Group Therapy

A comprehensive guide to group therapy: how it works, what to expect, the different types of groups, and the research showing it is as effective as individual therapy for many conditions.

14 min readLast reviewed: March 27, 2026

What Is Group Therapy?

Group therapy is a form of psychotherapy in which a trained therapist works with a small number of people — typically five to twelve — at the same time. Rather than a one-on-one conversation between client and therapist, group therapy uses the interactions between group members as a central part of the healing process.

The idea is both simple and powerful: many of the difficulties people face — loneliness, shame, difficulty in relationships, feeling misunderstood — are relational problems. And relational problems are best worked through in a relational setting.

Group therapy is not a lesser version of individual therapy. It is a distinct modality with its own evidence base, its own mechanisms of change, and, for many conditions, outcomes that match or exceed what individual therapy can achieve.

How Group Therapy Works: Yalom's Therapeutic Factors

In the 1970s, psychiatrist Irvin Yalom identified 11 therapeutic factors — the mechanisms through which group therapy produces change. These factors remain the theoretical foundation of group therapy today:

Instillation of hope: Seeing others who have faced similar struggles and made progress gives you genuine reason to believe change is possible.
Universality: Discovering that you are not alone in your suffering. Many people enter therapy believing their problems are uniquely shameful or abnormal. Hearing others share similar experiences can be profoundly relieving.
Imparting information: Learning from both the therapist and other group members — psychoeducation, coping strategies, and practical guidance.
Altruism: Helping other group members, which increases your own sense of competence and self-worth. Being useful to others is therapeutic in itself.
Corrective recapitulation of the primary family group: Many groups come to resemble a family, with the therapist in a parental role and members as siblings. This allows you to re-experience and rework family dynamics in a healthier environment.
Development of socializing techniques: Learning and practicing interpersonal skills through direct interaction with others, with real-time feedback.
Imitative behavior: Observing how others handle situations — including the therapist — and trying out those approaches yourself.
Interpersonal learning: The group becomes a social microcosm where your typical relational patterns emerge. With feedback from the group and the therapist, you can see these patterns clearly and experiment with new ways of relating.
Group cohesiveness: The sense of belonging, acceptance, and trust that develops within the group. Cohesiveness is to group therapy what the therapeutic alliance is to individual therapy — the foundation on which all other work rests.
Catharsis: Expressing deep emotions in a safe, accepting environment. Catharsis is most therapeutic when it occurs within a cohesive group where the emotional expression leads to understanding and connection.
Existential factors: Confronting fundamental realities of human existence — that life is sometimes unfair, that suffering is part of being human, that each person is ultimately responsible for their own life — within the shared experience of the group.

Not every factor operates in every group at every moment. Different types of groups emphasize different factors. But together, they explain why group therapy works: it provides an environment where people can be truly seen, feel genuinely connected, and practice new ways of being — all at the same time.

Types of Group Therapy

Group therapy is not one-size-fits-all. Different types of groups serve different purposes, and understanding the distinctions can help you find the right fit.

Process Groups (Interpersonal Groups)

Process groups are the most traditional form of group therapy. They focus on what is happening between members in the room, in real time. Rather than discussing outside problems in detail, a process group uses the interactions within the group — the alliances, tensions, reactions, and emotions that emerge — as the material for therapy.

A process group therapist might ask, "What are you feeling right now as you listen to Sarah share that?" or "I notice you tend to go quiet when conflict comes up in the group. What's happening for you in those moments?"

Process groups are particularly effective for people who struggle with relationship patterns, social anxiety, loneliness, or difficulty understanding how they come across to others.

Duration: Typically ongoing (6 months to several years), meeting weekly for 75-90 minutes.

Cognitive-Behavioral Groups

These groups apply CBT principles in a group format. They are structured, time-limited, and focused on specific conditions — such as anxiety, depression, or insomnia. Sessions follow a curriculum, with psychoeducation, skills practice, and homework.

The group format adds an important dimension: members practice skills together, share their experiences with techniques like thought challenging or behavioral activation, and hold each other accountable between sessions.

Duration: Typically 8-16 sessions.

Psychoeducational Groups

Psychoeducational groups prioritize teaching. They focus on providing information about a specific topic — such as stress management, anger management, parenting skills, or understanding a diagnosis. While interaction between members is encouraged, the primary emphasis is on learning content rather than processing emotions or interpersonal dynamics.

Duration: Typically 4-12 sessions.

Support Groups

Support groups provide a space for people facing a shared experience — grief, chronic illness, caregiving, divorce, recovery — to connect and support one another. They may be led by a professional or by peers who share the experience.

Support groups emphasize universality and mutual aid rather than formal therapeutic techniques. They are often ongoing and open, meaning new members can join at any time.

Duration: Ongoing, with no set endpoint.

Skills Training Groups

Skills training groups focus on teaching and practicing specific coping or interpersonal skills. The most well-known example is the DBT skills group, which teaches mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness over a structured curriculum.

Other examples include social skills groups, assertiveness training, and anger management skills groups.

Duration: Typically follows a set curriculum (e.g., 24 weeks for DBT skills groups).

Name	Focus	Best For	Duration	Format
Process Group	Interpersonal dynamics and relational patterns	Relationship difficulties, social anxiety, self-understanding	Ongoing (6+ months)	Open-ended discussion, here-and-now focus
CBT Group	Changing thoughts and behaviors for a specific condition	Anxiety, depression, insomnia, specific phobias	8-16 sessions	Structured curriculum with homework
DBT Skills Group	Teaching four core skill modules	Emotional dysregulation, BPD, self-harm	24+ weeks	Psychoeducational with practice exercises
Support Group	Mutual aid and shared experience	Grief, chronic illness, recovery, life transitions	Ongoing, open membership	Peer-led or professionally facilitated sharing

What Conditions Does Group Therapy Treat?

Group therapy is effective for a remarkably wide range of conditions. For many of these, research shows outcomes comparable to individual therapy:

Depression: CBT-based and interpersonal groups have strong evidence. A meta-analysis in Psychotherapy and Psychosomatics found group CBT to be as effective as individual CBT for depression.
Anxiety disorders: Including generalized anxiety, social anxiety, and panic disorder. Group CBT for social anxiety is particularly well-studied and may offer unique advantages, since the group itself provides a natural exposure environment.
Substance use and addiction: Group therapy is a cornerstone of most addiction treatment programs. Twelve-step facilitation, relapse prevention groups, and process-oriented groups all have evidence supporting their use.
PTSD and trauma: Group-based CPT (Cognitive Processing Therapy) and other trauma-focused groups have demonstrated effectiveness, particularly for veterans and survivors of shared traumatic experiences.
Grief and bereavement: Support and process groups provide a space to grieve alongside others who understand the experience.
Eating disorders: Group therapy is commonly used in eating disorder treatment, both in outpatient and intensive settings, often combining psychoeducation with process-oriented work.
Social anxiety: The group setting provides built-in exposure to the social situations that trigger anxiety, making it uniquely well-suited for this condition.
Personality disorders: DBT groups for borderline personality disorder and schema therapy groups have strong evidence bases.
Chronic pain and medical conditions: Groups help manage the psychological impact of chronic illness and provide mutual support.

What to Expect in a Group Therapy Session

If you have never been to group therapy before, it is natural to feel anxious. Most people do. Here is what you can expect:

Before the Group Starts

Most group therapists conduct an individual screening session before you join. This serves several purposes:

Assessing whether the group is a good fit for your needs
Preparing you for what to expect
Answering your questions
Ensuring the group composition will work (therapists carefully consider the mix of members)

The First Session

The therapist will typically establish ground rules, including:

Confidentiality: What is shared in the group stays in the group. This is the most important norm.
Attendance: Regular attendance is essential for the group to function. Most groups ask for a commitment of a minimum number of sessions.
Respectful communication: Listening without interrupting, speaking from personal experience rather than giving advice, and being honest but kind.
No outside socializing: Many process groups discourage or prohibit members from socializing outside the group, as it can complicate group dynamics.

You will not be forced to share before you are ready. Most therapists encourage new members to take their time and observe before jumping in.

A Typical Session

Sessions usually last 60 to 120 minutes, depending on the type of group:

Process groups: 75-90 minutes. Sessions typically begin with a brief check-in, then open into unstructured discussion guided by the therapist. The therapist helps the group notice patterns, explore emotions, and give each other feedback.
CBT/skills groups: 60-120 minutes. Sessions follow a more structured format with a set agenda, psychoeducation, skills practice, and homework review.
Support groups: 60-90 minutes. Members take turns sharing, with the facilitator ensuring everyone who wants to speak has the opportunity.

Group Size

Most therapy groups include 5 to 12 members. This range is large enough to provide diversity of perspectives and relational dynamics, but small enough that each member gets individual attention and airtime.

5-12 members

The ideal group therapy size — large enough for diverse perspectives, small enough for meaningful connection and individual attention

Benefits of Group Therapy

It Works — The Research Is Clear

Group therapy is one of the most well-studied forms of psychotherapy. Here is what the evidence shows:

329 randomized controlled trials involving more than 27,000 patients have demonstrated that group therapy is effective across a wide range of conditions.
The American Psychological Association recognizes group therapy as equivalent to individual therapy in effectiveness for most conditions.
A landmark meta-analysis by Burlingame, Strauss, and Joyce (2013) found no clinically significant difference between group and individual therapy outcomes for depression, anxiety, substance use, and eating disorders.
Group therapy is especially effective for conditions with an interpersonal component, such as social anxiety, relationship difficulties, and personality disorders.

Unique Benefits Individual Therapy Cannot Provide

Beyond equivalence with individual therapy, group therapy offers advantages that a one-on-one setting simply cannot:

You realize you are not alone. The experience of universality — hearing others articulate the exact thoughts and feelings you believed were unique to you — is one of the most powerful experiences in therapy.
You get multiple perspectives. Instead of one therapist's viewpoint, you receive feedback and insight from several people with different life experiences.
You practice skills in real time. The group is a living laboratory for interpersonal learning. You can try new ways of communicating, setting boundaries, or expressing vulnerability — and get immediate, authentic feedback.
You help others, and it helps you. The act of supporting someone else in the group boosts your own sense of competence and self-worth.
You see your patterns more clearly. The way you behave in the group tends to mirror the way you behave in life. With gentle feedback from others, you can see blind spots that may never surface in individual therapy.

Cost Effectiveness

Group therapy is significantly more affordable than individual therapy:

$15-$50 per session

The typical cost of group therapy — approximately 25-50% of the cost of individual therapy. Research estimates group therapy could save the U.S. healthcare system $5.6 billion annually.

Group therapy sessions typically cost $15 to $50 per session, compared to $100-$250+ for individual therapy.
This represents approximately 25-50% of the cost of individual therapy.
Many insurance plans cover group therapy with the same benefits as individual therapy.
Research published in the American Journal of Managed Care has estimated that wider adoption of group therapy could save the U.S. healthcare system approximately $5.6 billion annually without sacrificing outcomes.

Who Is Group Therapy Best For?

Group therapy may be a strong fit if you:

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Feel isolated, lonely, or like nobody truly understands what you're going through
Struggle with relationships or notice the same interpersonal patterns repeating
Want to build social confidence or practice social skills in a safe environment
Are dealing with a condition that benefits from shared experience (grief, addiction, chronic illness)
Want an affordable option that does not sacrifice quality
Have done individual therapy and want to take your growth further
Want feedback from multiple perspectives, not just one therapist's
Are in a DBT program and need the skills group component
Want to learn that your struggles are more common than you think

Note: This is not a diagnostic tool. It is provided for informational purposes only. Please consult a qualified healthcare professional for diagnosis and treatment.

Who Might Prefer Individual Therapy First

Group therapy is not the right starting point for everyone. You may want to begin with individual therapy if:

You are in acute crisis (active suicidal ideation, severe self-harm, psychosis) and need intensive one-on-one support before joining a group.
You have severe social anxiety to the point where joining a group feels completely impossible. In this case, individual therapy can help you build enough skills to eventually benefit from group work.
You need to process highly personal material (such as detailed trauma memories) that requires the privacy and pacing control of individual therapy.
You have difficulty maintaining confidentiality or respecting others' boundaries, which could disrupt the group.

Many people benefit from doing both individual and group therapy simultaneously. Individual therapy provides a private space to process personal material, while group therapy offers the relational practice and diverse perspectives that individual therapy cannot.

Online vs. In-Person Group Therapy

The expansion of telehealth has made online group therapy widely available. Both formats have advantages:

In-Person Groups

Easier to read body language and nonverbal cues
Stronger sense of physical presence and connection for some people
Fewer technological barriers
Better suited for experiential techniques (role-playing, art-based exercises)

Online Groups

Greater accessibility for people in rural areas, those with mobility challenges, or those with demanding schedules
Can feel less intimidating for people with social anxiety
No commute time
Evidence from studies during and after the pandemic suggests that online groups can be as effective as in-person groups for many conditions, though some participants report finding it harder to build the same depth of connection through a screen

The best choice depends on your personal preferences, practical constraints, and the type of group. Process groups, which rely heavily on interpersonal nuance, may benefit more from in-person meetings. Psychoeducational and CBT-based groups often translate well to online formats.

How to Find a Group

Finding the right group requires a bit of research, but several resources can help:

Ask your individual therapist. If you are already in individual therapy, your therapist can often recommend groups that fit your needs and may know group leaders personally.
Contact local mental health clinics and training centers. Many clinics, university counseling centers, and psychoanalytic training institutes offer therapy groups at reasonable rates.
Check with your insurance provider. Many insurers maintain directories of covered group therapy options.
Search online directories. Psychology Today, the American Group Psychotherapy Association (AGPA), and SAMHSA's treatment locator all include group therapy options.
Ask about the therapist's training. Look for a group leader with specific training in group therapy. The Certified Group Psychotherapist (CGP) credential from the AGPA indicates specialized training and supervision.

When evaluating a group, consider:

Is it the right type? Make sure the group's format (process, CBT, support, skills) matches what you are looking for.
Is the focus relevant to you? Some groups are condition-specific (depression, grief, addiction); others are broader (general interpersonal growth).
What is the time commitment? Closed groups with a set start and end date require different planning than ongoing open groups.
Does the leader do a screening interview? A good group therapist screens all prospective members. This is a sign of a well-run group.

Understanding Group Therapy

Group Therapy Compared

For Specific Conditions and Populations

Frequently Asked Questions

Yes, for most conditions. A comprehensive review of 329 randomized controlled trials found that group therapy produces outcomes equivalent to individual therapy for depression, anxiety, substance use, eating disorders, and many other conditions. For some issues — particularly those with a social or relational component like social anxiety — group therapy may actually be more effective because it provides real-time interpersonal practice.

No. You will never be pressured to share more than you are comfortable with. Most group therapists encourage new members to take their time, observe, and participate at their own pace. Over time, as trust builds, most people find they naturally want to share more — but it is always your choice.

This is uncommon, but if it happens, the group therapist will address it directly. In some cases, one of you may be moved to a different group to protect confidentiality and comfort. If you have concerns about running into someone you know, discuss this with the group leader before joining.

It depends on the type of group. Time-limited groups (CBT-based, psychoeducational, skills training) typically run 8 to 24 sessions. Process groups and support groups are often ongoing, with members joining for 6 months to several years. Most group therapists ask for a minimum commitment of 12 to 16 sessions so you can experience the full benefit.

Yes, and many clinicians recommend it. Individual therapy provides a private space for personal processing, while group therapy offers relational practice, diverse perspectives, and the experience of being part of a community. The two formats complement each other well.

Group therapy typically costs $15 to $50 per session, roughly 25-50% of the cost of individual therapy. Many insurance plans cover group therapy. Some clinics and training centers offer groups on a sliding scale. Given that research shows equivalent outcomes to individual therapy, group therapy is one of the most cost-effective mental health treatments available.

Confidentiality is a foundational rule in every therapy group. All members agree not to share what others have said outside the group. However, unlike individual therapy, the therapist cannot guarantee that every member will uphold this rule — it depends on the integrity of the group members. That said, breaches of confidentiality in therapy groups are rare, and therapists take this norm very seriously.

It might feel that way, but group therapy is actually one of the best treatments for social anxiety. The group provides a safe, structured environment to practice the very social interactions that cause anxiety — with support, feedback, and gradual exposure. Many social anxiety treatment protocols are specifically designed for group delivery. If your anxiety feels too severe to start in a group, individual therapy can help you build skills first.

Find a Therapy Group

Group therapy offers the connection, perspective, and support that can transform your healing. Connect with a therapist who can help you find the right group for your needs.

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