54 Introduction to Therapy and the Psychological Therapies

54.6 Group and Family Therapies

54-7 What are the aims and benefits of group and family therapies?

Please continue to the next section.

Group Therapy

Except for traditional psychoanalysis, most therapies may also occur in small groups. Group therapy does not provide the same degree of therapist involvement with each client. However, it offers many benefits:

It saves therapists’ time and clients’ money, often with no less effectiveness than individual therapy (Fuhriman & Burlingame, 1994).
It offers a social laboratory for exploring social behaviors and developing social skills. Therapists frequently suggest group therapy for people experiencing frequent conflicts or whose behavior distresses others. For up to 90 minutes weekly, the therapist guides people’s interactions as they discuss issues and try out new behaviors.
It enables people to see that others share their problems. It can be a relief to discover that you are not alone—to learn that others, despite their composure, experience some of the same troublesome feelings and behaviors.
It provides feedback as clients try out new ways of behaving. Hearing that you look poised, even though you feel anxious and self-conscious, can be very reassuring.

Family Therapy

Family therapy This type of therapy often acts as a preventive mental health strategy and may include marriage therapy, as shown here at a retreat for military families. The therapist helps family members understand how their ways of relating to one another create problems. The treatment’s emphasis is not on changing the individuals but on changing their relationships and interactions.

One special type of group interaction, family therapy, assumes that no person is an island: We live and grow in relation to others, especially our families. We struggle to differentiate ourselves from our families, but we also need to connect with them emotionally. Some of our problem behaviors arise from the tension between these two tendencies, which can create family stress.

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Unlike most psychotherapy, which focuses on what happens inside the person’s own skin, family therapists work with multiple family members to heal relationships and to mobilize family resources. They tend to view the family as a system in which each person’s actions trigger reactions from others, and they help family members discover their role within their family’s social system. A child’s rebellion, for example, affects and is affected by other family tensions. Therapists also attempt—usually with some success, research suggests—to open up communication within the family or to help family members discover new ways of preventing or resolving conflicts (Hazelrigg et al., 1987; Shadish et al., 1993).

Self-Help Groups

Many people also participate in self-help and support groups (Yalom, 1985). One analysis of online support groups and more than 14,000 self-help groups reported that most support groups focus on stigmatized or hard-to-discuss illnesses (Davison et al., 2000). AIDS patients, for example, are 250 times more likely than hypertension patients to be in support groups. Those struggling with anorexia and alcohol use disorder often join groups; those with migraines and ulcers usually do not. People with hearing loss have national organizations with local chapters; people with vision loss more often cope on their own.

With more than 2 million members worldwide, AA is said to be “the largest organization on Earth that nobody wanted to join” (Finlay, 2000).

The grandparent of support groups, Alcoholics Anonymous (AA), reports having 2.1 million members in 115,000 groups worldwide. Its famous 12-step program, emulated by many other self-help groups, asks members to admit their powerlessness, to seek help from a higher power and from one another, and (the twelfth step) to take the message to others in need of it. In one eight-year, $27 million investigation, AA participants reduced their drinking sharply, although so did those assigned to cognitive-behavioral therapy or to an alternative therapy (Project Match, 1997). Other studies have similarly found that 12-step programs such as AA have helped reduce alcohol use disorder comparably to other treatment interventions (Ferri et al., 2006; Moos & Moos, 2005). Those whose personal stories include a “redemptive narrative”—who see something good as having come from their experience—more often sustain sobriety (Dunlop & Tracy, 2013). Also, the more meetings members attend, the greater their alcohol abstinence (Moos & Moos, 2006). In one study of 2300 veterans who sought treatment for alcohol use disorder, a high level of AA involvement was followed by diminished alcohol problems (McKellar et al., 2003).

In an individualistic age, with more and more people living alone or feeling isolated, the popularity of support groups—for the addicted, the bereaved, the divorced, or simply those seeking fellowship and growth—seems to reflect a longing for community and connectedness. More than 100 million Americans belong to small religious, interest, or self-help groups that meet regularly—and 9 in 10 report that group members “support each other emotionally” (Gallup, 1994).

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For a synopsis of the modern forms of psychotherapy we’ve been discussing, see TABLE 54.2.

Table 54.2
Comparing Modern Psychotherapies

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To review the aims and techniques of different psychotherapies, and assess your ability to recognize excerpts from each, visit LaunchPad’s PsychSim 6: Mystery Therapist.