Group Therapy vs. Individual Therapy

Starting therapy can feel intimidating, and it helps to know what each format involves before you begin.

The format should fit your needs and your goals. Understanding how the two differ will help you make an informed choice.

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Understanding Group Therapy

Definition and overview

Group therapy involves one or more therapists working with several people at the same time. It provides a setting in which participants can share their experiences and learn from each other.

As with individual therapy, group therapy comes in different kinds, including support groups, psychoeducational groups, and process-oriented groups.

• Support groups: These groups focus on emotional support and practical advice. They are often led by a therapist or a peer leader, and members share their experiences and offer each other support. Support groups are commonly used for anxiety, depression, and living with chronic illness. Seeing that other people carry the same difficulty can reduce isolation.
• Psychoeducational groups: These groups aim to teach members about their condition and about ways of managing it. They usually involve structured sessions with set topics and are led by a therapist. Topics range from stress management to the effects of trauma, and structured programmes such as dialectical behaviour therapy include a skills group of this kind.
• Process-oriented groups: These groups focus on what happens between members. They allow participants to look at their emotions and their relationships as these appear in the group itself. Depending on the therapy style, the therapist may be more or less active in guiding discussion. This form suits people who want to look at how they relate to others.

Benefits of Group Therapy

• Social support: Being part of a group can reduce isolation, and members often describe a sense of belonging.
• Shared experiences: Hearing how other people describe similar difficulties can offer perspectives you would not arrive at alone, and can make your own experience feel less unusual.
• Skill practice: A group gives you a place to practise talking to and listening to other people, with role-play and structured exercises in some groups. In unstructured process groups the members take more responsibility for this themselves, for example by sharing personal accounts and telling each other how those accounts land.
• Feedback from several perspectives: You hear from the therapist and from other members. Several viewpoints on the same difficulty can show you sides of it that one viewpoint does not.
• Accountability: Members often hold each other to the commitments they have made, which some people find helps them keep attending and keep working.

Challenges of Group Therapy

• Potential for conflict: Group dynamics can lead to disagreement or discomfort between members. Working through those moments is demanding, and it is also part of what a group offers.
• Less individual attention: The therapist's attention is divided, so you receive less individual feedback than you would one to one. If you need close individual attention, a group may not give you enough of it. The reverse can also hold, since members often speak more freely to each other and bring knowledge the therapist does not have.
• Confidentiality: Confidentiality is a condition of group membership, but it rests on every member keeping to it rather than on one professional. Some people are not comfortable with that.
• Uneven participation: Some members speak a great deal and others very little. This affects the group and how much attention each person receives. Naming and working with that pattern is usually part of the group's work.

Understanding Individual Therapy

Definition and overview

Individual therapy involves one-to-one sessions with a therapist. The work is directed at your concerns and goals alone. Several approaches are used in individual therapy, among them cognitive behavioural therapy, psychodynamic therapy, and motivational interviewing.

• Cognitive behavioural therapy (CBT): Works with the links between thoughts, feelings, and behaviour. It is structured and goal-directed, and often involves tasks between sessions. It is widely used for anxiety, depression, and phobias.
• Psychodynamic therapy: Looks at unconscious processes and at earlier experience as these shape present life. It aims at self-understanding rather than at symptom management alone, and is often chosen for long-standing difficulties.
• Motivational interviewing: A client-centred approach that works with ambivalence about change, exploring conflicting feelings rather than arguing against one side of them. It is commonly used in addiction treatment and in health behaviour change.

Benefits of Individual Therapy

• Individual attention: The session is given to your concerns, which allows closer work on personal material.
• Flexibility: Sessions can turn to whatever is pressing that week. You and your therapist set the pace and decide what to take up first.
• Privacy: The one-to-one setting is private, which some people need before they can speak about sensitive material at all.
• The working relationship: Individual therapy gives time for a working relationship with one therapist to develop, without the demands of a group. That relationship is worth attending to. A meta-analysis of 295 studies covering more than 30,000 patients found a consistent association between the quality of the alliance between client and therapist and how therapy turned out, holding across treatment approaches, measures, and countries (Flückiger et al., 2018). The finding is a correlation rather than proof that the relationship causes the result, and it is not particular to individual work, since the same body of research covers group therapy. What it does suggest is that how you get on with the therapist is worth raising with them rather than treating as a side issue.
• Focus on your own goals: You can set specific goals and review them with your therapist as the work goes on.

Challenges of Individual Therapy

• No peer contact: There are no other members present, so there is no opportunity to learn from how other people handle similar difficulties.
• Higher cost: Individual therapy usually costs more per session than group therapy, because the therapist's time is given to one person.
• Reliance on one therapist: All the feedback comes from one person. It is worth building understanding and skills you can use outside the room and after the therapy ends.
• Limited peer support: You do without the recognition that comes from other people describing experiences close to your own.

Key Factors to Consider When Choosing

Nature of the Issue

Types of issues best suited for group therapy

Group therapy is often used where the difficulty involves other people, such as social anxiety, depression, shame, or grief. The setting gives you contact with others and a place to practise it.

• Social anxiety: A group gives you a setting in which to practise social contact and to hear how it lands, in conditions that are less exposed than ordinary social life.
• Depression: Depression tends to narrow contact with other people. Regular contact with a group works against that narrowing.
• Grief and loss: Grief support groups allow members to speak about a loss among people who are living through something similar.
• Shame: Shame is usually kept private, and privacy keeps it in place. Hearing others describe experiences close to your own, and saying your own aloud in a setting where it is met without judgement, is part of how group work addresses it. People often find that what they are ashamed of is something many people carry, such as a wish to be loved and admired.

Types of issues best suited for individual therapy

Individual therapy is often better suited to material that needs privacy and sustained attention, such as trauma, severe anxiety or depression, and complicated family situations.

• Trauma: Individual therapy provides a private setting in which to work on traumatic experience, at a pace set with the therapist. Specific approaches such as EMDR (Eye Movement Desensitization and Reprocessing) are used in this setting.
• Severe anxiety or depression: One-to-one attention allows the work to be shaped around your circumstances, and gives a more contained setting for intense feeling.
• Personality difficulties: Individual therapy allows close attention to long-standing patterns of relating. This is not a choice between formats: established programmes for personality difficulties, dialectical behaviour therapy among them, combine individual sessions with a group, and mentalisation-based and group-analytic work also use both.

Personal Preferences and Comfort

• Comfort with sharing: Consider how it is for you to speak about personal experience in front of several people compared with one. Some people speak more freely in a group; others need one listener.
• Privacy: Individual therapy offers confidentiality held by one professional, while group therapy relies on every member keeping to it. If speaking in front of others is too daunting to begin with, individual therapy is the more practical starting point. It is worth knowing that a group that begins as a room of strangers does not usually stay one.
• Openness to peer contact: If you want to hear from others and to give as well as receive support, a group offers that directly.
• Sensitive topics: Material such as past abuse or complicated family history is often easier to take up privately at first.
• Trust: Trust in a group takes time to build, which may affect how much you say in the early months. Ask the group's therapist how confidentiality is agreed and held.

Practical Considerations

• Cost: Group therapy usually costs less per session than individual therapy. Consider what you can sustain over months rather than weeks.
• Cover and funding: Check what your medical aid, health insurance, or public health service covers for group and for individual therapy. Cover differs by country and by scheme, and the two formats are not always funded on the same terms.
• Sliding-scale fees: Some therapists and clinics set fees according to what you can pay. It is reasonable to ask.
• Specialisation: Ask about a therapist's training and experience with the difficulty you are bringing, in whichever format you are considering.
• Scheduling: Groups run at set times and expect regular attendance. Individual sessions can often be scheduled with more flexibility.

Making the Decision

Self-Assessment

• Questions to ask yourself: Am I willing to speak about my experience in front of a group? Do I need one-to-one attention at this point?
• Your goals: Identify what you hope to get from therapy, in the short term and over a longer period, and which format is better placed to offer it.
• Comfort levels: Think about how it would be to discuss personal material in a group compared with individually.
• Previous therapy: Consider any therapy you have had before. What worked well, and what did not? That is useful information about what suits you.
• Readiness: Consider whether you are in a position to take part actively in a group at the moment, or whether you need the focus of individual sessions first.
• Current mental health: Group therapy is generally not the right starting point during an acute crisis. Individual or urgent care usually comes first, and a group can follow.
• Commitment: Consider whether you can attend regularly. Groups in particular depend on it.

Consulting with Professionals

Discussing options with a mental health professional

Talk to a therapist or counsellor about the options. They can make recommendations based on your circumstances and set out what each format does and does not offer.

• Tailored recommendations: A therapist can weigh the two formats against your particular situation rather than in general.
• Seeking recommendations: Ask a general practitioner or another healthcare provider, or people you trust who have been in therapy themselves.
• Peer accounts: First-hand accounts from people who have attended a group or worked individually give you a sense of what to expect.
• Referrals: A referral from someone you trust is a reasonable starting point, though it is still worth checking the therapist's registration and their experience with your concern.
• Switching formats: You can start in one format and move to another if your needs change.
• Trial and adjustment: Finding the right format often takes some adjustment. Changing course when something is not working is a legitimate decision, best made with your therapist rather than alone.

Trial and Evaluation

• Starting with one format: Begin with the format that fits your own assessment and the professional advice you have had, and give it a fair period before judging it.
• Initial commitment: Agree a set number of sessions before reviewing. Early sessions in any format are rarely representative of the work.
• Staying open: Approach the first sessions with a willingness to take part, including the parts that feel awkward.
• Flexibility: Be willing to change the approach if it is not doing what you need.
• Consult your therapist: Involve your therapist in any decision to switch formats. Endings and transitions handled openly are part of the work.

Continuous Self-Reflection and Feedback

Regular check-ins: Review your progress and any concerns with yourself, with your group, and with your therapist. Saying what is not working is itself useful material.

• Routine reflection: Set aside time after a session to consider what happened in it and what you want to return to.
• Talking to your therapist: Keep the conversation about the therapy itself open, including disagreement about it.
• Reviewing goals: Reassess your goals from time to time. What you came for and what you end up working on are often not the same thing.
• Adjustments: Be open to trying different approaches your therapist suggests, and to saying when one does not suit you.

Key Takeaways

• Group therapy: Offers contact with others, shared learning, and a place to practise relating in a setting where it can be discussed. What a group offers depends a great deal on its composition and on the therapist's training.
• Individual therapy: Offers private, focused sessions and closer attention to personal material, which suits sensitive subjects such as childhood sexual abuse.
• Consider your needs: The nature of the difficulty, your own comfort, and practical matters such as cost and availability all bear on the decision.
• Professional guidance: A conversation with a mental health professional will tell you more about the choice than reading about it will.
• The two are not exclusive: Many people use both, at the same time or one after the other. Review how the format is working rather than deciding once.

FAQs

What are the main differences between group therapy and individual therapy?

Group therapy involves several participants sharing, learning, and practising relating to others. Individual therapy is a one-to-one session with a therapist.

Can I switch from group therapy to individual therapy or the other way round?

Yes. You can change format as your needs change, and many people use both. Discuss the change with your therapist rather than simply stopping.

How do I know if group therapy is right for me?

Consider whether you want contact with peers, whether you are willing to speak in front of a group, and whether your concern is one that involves other people, such as social anxiety or difficulty in relationships.

What if I need individual attention but cannot afford individual therapy?

Ask about sliding-scale fees, community mental health services, university training clinics, and non-profit services in your area. Combining a group with occasional individual sessions is another option.

Are there specific issues that are better addressed in individual therapy?

Single-incident trauma, severe depression, and material that you are not yet able to speak about in front of others are commonly taken up individually, at least to begin with.

Additional Resources

• Society for the Advancement of Psychotherapy: Individual vs Group Psychotherapy
• American Psychological Association: Group therapy
• Flückiger, C., Del Re, A. C., Wampold, B. E., & Horvath, A. O. (2018). The alliance in adult psychotherapy: A meta-analytic synthesis. Psychotherapy, 55(4), 316–340.