9 therapy prompts for quiet clients
Struggling to engage quiet clients in sessions? Here are some ideas to help spark conversation and build trust in therapy.
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6 group therapy techniques to try
Just as there are many styles of individual therapy, group therapy sessions can be conducted in several different ways.
When most clients think of therapy, they might picture a one-on-one session between a client and clinician. But clinicians know that therapy doesn’t always have to be individual. Group therapy has plenty of upsides, including efficiency for the practitioner and cost-effectiveness for the clients. Aside from its practicalities, group therapy may offer treatment benefits that are different from or additive to those of individual therapy — for example, built-in social support and role-modeling for the participants.
Haley Moutier, a licensed mental health counselor at the Bellevue Center for CBT & DBT in Washington state, has led therapy groups for children and teenagers. She says her group sessions (which sometimes involve clients’ parents as well) create different dynamics than in individual appointments. “Teens are willing to be open with the clinician and their parents when they have other teens in the room who can agree with their point of view and validate them,” she says.
Here’s how group therapy works, and how it can enhance your offerings as a therapist.
What is group therapy?
Group therapy brings together multiple clients and one or more clinician(s) for collective sessions. While group sizes and meeting cadences vary, a standard therapy group might meet weekly and include up to about a dozen patients, working with one or two therapists. Depending on the format, participants may interact with each other, in addition to the clinician(s), and are often encouraged to share in front of the entire group.
Four types of group therapy
Just as there are many styles of individual therapy, group therapy sessions can be conducted in many different ways. Four major types include:
- Cognitive behavioral groups: As in one-on-one cognitive behavioral therapy, these groups aim to help clients identify and alter distorted patterns of thought, emotion, and behavior.
- Support groups: Support groups bring together people who are going through the same difficult life experience, such as grief or chronic illness.
- Psychoeducational groups: As the name implies, these groups are meant to teach clients about their diagnoses, coping skills, symptom-management strategies, and/or healthy lifestyle habits.
- Skill development groups: Commonly offered to clients with social or behavioral issues, skill development groups help people learn practical tools for better daily functioning and well-being.
Group therapy techniques
Therapy groups often operate quite differently than individual therapy sessions. Below are six techniques that may be useful in group therapy settings.
Think, pair, share
Group discussions can be approached in several different ways. Some may be highly structured — oriented around a specific topic, for example, or systematically asking each person to share one-by-one — while others may be more free-flowing. The “think, pair, share” method asks clients to think about a question individually, discuss their ideas with a partner, and then with the group at large.
The idea is generally to build community, share widely applicable insights and experiences, and help clients practice interpersonal skills. Sometimes, Moutier adds, separating into breakout groups within the larger group can help facilitate good discussions.
Reflective listening
Reflective listening helps participants learn to truly hear, understand, and respond to what another person is saying. In a group setting, such as a support group, reflective listening can be a great way for participants to practice social skills.
Role play
Some group leaders may use role play exercises to help participants act out (or reenact) challenging or upsetting scenarios so they are prepared to handle them in the outside world. These exercises can also help participants practice social skills and gain better insight into the experiences or emotions of their fellow participants.
Experiential activities
Experiential therapy goes beyond traditional talk therapy to include activities like art, music, movement, interaction with animals, and more. Experiential activities can help group participants bond, open up, and process their feelings in ways that may feel more accessible than putting them into words. In her groups for kids and teenagers, Moutier also uses games to help reinforce what her clients have learned.
Mindfulness exercises
Mindfulness practices are great tools for reducing stress, coping with difficult emotions, and improving self-awareness. These exercises may be among those taught in psychoeducational or skill development groups.
Modeling
Moutier says she often uses examples from her own life when teaching skills in her group sessions. “It makes the skills feel more approachable and allows me to give feedback on my own skill usage, if the clients are struggling to understand a skill or are very embarrassment-sensitive,” she says.
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