Why would a family be referred to group therapy?

Groups can be very effective in helping people change. Group therapy takes place in an environment which usually feels comfortable and supportive. Individuals of all ages may learn most easily from contemporaries. The opportunity to help others may foster the ability to relax, feel valued, and formulate goals. Some people have difficulty tolerating the intensity of a one-to-one relationship (for example, youngsters who are shy or angry with adults, people who have poor verbal skills). They may experience group sessions as giving them more time with less pressure to talk.
Group therapy is particularly suited to stages of child and adolescent development during which social energy is directed towards peers. Children and adolescents often enjoy group therapy and have strong attachments to other members. Teenagers can persuade peers to behave more appropriately or to “open up” whereas talking with a therapist alone may engender discomfort and resistance. Support of the group helps children and adolescents deal with difficult therapy issues: depression, anxiety, family troubles, etc.

Group therapy works well for children with social and behavioral difficulties. The therapy provides opportunities for modeling and practice which could only be talked about in individual sessions. Groups give children who have trouble with friendships a protected environment for learning and practice.

Group therapy addresses parents’ issues with children at different developmental stages. Sometimes parents will benefit most from the support of others in similar situations; at other times concrete information and techniques will be most helpful. In all cases, one of the most powerful aspects of groups is that parents see that their experiences are not unique; anxiety is reduced and effective parenting is maximized.

If peers are so important in group therapy, what is the role of the therapist?

Professionally-led therapy groups can be very powerful because they are carefully organized to achieve desired goals. Therapists must be skilled at evaluating individual needs and formulating treatment plans which may include multiple modes of treatment and professional collaboration. They must be prepared to deal with the patient for whom group is not appropriate. They must choose, match and prepare members. Techniques of therapy vary. In some groups, leaders teach specific skills, as in parent training, social skills or study skills groups. In other groups, therapists foster learning by facilitating relationships and by helping members observe and plan their behavior. In child and adolescent groups, the therapist must maintain the difficult balance between fostering trust and confidentiality for the children and providing adequate support and information for parents.

Should resistant children and adolescents be “forced” to go to group therapy?

Often this is a less difficult issue than parents expect. Children and adolescents frequently experience groups as fun and valuable, at least after a few sessions. However, the decision to start group therapy, like other important health and educational decisions, must be made by adults. Parents and professionals should take a child’s preferences into consideration, but, in collaboration with the therapist, insist that he/she participate in group, or any other needed therapy. Good therapeutic work can often be done even when a child or adolescent objects to a plan.