Group Therapy: Choosing Between Formats to Find Your Best Fit

When people think of therapy, they tend to imagine one person and one therapist, yet group therapy is often as effective, brings advantages, and costs less. Finding and deciding to join a group therapy is a big and often exciting step, but they come in different formats, so it’s worth learning about each before joining. Because picking the right kind of therapy is key (see this guide) to feeling supported and getting the most out of your sessions.

While less well-known, group therapy is an excellent choice and is highly effective in treating a wide range of issues, from anxiety and depression to substance use and trauma. In fact, research shows group therapy can be just as effective as individual therapy for many mental health conditions. 

One meta-analysis by Barkowski et al. (2020) found that participants in group therapy experienced significant improvements in mood, social functioning, and overall mental health, comparable to those in individual therapy. With that in mind, it’s just a matter of finding the right group for you, and this guide will help you achieve that. We explore different approaches to group therapy, how the formats vary, and how to pick a group that best fits your specific needs and goals.

Which Group Therapy Approach Best Fits Your Needs?

There are several types of group therapy approaches, each designed with a different focus. Depending on what you’re hoping to get out of therapy—whether it’s learning practical skills, exploring emotional patterns, or receiving peer support—one of these will stand out.

Cognitive-Behavioral Group Therapy (CBGT)

CBGT is one of the most structured types of group therapy. It focuses on addressing negative thoughts and behaviours and replacing them with healthier patterns. This makes it ideal if you’re looking for practical tools to manage issues like anxiety, depression, or panic attacks.

CBGT has been extensively researched, and studies consistently show its effectiveness in reducing symptoms of anxiety and depression. A 2015 study found that individuals in cognitive-behavioural groups saw significant symptom reductions—comparable to the benefits of one-on-one CBT. The group setting has advantages in that it allows participants to practice the techniques they learn and get real-time feedback from peers, which enhances the therapeutic process.

Psychodynamic Group Therapy

Psychodynamic group therapy takes a different approach, focusing on understanding the unconscious reasons behind your behaviours. It’s less about learning specific coping skills and more about exploring hidden meaning, unconscious patterns, and how past experiences affect the here and now, your relationships, and daily life. One key benefit of psychodynamic therapy is the sense of universality—the realization that others in the group share similar internal struggles, thoughts, and emotions.  Research shows that this shared experience can significantly reduce feelings of isolation and shame, both of which are common barriers to recovery.

Group-Analytic Therapy

Group-analytic therapy, similar to psychodynamic groups, focuses on how you relate to others within the group and how the group acts as a collective. The idea is that the group acts as a mirror of your outside relationships and world.  These groups are especially useful for understanding how your behaviour and emotions impact others—and how theirs impact you. Over time, the group becomes a reflection of real-life social interactions, helping you develop a better understanding of your relational patterns. Because this approach emphasizes here-and-now feedback from group members, it is particularly useful for anyone wanting to improve interpersonal relationships. It taps into the power of the group to help you reflect on and shift these patterns, making it a valuable tool for personal growth.

Support Groups

If you’re looking for emotional support from people who understand what you’re going through but not necessarily a structured or ongoing committed therapy process, support groups might be the way to go.  These groups provide a shared space to connect with others dealing with similar issues—whether it’s grief, addiction, or chronic illness. While less focused on formal therapeutic techniques, support groups offer invaluable peer support and understanding. Support groups often foster a strong sense of community and belonging, which can be incredibly healing. Research has found that the shared empathy and encouragement in these groups can help alleviate feelings of isolation and improve emotional well-being.

What Group Therapy Format Works for You?

Once you’ve chosen the therapy approach, it’s time to consider the group’s format. The structure of the group can greatly impact your experience, so consider which of the following best fits your needs and lifestyle.

1. Open vs. Closed Groups

• Open Groups: In open groups, new members can join at any time, which keeps the group dynamic and fresh. However, this constant change can sometimes make it harder to build deep trust among members. If you value hearing many different perspectives over forming and working with close bonds, open groups could be a good option.
• Closed Groups: In closed groups, the membership is fixed from the start, which allows for more consistent relationships. Members stay together for the duration of the group, fostering trust and deeper connections. If you’re seeking stability and depth and want a group where relationships can grow over time, a closed group might be a better fit.

2. Time-Limited vs. Ongoing Groups

• Time-Limited Groups: These groups run for a set number of sessions, usually 6 to 12 weeks. They often focus on a specific goal, like learning how to manage anxiety or process grief. The limited timeframe creates a sense of focus and urgency, which can be motivating when working toward a clear objective. 
• Ongoing Groups: In ongoing groups, there’s no set end date. The group continues for as long as it’s helpful to the members. This format allows for deeper exploration and relationship building over time, and it’s ideal if you’re dealing with long-term or evolving issues. 

3. Homogeneous vs. Heterogeneous Groups

• Homogeneous Groups: In these groups, members share a common issue or identity, like addiction recovery, grief, sexual abuse, or anxiety. This can create a strong sense of understanding and empathy among group members because everyone faces a similar challenge. Homogeneous groups are particularly useful in cases where shame plays a big role (e.g., incest) or you need to be with people who “get” what you’re going through.
• Heterogeneous Groups: These groups bring together people with different issues, backgrounds, or experiences. While you won’t always find others with the same struggles, diverse experiences can offer broader insights. Sometimes, hearing from people with a different perspective can help you gain new ways of thinking about your situation.

Key Considerations for Choosing a Group

Now that you’re familiar with the different group therapy approaches let’s consider some key factors that will help you narrow down your options. These considerations will make sure that the group you choose is the best fit for your needs, goals, and practical concerns.

What Are Your Goals?

The most important question to ask yourself is: What do I want to achieve through group therapy? Your goals should guide your decision on the type of group that’s right for you.

• Skills-Based Goals: If your main goal is to learn specific coping skills, a structured format like Cognitive-Behavioral Group Therapy (CBGT) may be your best bet. For instance, CBGT is highly effective at teaching strategies to manage anxiety and depression through targeted techniques like cognitive restructuring and behavioural activation.
• Emotional Exploration: If you’re more focused on exploring your emotions or understanding your past, Psychodynamic Group Therapy or Group-Analytic Therapy will provide a deeper dive into emotional and relational patterns. These groups allow you to reflect on your internal world and how it impacts your current relationships.
• Peer Support: If you’re mainly looking for connection and emotional support from others with shared experiences, support groups are a great fit. Research shows that these groups foster a strong sense of belonging, which can reduce isolation and increase overall emotional well-being.

Group Size

The size of the group can affect how much you can participate and how deeply you connect with others. Depending on your comfort level and needs, both large and small groups have their benefits.

• Smaller Groups (5-8 people): These offer more intimate settings where everyone can speak and engage. Smaller groups are better for those who want deeper personal connections and more individualized attention. 
• Larger Groups (10-15 people): These provide a broader range of perspectives and experiences, but individual members may have less time to speak. Larger groups can benefit those who value diversity of opinion and want to observe how different people approach similar problems.

Facilitator’s Style

The style of the group leader or therapist makes a big difference to your experience. Some facilitators take a more active, hands-on role, guiding discussions closely and providing frequent feedback. Others prefer to let the group dynamic unfold naturally, stepping in only when necessary.

• Hands-On Facilitator: This style is great if you prefer structure, clear direction, and regular guidance throughout the session.
• Facilitator as Observer: This approach works well if you’re more comfortable with a flexible, organic process where the group leads the conversation and explores its dynamics.

Practical Considerations

You’ll also need to consider practical factors like cost, scheduling, and location. These details might seem secondary, but they can heavily influence your ability to stick with group therapy.

• Cost: Group therapy is often more affordable than individual therapy. Some groups offer sliding-scale fees or are covered by insurance, so it’s worth exploring the financial aspect to ensure it’s sustainable for you.
• Time and Location: Think about your availability and the logistics of attending. If in-person sessions are difficult to attend, many groups now offer virtual formats, which research has shown can be just as effective as in-person therapy. A 2020 study found that online group therapy provided similar benefits to face-to-face sessions regarding emotional support and symptom reduction.

Practical Tips for Trying Out Groups

After narrowing down your options, it’s a good idea to try a group before committing long-term. Here are some practical steps to help you make the best choice:

• Ask for a Trial Session: Many groups allow prospective members to attend one or two sessions before committing. This allows you to observe the group dynamic, facilitator’s style, and whether you feel comfortable.
• Talk to the Facilitator: Before joining, ask the group leader about the structure of the sessions, what you can expect from the group, and how issues are addressed during meetings.
• Be Patient: It’s normal to feel anxious or unsure during your first few sessions. Give yourself time to adjust before deciding whether the group is a good fit.
• Trust Your Instincts: If, after a few sessions, you consistently feel uncomfortable or out of place, it’s okay to explore other groups. Finding the right group therapy experience can take time, and the goal is to feel supported and engaged.