How does Group Psychotherapy work?
Research studies  show that group members identified these group-therapeutic factors as most important.
1. Self-understanding – members described the value of discovering positive parts of themselves through the ability to care for another, to relate closely to others and to experience compassion. As members gain a fuller access to themselves, they become emboldened and feel increased ownership of their person/self, including getting to know those parts that felt negative or 'bad' (envy, jealousy, anger, irritation etc.).
The most commonly cited factor in this study was,
"Discovering and accepting previously unknown or unacceptable parts of myself'"
2. Catharsis – an intense emotional experience – an essential component of group process and a commonly identified factor in research. It is necessary but in itself, insufficient because it needs to be accompanied by the ability to reflect and learn at a cognitive level.
These factors capture the sense of liberation and the skills needed for the future:
"Being able to say what was bothering me instead of holding it in"
"Learning how to express my feelings"
"Expressing negative and/or positive feelings toward another member"
3. Cohesiveness - acceptance, intimacy and understanding as a group norm. Regular attendance and group cohesiveness are strongly co-related in a new/immature group. Continued attendance is a prerequisite for successful treatment. Studies show that members who attend for 4-5 months have better outcomes than people who stop attending within 12-14 weeks. A cohesive group takes time to develop; such a group has norms that encourage open expression of disagreement and conflict alongside expressions of support, acknowledgement, care and acceptance that are valued by members:
"Belonging to and being accepted by a group"
4. Interpersonal learning. The need to be closely related to others is viewed as basic as any biological need; the individual develops a concept of the self that is based on the perceived appraisals of significant people in his or her life. This process of constructing our self-regard, on the basis of reflected appraisals that we 'read' in the eyes of others, continues through the developmental cycle. Research shows that satisfying peer relationships at adolescence, for instance, are important for self-esteem. Early appraisals that are negative may become the basis for a person's appraisal of the self. Interpersonal learning through the validation of others is the process for correcting distorted emotional experiences. Members identified the following factors as important:
"Other members honestly telling me what they think of me"
"The group's teaching me about the type of impression I make on others"
"Learning how I come across to others"
"Feeling more trustful of groups and of other people"
"Learning that I sometimes confuse people by not saying what I really think"
5. Existential factors – these are the factors that relate to human existence and our confrontation with the human condition – our mortality, our freedom and our responsibility for constructing our own life design. Existential factors are highly valued by members but in and of themselves are insufficient. The most commonly cited of existential factors is:
"Learning that I must take ultimate responsibility for the way I live my life no matter how much guidance and support I get from others"
6. Identification – a transitional factor that permits members to engage more fully in therapy and other aspects of their lives. Members identified this factor as very important:
"Seeing that others could reveal embarrassing things and take other risks and benefit from it helped me to do the same"
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 This data was compiled from 20 long-term therapy groups for the worried-well experiencing, for instance, depression, low self-esteem, isolation, and relationship difficulties. Members, on average, attended group therapy for 16 months. All the members in this study were about to finish or had recently finished group therapy and external, independent checks were conducted to ensure that the members were successfully treated through group therapy.
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