Group therapy is a treatment approach that utilizes a community setting to facilitate specific interventions. Group Cognitive Behavioral Therapy refers to a support group that works to educate group members’ on techniques to improve cognition, relational skills, and impacted behaviors. Group CBT could be an excellent option if you seek a support system throughout your healing journey, so you don’t have to do psychotherapy alone.
What Is Cognitive Behavioral Group Therapy?
Cognitive Behavioral Therapy (CBT) is one of the most common types of therapy. In group CBT, the therapist helps you within a group system to alleviate the pressures of identifying negative thought patterns that negatively impact your behaviors and emotions. CBT groups empower you to reshape your experience by getting to the root of the thought. Any CBT modalities (individual or group therapy), when used consistently for two months, can help relieve feelings of stress and anxiety related to underlying negative emotions.1
Benefits of Group CBT Therapy
Groups offer a powerful support system to help us remember that we are not alone in treating our mental health. Group therapy can bring a lot of rich feedback that you can utilize into an actionable plan with support from others dealing with the same struggles as you. A lot of confidence and feelings of safety can come from normalizing issues in group settings.
The benefits of CBT group therapy can include:
- Increased support networks
- Ability to practice learned techniques in action within a group setting
- New life perspectives through improved self-worth and less negative self-talk
- Increased feelings of fulfillment, progress, and recovery
- Improved interpersonal relationships, reducing interpersonal conflicts
- Opportunities for personal growth learning from other’s experiences
- It provides a safe space to be with others who offer empathy and compassion
- Teaches you how to practice gratitude and structured conversations
Who Is NOT Right for Group CBT?
CBT in a group setting may not be a good fit for everyone as social settings can be an overwhelming experience for some. However, CBT in an individual format will still be helpful for those struggling with mood and behavioral disorders.
Those who should consider individual CBT over group CBT include:
- Those with a history of abuse or trust issues
- Underlying personality disorders
- Social Anxiety
- Social phobias (i.e., Anthrophobia, Glossophobia, Scopophobia)
- Concerns regarding privacy
How Does Group CBT Work?
The basic structure of group CBT includes having a set of ground rules that ask everyone to treat others with respect and maintain the confidentiality of its members. Groups can either be open to allow new members weekly or a closed cohort with the same individuals for however long that group series lasts. Groups are composed of 5-10 individuals per session, and sessions tend to run weekly for 1.5 hours – 2 hours, depending on the group.
Here are five of the basic principles of group CBT:
1. Cognitive Restructuring With Behavioral Experiments
This technique involves identifying negative or unhelpful thoughts and replacing them with healthier ones grounded in reality. Behavioral Experiments allow everyone to observe their beliefs’ validity through new experiences of planned activities to elicit desired behaviors. Cognitive Restructuring challenges your cognition to reframe how you see things, thus changing your thought patterns.
2. Normalization Through Group Identity
Normalization is a big part of group CBT as many people feel that their thoughts are irrational, falling into a negative self-talk cycle. Groups offer support from others so that those needing CBT can receive validation to normalize their experiences. A shared identity can help build a sense of acceptance that allows people to reduce any personal stigma they may have about themselves.
3. Collaborative Therapeutic Relationships
Generally used as an individual-centered technique in CBT, in a group setting it allows members to contribute to everyone’s healing process. Collaboration in group therapy is central to the effectiveness of the safe space to promote healing and recovery. A therapist then fills the role of a facilitator to moderate the group’s response and ensure everyone is processing feedback in healthy ways.
Some encouraged behaviors of group CBT practices include:
- Work together
- Share your thoughts
- Empower each other
- Be honest
- Let yourself be vulnerable
4. In-Vivo Exposure
Groups can be a perfect space to face your fears knowing that you have a room full of supporters who are there to protect you from harm. This technique involves one individual in a group facing the object or idea that is causing a lot of fear and gives them the safe space in the group to face that fear directly.
5. Positive Reinforcement & Vicarious Learning
When we practice new behaviors and challenge our thought patterns, we prove to ourselves that we can successfully redirect ourselves. Groups offer a lot of validation and positive reinforcement, which can help solidify the change. When we struggle in this environment, the proof from others that it is possible empowers us to improve our thoughts of doubt. We learn by observation, and groups allow us to see others like us find triumph.
How Long Is the Timeline for Group CBT?
Group therapy sessions can last from 8-16 weeks. Initially, the session frequency may be more intense, such as two group sessions in one week and then taper off. However, for others, it may remain constant at one group a week for the duration of the program. At the end of the group, the therapist will meet with the individuals to discuss their goals and talk through where they are, and if they have completed their goals, they will graduate.
Some people may take a break after one group program ends and consider joining another program. The therapist may recommend another group or individual therapy if they are still working through their goals.
Factors that affect the timeline of your group CBT treatment include:
- the presenting issue
- the group size
- the age of the participants
It is up to you and the therapist to develop an appropriate treatment plan to help determine when graduation from the program is warranted. Suppose you do not graduate with others in your group. It is not a reflection that you are not doing the work but that you are still making significant progress. Healing is hard and takes time, so remember to keep going at the right pace for you.
Is Group CBT Effective?
Group CBT can be very effective and offer a sense of normalization for issues those in the group are burdened by. Group CBT provides individuals a safe space to practice skills learned and develop these skills in a social setting. The group members feed off each other, and if one or two people are doing well, that energy moves throughout the group.
Group CBT for Depression
CBT for depression has high effectiveness when treating the disorder in a group setting. Symptoms of depression decrease after group CBT and continue to have a lasting impact months after treatment ends. About 50% of those who go through group CBT for depression have reported improved depression symptoms. Months later, into group CBT, that increased to about 60%.2
Group CBT for Anxiety
CBT for anxiety gives individuals in the group the structure of therapy with the availability to practice within the group. Given the psychopathology of anxiety, group CBT has had a significant impact on helping people in these groups manage their thoughts and behaviors. Everyone in these groups has different goals they may be developing. Still, the therapist can help facilitate progress by utilizing strengths from others to help others, which mitigates anxiety and improves their relational skills.3
Group CBT for Other Disorders
Individual CBT has a broad scope in treating various mood and behavioral disorders. The effectiveness of CBT in a group setting is still being explored for additional mental health concerns. Still, there is potential for its broader use based on its impact on symptoms of depression and anxiety.
Some other potential uses for Group CBT include:
How to Find a CBT Therapy Group
If you are already in individual therapy, your therapist may be able to help locate and recommend a group that may fit your needs. If you are not in individual therapy, searching online for group therapists is a great way to find out what is available in your area. Searching an online directory can help you find a therapist treating the issues you wish to address. An initial consultation call to learn about their services can be helpful. They may even be able to share if they are holding groups or refer you to someone who is.
Some questions to ask during a CBT group consultation include:
- Does the therapist align with you and meet your needs?
- Do they have experience with the issues I am facing?
- Do they have experience with groups?
- How big is the group?
- Will new people keep coming, or will it be the same people each week?
- How long will groups last for each session, and how many sessions do groups have?
- Will there be homework?
- Will my information be shared with anyone? What if someone talks about me in a group?
- How much does it cost?
- How will I know if I am doing better?
- Can I stop the group if it’s not right for me?
- Will you be able to be my private therapist if you are my group therapist?
How Much Does Group CBT Cost?
Groups can cost anywhere from $120 per session without insurance to $40 (or less) with insurance. Your insurance may cover group therapy, so it’s noteworthy to work with your provider to understand your benefits. You can also work with your therapists or group facilitators to see how billing works, as each practice’s network and insurance coverages differ. If you have “intensive outpatient behavioral health” as a benefit, you can ask if your group fits into that category.
If groups are not at all covered by insurance, practices or therapists may be able to offer a sliding scale fee. It’s meaningful to get a copy of your benefits and talk with someone in a therapy office who understands it to learn about what that practice can do for you. They may be able to refer you to another therapist that may accept your insurance or research study that does charge participants.
Final Thoughts
What you are dealing with is unique, but you are not alone. Working with a group CBT therapist can make a big difference in how you feel and process things in life with a renewed sense of support. Together you and your group mates will be able to support one another and grow healthier ways of living life together.
For Further Reading
CBT Group Therapy Infographics
