Psychotherapy, therapy or counselling has become more and more acceptable, with old and young flocking to find a therapist of choice, in much the same way that people log in online and look for a local family doctor taking new clients. We all want our own person to talk to, to work through the difficulties we have faced in the past, and that seem to still haunt us today, and to help us tackle the immediate challenges we are dealing with in the present.
And all this occurs within the context of a one on one relationship with a therapist – individual psychotherapy. Couples counselling is of course a highly coveted addition to the one on one therapy, and family therapy is beginning to be accepted as a small selective group therapy unit that can address specific concerns related to a family, family dynamics, the addition of a new family member, death or breakdown of relationships within the family unit.
Group therapy, however, is seen as the ugly stepsister. It gets poor rap, frequently being seen as the cheaper, less effective therapeutic options. Those who access OHIP funded mental health services may find themselves signed up for a CBT group for anxiety, others may be ‘persuaded’ to join an anger management group. But there isn’t a plethora of privately-run, or publicly-funded, group therapy options.
This is a shame, and does not give due recognition to the efficacy of groups to facilitate healing. Group therapy plays a vital role in the healing journey of children youth and adults experiencing mental health challenges.
1. Let’s You Know You Are Not Alone
Group therapy bring together a small number of individuals who are experiencing similar challenges. It creates a safe space, where those who are frequently isolated and alienated by their illness, can meet together, build supportive relationships, find companionship and sense of belonging.
I am frequently struck, by the common theme of loneliness that I hear from the lips of so many of my clients.
As human-beings, as men, women, teens, and children we are intrinsically social. We need to be part of a community of fellow human-beings. We need to feel connected, to feel loved, cherished and esteemed.
Remember Barlow’s monkey’s, the monkeys wanted the ‘cloth-monkey’, even if the cloth-monkey didn’t provide the milk. We all need to be connected.
In the popular Netflix series, ‘Prison Break’, we witness the brutality of solitary confinement or ‘the shoe’, as the inmates refer to it.
2. Breaks the Cycle of Isolation
No one wants to be alone. We may choose to self-isolate for a while to rest, to reflect, and to redirect. Some may self-isolate as part of the drive to protect themselves from what they believe to be a hostile world. And many begin to self-isolate as part of a decline in their mood, and a loss of confidence in their ability to interact with other people outside their immediate circle.
These isolations can be self-perpetuating and self-reinforcing, and very difficult to break out of. Anxiety drives us to avoid, and when we avoid other people, and other places, it becomes ever more difficult to shift from avoidance to engagement – ask anyone who has stopped going to school/work for any length of time and is trying to get back to school/work. Depression at its worst pushes us to turtle inward, locking ourselves inside our homes, rooms, and detaching from even the social interactions that occur virtually.
Individual therapy – can be great. It gives that person one person who can hear them, relate to them, support them, and encourage them to move beyond the confines of their own anxiety and/or depression. But, individual therapy, doesn’t do anything very much to foster a person’s relationships with other people, to help the kid in the playground walk across and kick the ball to a would-be friend, or the teen set their phone aside and ask their peer if they want to hang out at lunch.
Individual therapy can help them get there, but the path may be slow, and it may be lonely. Many kids, teens, and even adults who are experiencing symptoms of anxiety and depression struggle with feelings of being different to their friends. They often feel as if there is something wrong with them, and oh so often, feel like they are the only ones who feel this way, the only ones who are ‘weird’ or ‘crazy’, or just different.
Group therapy breaks down that wall of isolation. It takes the individuals who are struggling with horrible feelings of internal angst, sadness and fear, and introduces them to other people their own age who feel the same way.
I wish that I had a magic wand that I could wave, that would draw the curtain not only on what mental illness is, how it feels, and how utterly ghastly it can be, but also on the isolation that sets in around those suffering with mental illness.
3. Creates Opportunities for You To Have Positive Experiences Relating to Peers
The craziest thing is I have known clients admitted to hospital, teens lonely, depressed, suicidal, crippled by anxiety, and told by the hospital staff, ‘you shall not talk to anyone else on the ward’. And the kids try to obey, try to follow the rules, but when the night falls, the families go home, and the staff drift away to the offices, these kids meet, they hang out, they talk, and they find, sometimes for the very first time, that they are not alone, that there are others, many others out there that are battling some of the same demons they themselves are battling.
Group therapy isn’t just about education. Education has a place, and can be incredibly illuminating and life changing. But group therapy is far more than education, it is about relationships. It is about taking a child, or tween or teen that has struggled to find a ‘best friend’, or even any friend, who has walked to school alone, eaten lunch alone, and often been bullied, and providing them with a safe place, where they can create relationships, experience what friendship looks and feels like, and begin to build the skills and confidence they need to translate those friendship-making roles into the school community.
Kids need kids, tweens need tweens, and teens need teens.
We can be awesome parents, second-to-none, but we can never be our son’s or daughter’s peer.
4. Fosters Self-Development, Self-Esteem, and Self-Confidence
From the age of 8 years, a kid’s primary relationships are with their peers, not with their parents! It is in relationship with their peers that they work out who they are as little people, how they role, what they like, what they don’t like, and how to do social in the real-world. That all happens in the context of peer-to-peer relationships, not in the context of the nuclear family. As parents we can’t give that to our kids. We can facilitate that, we can encourage that, we can set them up in environments that nurture those peer-to-peer relationships, but we can’t be our kids peer.
That’s why we have groups. As a group of individuals, we are a whole lot more than the number of individual parts. As groups in therapy, we become much more than the sum of the individual persons, or the process of individual therapy.
5. Opens Up A Conversation about Mental Health
Yes, education can and does play a vital role in group therapy. The extent to which a group is primarily psycho-educational, or leaning more heavily toward social interaction and support, is highly dependent on what the group was set up for, and who is running the group.
I find that any teen who has attended therapy, or been admitted for any length of time to hospital often has a pretty good understanding of the basic concepts of Cognitive Behavioural Therapy, (CBT). What they lack is often the therapeutic relationship with a therapist, and/or other teens. And it is only within the context of those relationships that any real learning, or growth can occur. ‘Getting-better’ isn’t about following a cut-out rule worksheet, or reading a workbook. While the business of self-help books still blossoms, in my opinion there is limited benefit in giving anyone, much less a teen, a work book to ‘work through’ to get better. If they were able to do that, they probably wouldn’t be sick!
That isn’t to say that the assumption is that anyone who attends group ‘knows CBT’, but more that there is more to getting better than mastering the skills CBT or any other therapy for that matter offers.
What groups can offer, is a great place, to explore how teens understand mental health, and mental ill-health, how families, schools and society has responded to them, when they have been unwell. What they have found to be the benefits and challenges of the treatments offered, as well as what they can teach, and offer one another by way of support and encouragement.
6. Teaches a Whole Bunch of Practical Skills
So, yes, the groups will teach, and practice the use of a whole load of theoretical and practical skills to help kids, teens and adults flourish in life, while experiencing the unique challenges of living with a mental health diagnosis.
But it is most definitely not school!
The kid’s groups are full of spilling and splattering paint, and bashing on a wide assortment of drums, and the teen groups would die if they went anywhere near being like-school!
I invite you to join us in any one of the many groups we have running this fall. If you have any questions about what groups you, or your family, might enjoy and benefit from give us a call, and ask. If you have any questions or concerns about how groups run or function just let us know.
We want to be a community of people who offer a wide range of services to meet the mental health needs in our community. Group therapy is an exciting addition to the existing individual therapy options we already have available.