Description Of Treatment

Group psychotherapy is a widely used treatment modality. However, there are many types of groups for different conditions and often several models of groups for a particular condition. This makes a description of the field somewhat complex, and even the term "group therapy" relatively lacking in meaning except that several people are meeting together. Group psychotherapy is widely used as an intensive treatment modality to address psychological issues especially those involving unsatisfactory interpersonal patterns. Group therapy is also used in a more structured manner to address negative cognitions, to learn skills such as assertiveness, and for psychoeducational purposes. This wide range of group applications involves the use of groups that are conducted in quite different ways.

This article begins with an overview of the effectiveness of group therapy and the sorts of problems that can be treated in groups. This includes the question of how many group sessions are needed to be helpful. Then an overview of basic group theory is provided emphasizing the importance of considering the whole group as the vehicle for treatment. This is followed by a discussion of the generic processes that occur as a group develops. Different types of group models are then reviewed and what problems each is designed to address. Finally, there is a description of how group programs can be developed for use in larger systems of health care.

Group therapy has been studied extensively and in particular there have been a number of large and com prehensive studies over the last decade. A recent survey of 23 high-quality randomized outcome studies found effect sizes (a statistical measure of change) in a range of 0.76 to 0.90. This means that treated patients were doing significantly better than 78 to 82% of control patients who did not receive active treatment. The clinical literature derived from regular treatment settings suggests similar outcome changes. A number of studies have directly compared the results of group therapy and individual therapy for a similar patient population and using the same theoretical treatment model. With very few exceptions, both modalities have about the same clinical outcome across a wide range of clinical applications.

The list of conditions treated in groups is extensive. Virtually all models of individual therapies have been used in group therapy. The highest use of intensive group models is with the more common conditions of depression, anxiety states, eating disorders, and personality disorders. Groups of a more supportive nature are widely used as an adjunctive treatment for more severe and chronic conditions such as bipolar disorder and schizophrenia.

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