can get from the group, as well as fear of exposing themselves. It is common for conflicts between members to appear and the authority of the therapist to be questioned.

3. Working stage

According to Corey, in the work phase there is cohesion between the participants from the addressing specific problems and conflicts that arise in the group itself. The therapist can challenge members with the goal of moving toward therapeutic goals.

4. Final or consolidation stage

In the consolidation stage, a recap of progress made by members, which aims to integrate the experience of group therapy into everyday life.

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