Pros And Cons Of Group Therapy

The Encounters of Group & Individual Therapy
Lori Edwards Azuru
Liberty University

Abstract
This research paper discusses the topic of the dissimilarities, as well as the pros and cons of individual and group therapy. Discussing the history of group therapy and visiting its early development, while discovering its advancement into the twenty-first century. Examining the origins of individual therapy, and those who laid a foundation for others to build upon. This paper will also go into detail when dealing with the challenges of a falling economy, changing healthcare, and how clients, and leaders of the help professions are affected by these issues. Lastly, discuss why one would choose group counseling verses
individual therapy. Concluding by discussing the leadership qualities and ethics that are needed when dealing with conflicts in groups.
Keywords: individual, group, counseling, therapy, ethics

The Encounters of Group & Individual Therapy
People often feel a sense of loyally to groups or persons who have helped them overcome obstacles in their lives. Based upon how one was raised, it is likely to be predisposed to a certain way of doing things. A child that was raised in a rural community in a small town may feel the need for privacy, in comparison to a child that was raised in a three generation home where one is privileged to have the restroom themselves, if only for a few minutes. On the contrary, there is a possibility that one could have grown up in that same small rural town who longed to connect with others, and find some commonality. What causes one person prefer to join a group while others may want to seek out individualized help, and more importantly is there a difference. This paper will explore group and individual therapy, what are the differences, and which one is considered more effective.
This paper will also explore case studies that involve those individuals who were treated in group therapy compared those who were treated individually, including the pros, cons, and what the outcomes are. It will also address the ethics that are involved, including privacy issues, and the major leadership challenges that therapist face when dealing with these complicated matters. The conclusion of this study will be founded on the results of the subjects that are discussed in the research findings. Choosing between group therapy and individual counseling can be confusing for many, as well as challenging; understanding the specifics about group therapy practices, benefits, and disadvantages can help one to make an informed decision about which type of treatment process is right for them (Hill, 1990).
According Jonathan Engel (2008), author of American Therapy: The Rise of Psychotherapy in the United States, there has been a major shift in the way that psychotherapy is administered. Many psychotherapist have been fortunate enough to witness extraordinary changes over the course of his or her careers. Very few therapists have adhered exclusively to their original training in the effort to relieve their clients’ their emotional pain. These changes include modernizations in treatment, client expectations, and the availability of healthier medications. The modernized therapists’ are now more sophisticated and complex in the understanding of people’s discomfort, and are improving on the development of treatment plans that address the sole needs of the individual (Haggerty, 2014). “Staying current with evolving research and adapting is a part of the responsibility of being a therapist”, the end outcome is that the American therapist of today is usually diverse in orientation and training (Engel, 2008). Many psychologists, psychiatrists and social workers are now deviating from their former dependence of the early methods of Freud. This deviation has caused many therapist to depend on the outcomes of current research (Engel, 2008). This is also true for the current social worker, who initially focused on poverty, illiteracy and underprivileged; they too have begun to cultivate their practice in hope that they could focus more on their client’s interpersonal and personal problems (Hill, 1990). Consequently, this shift has caused the origins of psychiatry, psychology, and social work, who were originally diverse, to appear to be similar when it comes to dealing with the modern client’s needs. These shifts have led to competition for patients, which has required the help professions to work harder, and become more accountable to the client, in order to accomplish more in each session.
Not only has accountability changed, the cost of individual sessions has increased. As a result sessions have now become shorter and more focused, rather than the former long-term analysis. This has also led to the possibility of more clients being treated, by utilizing group therapy (Engel, 2008). Although Group therapy has become more popular in the last decade, there was a time when it was looked at negatively, meaning it was thought to be intended for those who were substance abusers, as well as, court ordered to attend such meetings as Alcohol Anonymous, and other group therapy programs (Council on Alcoholism & Drug Abuse, 2015). However, group therapy is now a widespread form of counseling; support groups and other types of therapy groups are formed daily, and are in every city. These diverse groups are formed to deal with every kind of disease, syndrome or communal issue (Simmerman, 2007). History of Group Therapy The origins of group therapy dates back to the early 1900’s, during this time many patients suffered from
tuberculosis. Because the treatment was successful, several therapist continued to utilize the group therapy treatment to those who suffered from the emotional effects of WW II. By the mid 1950’s group therapy had begun to take shape in London, England. It was Kurt Lewin who coined the term “group dynamics” in a commentary he wrote in 1947; his theory was known as the “Systems Theory: The group whole is greater than the sum of its parts” (Schachter, 2015).
Lewin believed that a group that was established could accomplish much more than a single individual. He also agreed that further knowledge could be gained by these unified groups, rather than by assessing members individually. He described this concept as the means by which groups and individuals act and react to unstable conditions. This field emerged as a theory devoted to the development of knowledge concerning the nature of groups, including the way they form, grow, including their connections with other groups, individuals and establishments (Haggerty, 2014). Many did not agree with Lewin’s philosophy during the early years of research on group processes, and sadly enough numerous psychologists rejected the validity of group phenomena. Critics shared the belief that groups did not occur as systematically valid entities. Soon others would emerge on the scène with their own theories about group therapy and therapeutic factors (Schachter, 2015). Irvin D. Yalom M. D. was born in Washington, D.C., June 13, 1931. This Emeritus Professor of Psychiatry
at Stanford University School of Medicine, would further the advancement of psychiatry, in addition to his scientific contributions to professional journals (Yalom, 1995). Yalom’s (1995) first book, The Theory and Practice of Group Psychotherapy has been extensively used as a text for training therapists. Yalom (1995), defined 11 therapeutic factors as "the actual mechanisms of effecting change in the patient"; he believed these factors influenced the processes of change and recovery among group therapy clients. Benefits of Group Therapy Yalom (1995) notes that there are many approaches to group therapy; however, the group in itself is a force that becomes the catalyst in solving the challenges within the group. This then brings about more group interaction, and the process continues to build momentum and strength to those individuals who are members of the group. The group process also involves cognitive therapy, which teaches one how to identify the thoughts that underlie what he or she is feeling; this then provides a simple method to determine if those thoughts are accurate (Yalom, 1995). The group leader and members can potentially become a sounding board for the individual’s thoughts. If a thought is not realistic, it can then be exchanged with a more realistic one, based on what one can learn from the sharing of the group members’ experiences, as well as the group leader (Anderson & Rees, 2007). There are other positive aspects of group therapy; this is proven in a 2001 study concerning weight loss. Seventy-five obese adults were asked which type of therapy they preferred, they were assigned randomly to group therapy or individual therapy. In spite of the fact that some members did not receive his or her choice in which type of therapy they would receive, during post treatment, those clients who were in group therapy produced significantly more reductions in weight and body mass than individual therapy. These results proposed that group therapy produced a greater amount of weight loss than individual therapy, this was also true even for those clients who expressed partiality for individual treatment (Renjilian, Perri, & Nezu, 2001) According to Holmes and Kiylighan, (2000) the reason for this success is due to the relational aspect of group members, and the fact that relationships are willingly formed, which helps with the therapy process. They go on to say, that the focus becomes more about the members as a whole, rather than focusing solely on his or her own problems. The healing process takes place because of the emotional awareness of others, in comparison to one’s own insight, as well as the positive listening skills that are gained from the group experience (Holmes & Kiylighan 2000). Conflicts and Ethics within Groups Although group therapy can be beneficial because of the positive experiences of being connected to others, these same connections can be unwanted by those individuals who are forced into group therapy. Forcing members who are not ready for group therapy into conflict can bring about a harmful consequences to all who are involved (Bemak & Chung, 2004). Many involuntary members many feel the need to disclose personal issues, because of the peer pressure of the group environment. This could cause conflict to arise within the group as a whole, due to the aggressive behaviors of one or two members in the group. (Council on Alcoholism & Drug Abuse, 2015). According to Corey, Corey and Hanes (2014), “Dealing with conflict is not something that is settled once and for all” (p. 55). When these conflicts arise the ethics of the group may become compromised. During these times of conflict strong leadership skills are needed; instead of dealing with these conflicts at a later time, Corey (2014) suggest dealing with the conflict immediately, so that other “unfinished business” can completed (p. 55). It is recommended by Bemak and Chung (2004) that group leaders should anticipate and prepare for such conflicts. “Leaders working with involuntary groups are challenged to establish procedures for members who want to leave the group, address psychological risks of group participation, and explore members’ concerns about confidentiality” (Callanan et al. 2011 p. 506.)
The American Counseling Association (2014) Code of Ethics plays a very important part of how these components are established. Leaders are expected to wisely consider the ethical decision making process, in addition to meeting the professional training standards in order to become competent group leaders. Because of the shift to group therapy over the preference of individual therapy, many counselors may not be adequately prepared for diversity of group issues (Engel, 2008). The ASGW (2000) Association for Specialists in Group Work states, that “there are two specified levels of competencies and related training”, the first being “core knowledge and skill competencies”, the second being “specialized training”, which is built on the former foundation (Association for Specialists in Group Work, 2000). It is suggested that practitioners who are interested in conducting group should receive effective training “so that they can maximize the unique group properties in their work”. (Callanan et al. 2011 p. 481). Individual Therapy The history of psychotherapy can be traced back to the ancient Greeks. While there theories were not always correct, they serve as a reminder of the constant need for continual training in the professional helps. In the late 1400’s some physicians began to support the use of psychotherapy and advocated psychotherapy for treatment of the insane. In 1853 an English psychiatrist by the name of Walter Cooper Dendy first coined the term “psycho-therapeia” (Haggerty, 2014). Sigmund Freud then came on the scene and was responsible for the development of psychoanalysis around the late 1800’s. He also made lasting contributions to the field with his clarifications of the unconscious, infantile sexuality, use of dreams, and his model of the human mind. Freud believed that mental illness could be traced back to the unconscious mind; furthermore, listening to the patient and providing interpretations, would bring these thoughts to the conscious level and help relieve the patient’s symptoms (Haggerty, 2014). During the 1940s interpersonal therapy established by Carl Rogers. Rogers concentrated on the kindliness, authenticity and approval from the counsellor to the individual. Throughout the 1950’s the growth of American psychology led to more innovative, active treatments that involved the psychotherapeutic process (Schachter, 2015). By the late 1960’s many diverse treatments had become available, including cognitive-behavioral therapy, which focuses on the importance of the thoughts and feelings of an individual. These prolonged treatments went on for as long as two years. However, due to the reformation health care, and restrictions to coverage for mental health issues, treatments have become brief and more specific (Engel, 2008). Concerns with Individual Therapy Although it may seem as though there would be not be any major conflicts with individual therapy concerning other individuals, the issue of ethics, professional competence, and clients expectations is still of great importance. Because of the shift in the help professions, client’s expectations has also increased. Time limited therapy sessions has caused many clients to become more critical about their time spent during therapy (Engel, 2008). Studies have shown a greater expectancy for individual counseling in comparison to group counseling, particularly in males. Males tend to want to get more advice from counselors, rather than work through their emotional issues (Subich & Coursol, 1985). This brings up the issue of ethics concerning client rights and the counselor’s responsibilities. Just because a male client wants to rush through the counseling process, while it might be tempting, does not mean the counselor has a right to impose his or her thoughts and values on the client to appease them. Other concerns include confidentiality, legal issues, maintaining boundaries, and multiple relationships Callanan et al. (2011). Many of the same issues arise when it comes to professional competence, and the need for diversity training, however slightly change when a counselor deals with assessment and diagnosis.
Conclusion In closing, “Group and individual treatments have equivalent outcomes; however, they will always have diverse therapeutic processes”, says, Homes and Kiylighan (2000). They go on to say, “We found that the components of relationship-climate and other versus self-focus are more prominent in group psychotherapy, whereas emotional awareness-insight and problem definition change are more central to the process of individual treatment” (Holmes & Kiylighan, 2000). Concluding that relationships are a part of the outcome and the therapy, isolation can often fuel the problem, and accountability can be found in groups. On the contrary, group therapy can also come with the hesitation of acceptance of other members in the group. Leaders should be aware of these individuals, and encourage shy members to let his or her voice be heard. Leaders are also responsible for creating a safe and welcoming atmosphere (Holmes & Kiylighan, 2000). Individual therapy can also have benefits that cannot be found in group therapy. Such as the individual client addressing their specific needs, experiencing transformation, and lastly, going through the process of solving issues by using insight they have learned from these experiences. Since the client is in relationship with the therapist, trust is established. This adds to the confidence that the process works, and helps to maintain the relationship between client and therapist (Holmes & Kiylighan, 2000). One should research and explore which option best fits his or her personality. Recognizing that both group and individual therapy are equally important, can help a potential client come to a healthier decision about choosing which one works best for them (Anderson & Rees, 2007). Although economically times have turned for the worst, this should not affect the integrity of those who are in the help professions. Professional competence and training, in addition to serving the clients best interest, should always be at the forefront of the client counselor relationship (Engel, 2008).

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