Group support has been on my mind a lot lately. This month I saw the culmination of a long-time passion project: creating and publishing a directory of group support options in Metro Vancouver, including support groups, psychoeducational groups and therapeutic groups.  Some might argue that it’s not possible to assign the label of ‘passion project’ to a directory, but pshaw, it floats my boat.

An obvious point, perhaps, but Covid brought so much of therapy online and groups were no exception, becoming part of worldwide efforts to reduce isolation. And even though many Covid restrictions are now behind us, much of therapy has remained online, including groups, making previous location-based groups now accessible to people out of area.

So, I thought it would be interesting to talk about groups this month—not so much specific groups, which is what the directory is for—but rather what are mental health-related groups all about and what are their pros and cons, so you can decide whether a group might benefit you personally.

What is a group anyway?

Let’s look at some of their key features:

Open vs. Closed Groups

Is the group an open or closed group? With open groups, typically any interested party can show up and attend without prior registration. This is often a good option for folks who want to “test the waters” before committing to a group or want the freedom to bring a loved one, if feeling nervous.

In closed groups, there is often a person in charge of the group who pre-screens members for suitability, and/or, participants have registered for the group and the group is for registrants only.

Ongoing vs. Time Limited

Ongoing groups typically have no end-date: Alcoholics Anonymous (AA) is an example of this, while other groups—especially groups with an educational focus—are typically time-limited.

Group Frequency

This can refer to how often the group is meeting (e.g. Quarterly? Once a month? Once a week? Daily?) or how often is a time-limited group being offered? (e.g, once, twice, three times or four times a year?)

Group Focus

What is the nature of the group? How is it described and is it relevant to what you are looking for? Did someone else, such as a health professional suggest it to you and if so, why? Does this recommendation make sense?

Cost

Groups vary wildly when it comes to cost. Free options are often peer-led and rely on donations to keep them going, or are run by health authorities or agencies who receive external funding and can therefore offer the group at no cost. Fees are typically charged by private clinics, some organizations or private therapists and these fees will range.

Format

How is the group being held? Videoconference, In-person, Hybrid or Other (such as Facebook, Reddit or Meetup)? Some groups work better as an in-person format while others are held virtually (usually by Zoom) or have both options available.

Leadership

Who is running the group and do you have a preference when it comes to leadership?

Peer-Led Groups – the leader typically has lived experience and may also take on coordinating duties. Peer leadership may appeal to members who are looking for a lateral structure where members are assembling as a group of equals with shared experiences, without the power differential of a professional leader.

Professionally-Run groups may include facilitators from a number of different disciplines including social work, counselling, psychology, nursing, medicine, occupational therapy and more. Such professionals may be seasoned, junior or students/interns. Professionally-run groups are often delivered by local health authorities, although some community agencies may offer them as well. Some private counsellors and clinics also offer groups.

Professionally-led groups may appeal most to participants who are looking for a facilitator who is trained in managing group dynamics, are seeking niche knowledge about a particular topic, are looking to learn and apply specific therapeutic techniques or are seeking a group therapy experience.

Group Rules

Rules are unique to each group and are typically articulated at the start so that participants can decide beforehand whether they can abide by them before committing to the group.

Rules are developed to both create emotional safety for group members as well as set out expectations for behaviour in the group. Some examples of group rules may include: preserving the confidentiality of group members and their disclosures, not talking to one group member about another group member, rules around attendance, rules around who talks and when, etc.

Types of Groups

While there are many types of groups available, let’s look at support groups, psychoeducational groups and therapy-type groups.

Support Groups

It seems that there is a support group for almost any human concern, although this is not always the case. Support groups tend to be more informal although may still work with a loose agenda and, when done well, leave members feeling emotionally supported and understood.

Sometimes members will make human connections that they can find nowhere else, which can substantially decrease isolation. Feeling “not alone” is one of the most often-quoted benefits for going to a support group.

It is important to note, however, that not everyone benefits from support groups. This may be a poor option if groups make you intensely uncomfortable/anxious (common for many neurodivergent folks), if you’ve had prior trauma related to a group situation, if you’re worried that the group could go “off the rails” without professional leadership, if you disagree with the group rules or philosophy, or if you’re uncomfortable with the group members or dynamics. Sometimes choosing a different support group will rectify your concerns, other times it just confirms that a group may not be the right choice for you.

Psychoeducational Groups

Psychoeducation groups are typically structured groups that focus on providing information about particular concerns and ways of coping with them.

While many times such groups hope to yield psychological benefits for participants, psychoeducational groups do not typically have a “group therapy” focus.

Psychoeducation groups typically require pre-registration and sometimes pre-screening by the group’s coordinator.

This type of group may not be for you if you dislike “top-down” information, are challenged to concentrate as a learner in a group or classroom-type environment, feel very anxious in group settings, prefer a peer environment over a professional one, disagree with what is being taught or feel that you know more about the topic than what is being offered.

Group Therapy / Counselling

Groups led by one or more mental health professionals that has aims similar to individual psychotherapy, but in a group format.

Such groups can offer unique advantages including: learning to interact with others more comfortably, finding similarities in struggles, learning from others and encouraging mutual growth. Group therapy may also be a way for mental health professionals to help more people in a shorter amount of time, particularly if funding or resources are scarce.

Not everyone benefits from group therapy, for reasons which can include overwhelming anxiety in group situations, the co-occurrence of severe life crisis/interfering mental health challenges, an inability to get along with others in a group setting, or being in a place of extreme vulnerability where 1:1 therapy would be a better choice.

Questions to Ask When Choosing a Group

Part of making a decision about whether or not to join a mental health-related group is asking questions!

Self-Reflection Questions

1. What issue might I want to receive group support for?
2. Does a relevant group exist in my community or online?
3. What changes am I looking to see as a result of attending a group?
4. What would I need from the group in order to feel like I am getting something good out of it?
5. What helps me feel emotionally safe in a group situation?

Questions About Groups:

1. What is the focus of the group?
2. Do I need to register?
3. is there a waiting list?
4. Is there a cost involved?
5. Is the group peer-led or professionally-led?
6. If it’s an in-person group, how will I get there and will it be convenient? If it’s online, do I have privacy at home so that I can fully participate?
7. Is the group an open or closed group? Do I have a preference?
8. Is the group time limited or ongoing?
9. If the group is time-limited, when is the next group? How often is it offered?
10. Does the group follow a structure or is it more open-ended? What is my preference?
11. What happens when the group is over? Is there any follow-up available?

Group therapy can be a more affordable, or even free, option for personal growth either as a stand-alone experience or as an adjunct to therapy or other wellness activities. Regardless of your path, I wish you all well on your journey!