The Theory and Practice of Group Psychotherapy

"I came across it when I first started working with patients in the National Health Service. We had much more demand than we could possibly meet. So it was of practical interest: could we use group therapy? I soon realized that that can’t be the main rationale for using a therapy, that you can treat lots of people at the same time. But, actually, it was a very effective form of treatment. In many instances, group therapy is more effective than individual therapy. Yalom’s book was really helpful. All the way through, my question is: ‘What on earth is happening, and how can I make sure it’s most effective?’ What Yalom said—from his clinical experience, but later backed up by researchers including some of my own studies—was that there are 11 curative factors that can describe what is going on. “In many instances, group therapy is more effective than individual therapy” So, I found the book very helpful because it does focus on what the curative factors are. This is going back to my central question: how do people change? The two key factors, according to Yalom and subsequent studies, are group cohesiveness (which is people’s need to belong to a group) and interpersonal learning (which is what you learn from other people.) So, it’s not the centrality of the therapist that really matters; it’s social. It’s the group: it’s the other patients who are working the change. Most people come to therapy because they’ve got difficulty with other people either in their present or in their past. It’s helping people to learn more about those things by learning together, which is a really key factor. It’s interesting. It’s a very exhilarating experience, being in group therapy. Because, yes, there’s a lot going on, but you’re not there on your own—you’re there with a whole lot of people who want to understand themselves. It’s like being in a laboratory. People can find out: ‘Am I really the awful person I think I am?’—which is what people coming to therapy may be thinking—or, ‘Am I as different from others as I think I am?’ People then have the experience of learning together. It’s a wonderful experience to be there with a group which is working well and helping group members to understand themselves. It’s very exciting. Almost more so than individual therapy because there’s so much happening."