Chapter Review
What are some of the ways that groups are used to help their members change?
Individuals often turn to groups for help in achieving personal and therapeutic
change. As Lewin’s law of change states, “It is usually easier to change individuals
formed into a group than to change any one of them separately” (Lewin, 1951, p.
228).
Most change-oriented groups focus on therapeutic adjustment (therapy groups),
interpersonal and emotional growth (interpersonal learning groups), or overcoming
addictions or other life stresses (support groups).
Therapeutic groups are usually conducted by a mental health professional and
focus on psychological problems.
In group psychoanalysis, the therapist helps members to gain insight into their
problems by offering interpretations and working through transference effects.
Such therapies use a variety of analytic methods drawn from Freud’s (1926/1955)
approach to treatment, including identifying unresolved conflicts.
Members of humanistic groups, such as Rogers’s (1970) client-centered approach,
seek existential meaning, positive self-regard, and a better understanding of
themselves and their emotions.
Gestalt group therapy, developed by Perls (1969), makes use of experiments,
techniques, and extensive role-playing methods to stimulate emotional growth.
Psychodrama, developed by Moreno (1934), also uses role play and physical
activities.
In interpersonal group psychotherapy, the leader takes advantage of the group’s
dynamics to help members learn about how they influence others and how others
influence them. This “here-and-now” method was developed by Yalom (Yalom &
Leszcz, 2005).
In cognitive-behavioral therapy groups, the therapist uses principles derived from
learning theory to encourage specific behaviors while extinguishing others. This
approach makes use of behavioral methods, including behavioral contracts,
modeling, behavior rehearsal, and feedback.
Interpersonal learning groups help relatively well-adjusted individuals improve
their self-understanding and relationships with others.
In training groups, or T-groups, developed by Lewin and his associates, members
were encouraged to actively confront and resolve interpersonal issues through
unstructured discussions.
In psychoeducational groups, members take part in planned exercises that focus on
a specific interpersonal problem or skill. Most of these interventions involve a
learning cycle that begins with an orienting overview and then moves from
experience to discussion to analysis to application. Kolb’s (1984) experiential
learning theory assumes individuals learn best through a combination of direct
experience, observation, analysis, and action.
Process debriefing groups are used to help individuals who have experienced
significant trauma cope with the event and are designed to reduce PTSD.
Support groups often form spontaneously when people combine their energies and
efforts in an attempt to cope with or overcome a common problem. These groups
tend to be problem-specific, highly interpersonal, communal, autonomous, and
perspective-based.
Many support groups, such as AA, emphasize inspirational testimonials, mutual
help, shared similarities, collective encouragement, and changing the member’s
social networks.
Studies of online support groups for problems ranging from cancer to sexual abuse
to psychological disorders have suggested that these groups provide many of the
same resources to members as do face-to-face support groups.
How do groups promote change?
A number of therapeutic factors operate in groups to promote change. They include
hope, universality, observational learning, interpersonal learning, guidance,
cohesion, self-disclosure, catharsis, altruism, and insight.
Hope and universality: Groups, by providing opportunities to engage in social
comparison and mutual support, convince members of the universality of their
problems, elevate their levels of hope, and instigate a shared, group-level identity
(Marmarosh & Corazzini, 1997).
Social learning: Because groups include multiple individuals, rather than just a
single therapist/helper and a single client, they can make use of the sources of
interpersonal learning described in Bandura’s (1986) social learning theory.
Groups facilitate observational learning (modeling of behaviors), interpersonal
feedback, and guidance (direct instruction).
Coleadership (two or more leaders are present at all sessions) provides more
opportunities for social learning, feedback, and mutual guidance. Group
facilitators, like all group leaders, vary considerably along the directive–
nondirective dimension.
Group cohesion: Cohesion may be a necessary condition for an effective change-
promoting group.
As in all groups, cohesion can be based on attraction, task commitment, shared
identity and emotion, and strong relational bonds.
Therapeutic groups, like all groups, generally become more cohesive over time as
they move through the basic forming–storming–norming–performing–adjourning
stages of development identified by Tuckman (1965).
Kivlighan’s work indicates that interventions are more effective when they match
the developmental stage of the group (Kivlighan et al., 1985).
Cohesion yields a number of positive consequences for therapeutic groups,
including membership retention, improved communication, and increased
influence of the group on the individual.
Self-disclosure and catharsis: Groups become more intimate as members reveal
private information about themselves (self-disclosure). When group members vent
strong emotions, the resulting catharsis may reduce their stress.
Altruism and insight: Group members also benefit from the increased self-
confidence produced by helping others and by gaining insight about their personal
qualities from other group members.
People generally prefer individual-level treatment methods, in part because of
uncertainty about what the group will reveal to them about themselves.
Individuals who have taken part in therapeutic groups rate insight as one of the
most important of the curative factors.
How effective are groups in bringing about change?
Most group approaches are effective methods for helping individuals change their
thoughts, emotions, and actions, and so qualify as evidence-based treatments.
Meta-analytic reviews, such as those conducted by Burlingame and his colleagues
(2016), indicate group approaches are more effective for certain problems (e.g.,
social anxiety and addictions) than for others (depression).
Although group approaches adopt a variety of methods, studies such as the one
conducted by Lieberman, Yalom, and Miles (1973), do not consistently identify
one type of group method as superior to another.
Individuals who have participated in group-level interventions rate their
effectiveness very positively, with one survey indicating that AA was rated as the
most effective of all such groups.
Group approaches are generally effective, but they do not work for everyone or for
all types of psychological problems.
The number of individuals who drop out of treatment, premature terminations, is
higher in group treatments compared to individual treatment.
A small fraction of participants in groups experiences significant negative reactions
to the experience and so are considered psychological casualties.
Interventions are more effective when they are consistent with both the norms,
values, and practices of a particular cultural context.
More research is needed to understand fully the nature of the therapeutic group and
its impact on members, but given the powerful self-processes and interpersonal
processes that such groups instigate and the positive findings already reported by
researchers, groups should be considered a proven method for promoting growth
and change.
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