Individual or Group Therapy… Two Roads to the Same Destination

individual or group therapy two roads to the same destination

Very often, people new to the work of psychotherapy wonder which of the two models of treatment – individual or group session – is best to treat their concerns.

The quick answer is that it really doesn’t make much difference in the long run. People who work one-on-one with a therapist do just as well as a patient who joins a group therapy experience. But, there are subtle distinctions that may make a difference for people with addictions – group therapy offers a chance to make a public commitment to change.

Individual therapy, the mainstay in the field of psychotherapy, is the most frequently employed method of working with patients. The first step is to find an individual therapist and set up a series of session for a assessment. Often in the beginning, people will see a therapist twice a week for the first two weeks and then once a week thereafter. This process allows for a quick study of the circumstances that brings a patient to therapy, allows for a comprehensive assessment to be made about the needs for treatment, and the completion of an initial treatment plan that can guide the work.

The days when patients lay on a couch with the therapist sitting behind them who does little talking are long gone from the practice of psychotherapy. But, that image of how individual treatment works lingers in the minds of many people. Instead, most people are relieved to know that the sessions usually take place with the patient and the psychotherapist sitting opposite one another in a comfortable environment. The setting promotes the best kind of conversation that a patient and a therapist might have about the reasons for treatment. And, it is in that conversation that an alliance is formed between the patient and the therapist; an alliance to work together to address the problems in a patient’s life. A tailored treatment plan is developed to work on those problems.

Usually, therapy sessions last from 10-15 sessions, but it is not uncommon for people to be in psychotherapy for many months. It all depends on the nature of the problem and the skill of the therapist in empowering the patient to solve their problems. Individual therapy can be very rewarding as the bond that usually develops between a patient and his or her therapist is usually very strong. By the end of the process, a patient is usually strengthened in their ability to deal with their problems.
An interesting consideration for people in recovery from addictions is the recognition that it is often easy for them to manipulate one person (the therapist) in one-on-one therapy despite the fact that most clinicians try hard to be aware of that tendency. In fact, most alcoholics and addicts have spent a lifetime honing skills to control one-on-one relationships, and individual psychotherapy is not immune from the possibility that commitment to change voiced in these sessions may not be very intentional or solid at all.

One way around that is to build upon research done a decade ago on what makes for solid change. It is now clear that voicing change statements and articulating the plans to back them up is a critical component of any change effort. This is called “change talk” that moves in a positive direction for recovery as opposed to “sustain talk” that only perpetuates the addiction cycle. Moreover, the evidence is equally clear that the most lasting change with the greatest chance of moving a recovering person deeper into recovery and farther from relapse is when that change talk is public.

What venue of therapy is more public than the group therapy experience? Here, within the confidential confines of a group of like-minded people, an alcoholic or addict in recovery can vocalize about the changes that they know need to be made and are prepared to implement. By doing so in the public forum of the group, there is power that will help the recovering person’s commitment to true change and recovery.

Group therapy is this kind of different experience for someone in recovery. The primary advantage is that most people who enter group therapy have been dealing with their problems in an isolated way for a very long time, and the group experience gives them a chance to talk with several others about the nature of the problem and what can be done. There are other advantages to group therapy that are based on its style and the way it is usually organized.

Group sessions usually take place once a week in which eight or so people join together to talk about their psychological issues and also come up with solutions to those problems. The primary goal of the group therapist is to have patients form relationship bonds with other like-minded people. The ability to function in a group therapy setting is exactly the way a patient might behave in the outside world…the group becomes a social microcosm of a patient’s worldly experience. How a person works in group therapy indicates to a large extent how successful they will be in their real world.

To that extent, group therapy is not “spilling my guts” to strangers. In fact, the way a good group typically works is that a therapist will concentrate on the here-and-now experience of the members in the group itself. How a patient feels about others, what they say to others, and how they react to others in the present moment of the group itself goes a long way toward forming those strong relationships we know help people manage their lives. Many times members say right out loud, “Goodbye isolation; Hello relationships!”

So it is that individual and group therapy models offer different advantages that show one modality may not necessarily be better than the other. It all depends on what a patient is comfortable with. Yet, the bottom line is that most recovering people who are earnest about making changes and following through with them find in the group therapy experience a chance to be held accountable and rejoice with others in the achievement of changes made.

Roger P Watts bio

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