An Overlooked Avenue to Increasing Mental Health and Emotional Wellbeing
Humans thrive from healthy connection with others and support groups provide an untapped potential to find that connection, healing and growth.
By Amir Levine, PhD, LCSW-R
Understanding the Distinction Between Support Groups and Psychotherapy Groups
A support group is a gathering of people, either in person or virtually, who have a common condition, issue or life circumstance in order to receive and offer mutual support and coping skills. Support groups differ from psychotherapy groups, commonly referred to as “group therapy” in a number of ways.
For one, a psychotherapy group is based on a clinical diagnosis as determined by the DSM (diagnostic statistical manual of mental health disorders), whereas a support group does not require a DSM diagnosis and is instead organized around a life theme, issue or concern.
Only licensed mental health professionals can provide psychotherapy treatment, either individual or group therapy, whereas a support group may be facilitated by a professional or by peers depending upon the organization hosting the group.
Also, the fee for weekly support groups usually tends to be lower than the fee for an individual weekly psychotherapy session.
The Therapeutic Benefits of Support Groups
Due to the growing demand for mental health support, group models of care can be an effective modality to reach and help more people. Now that we are in the era of teletherapy, virtual support groups can be utilized to reach a significant number of people who otherwise would be limited in their ability to receive any form of treatment. Additionally, group models of treatment may be a more affordable way for clients who either lack health insurance coverage or who reside in an area with little if any access to care, to receive mental health support.
Most importantly, support groups can provide clients with a unique and vital form of therapeutic support which I refer to as communal relational support which provides participants with:
(1) the feeling that they are part of a larger community who accepts and values them for who they are.
(2) the ability to receive and offer support and thus are empowered with a sense of relational vitality.
(3) avenues to tap into our innate calling towards interconnectedness and to feel part of a bigger whole.
Additionally, support groups have been proven quite effective for a host of different issues. In a series of 11 meta-analyses conducted by Rosendhal, J., et al (2021) encompassing 329 studies, group models of treatment were found to be effective in treating bipolar disorder, schizophrenia, grief, anxiety, OCD, PTSD, and eating disorders. Group models of treatment can also be effective in helping people who struggle with history of discrimination and who are marginalized such as members of the LGBTQ+, minority and immigrant community.
Support groups have never been more important. People are significantly more lonely and isolated than ever before. It is estimated that about 40% of the population in the USA have reported feeling lonely, a situation which is correlated with a significant increase in mental and health related issues. The growing trend of loneliness has many possible causes such as the reduction in attendance to spiritual practices and community organizations, the increase utilization and reliance on technology and the increase in political distrust among different parties. Support groups thus provide another venue to seek out communal relational connection and support.
Overcoming Obstacles to Running Support Groups
Historically individual therapy has been recognized as the primary model of care for clients wanting to work on their mental health and wellbeing. According to research by Stephanie Pappas, clinicians often lack adequate training and awareness as to the benefits of facilitating support groups. Additionally, clinicians may be dissuaded due to the time, effort and logistics it may require to form and run a support group. Also, some clinicians may feel uncomfortable and anxious with the responsibility required to lead or facilitate the group and in managing the expectations of the participants.
Suggestions for forming and managing a support group:
- Choose an issue, problem or population which you as a clinician feel a connection to and you feel drawn to
- Connect with a mentor or supervisor to discuss the emotional and logistical challenges that may be triggered when facilitating a support group
- Clarify screening processes for participants to ensure appropriateness of fit with the group. Some clients may require a higher level of care or have other crises or situations that would be better addressed individually before joining a group.
- Decide what format you wish the group to follow. Different formats can be either a process group which focuses on the relational dynamics between group members, psychoeducational, experiential or support and skills group.
- Identify the topics and issues you would like to address and have a tentative plan for each session.
- Establish whether the group is an “open” group in which new members can join at any time, or if it will be a “closed” group where members can only join in the beginning of the group.
- Specify the group goals, rules and issues regarding confidentiality. Clients should all sign a consent form agreeing to the goals and rules of the group. This is a key issue as clients need to trust that their confidentiality and safety is a top priority.
- Create opportunities for members of the group to share their goals and intentions for the group and why they chose to join.
- Develop and promote group cohesion. During the initial phases of the support group, the facilitator may need to be more proactive in ensuring that everyone is heard and assisting members who are shy or naturally introverted to have a voice and participate in the group in ways commensurate with others.
- It is vital that groups have a culture of kindness, compassion, understanding and values mutual vulnerability. These are cultural attributes that need to be protected and also modeled by the facilitator.
- If a rupture happens between members and/or the facilitator, ensure that it is handled with care and compassion by first listening, understanding, acknowledging and with effort to learn from each one’s experience. Learning to manage conflict effectively can be a huge benefit of support groups.
- It is important that members have the ability to integrate their awareness into their everyday lives. For example members, who have a positive experience at managing conflict in the group can now experiment in applying such practices in their daily life.
- It is important to have a healthy termination process where members acknowledge their growth and process their feelings of the end of the group. During this phase of closure, members can express appreciation to group members for the support they have provided either through direct feedback and/or inspiration. Members can also discuss their hope and intentions for themselves and the group as a whole thereafter.
In Summary: The Power of Support Groups
Support groups have the ability to offer support for the growing mental health demands of our times. Group models of treatment have exhibited clinical effectiveness to treat various mental health conditions and offer support to many people who struggle with emotional difficulties and loneliness. Most importantly, support groups can offer communal relational support which can have significant benefits and can effectively augment individual therapy. Support groups can be a powerful way for participants to gain emotional support and validation, and strengthen social connection, experience stress reduction, learn new coping skills, discover new information about themselves and feel empowered.
References:
Rosendahl, J., et al. (2021). Recent developments in group psychotherapy research. American Journal of Psychotherapy, Vol. 7 (2).
Pappas, S. (2023). Group therapy is as effective as individual therapy, and more efficient. Here’s how to do it successfully. American Psychological Associations, Vol. 54 (2).
