Nancy Wesson, PhD, is a Licensed Psychologist psy9621, Certified Group Psychotherapist and founder of the Center for the Study of Group Psychotherapy (CSGP), a nonprofit group therapy training organization.

In my 30 years leading psychotherapy groups, I find that group psychotherapy is a very effective treatment modality. In this brief article I offer some pointers for starting a group and for keeping it going successfully.

“The joy of group therapy for me is watching group member connections, relationship building, and identification, that is, when members no longer feel alone with their psychological issues. This is one of the most important healing factors for group therapy. When describing the group, members will easily tell others that the group is not ‘the group’ but ‘my group’.” (Yalom & Leszcz, 2005).

Before starting the group

• Receive training in group psychotherapy to be able to effectively handle leadership challenges such as monopolizing, absenteeism, conflict, etc.

• Choose the type of group you would like to lead: process, psycho-educational, psychoanalytic, or a combination, and if you want a short-term or long-term group.

• Develop a written group agreement for the clients which includes confidentiality, time commitment expectations, absences, fees, acceptable group behavior (norms), and termination issues.

• Develop a marketing plan for attracting new group clients. For example, connect with individual therapists who are likely to refer their clients to your group.

Organizing the group

Once you have chosen the type of group you would like to lead, you need to find the right clients. Decide what criteria you are looking for in clients and interview them to make sure they will fit. It is important to consider if a client is appropriate for your group. Conduct a phone interview initially, and if they seem appropriate, conduct an in-person interview (if possible). It is also important to prepare the client for how the group will work and how it will feel to be a group member. This preparation will help your client feel more comfortable and committed to the group.

Starting the group

Begin your group when you have at least 4, preferably 5 clients who are ready to join the group. To create cohesion and connection, start the first session by encouraging members to connect with each other and to take time to discuss their lives and personal goals.

Most clients join groups not just for information but also for connection. You can encourage connection between group members by including time for group members to interact. The relationships between group members and the sharing of similar issues will bring your group members back to group each week.

It is helpful to see the “group as a whole,”(Bion, 1962) and not only as a collection of individual clients. Each group is an entity in and of itself, comprised of relationships as well as individual clients and help the group maintain it's own identity.

Maintaining the group

Keep the group stable, safe, and dynamic by addressing any issues in your agreement that come up in the group. If a member is not participating in the group, explore this gently in the group. (They may not think their contribution is important).

The group agreement is central to keeping the group safe and members committed. If a member is often late or absent, bring this to the group for exploration. If a member is very frequently absent and does not respond to group feedback, then meet with that member privately. Frequent absences by one member can easily lead to more member absences. The same is true for lateness and impulsive angry outbursts.

Encourage empathy, positive feedback, support, and the expression of feelings in the group. This will help group members feel connected to others in the group. Group members need to feel they are each an important part of the group.

Nancy Wesson, PhD, Licensed Psychologist, psy9621, CGP, has been trained by Irvin Yalom, M.D. and the American Group Psychotherapy Association. She is the founder of the Center for the Study of Group Psychotherapy, a nonprofit training organization (CSGP). She has led two psychotherapy groups for 28 years. For more information contact DrNWesson@CSGP.org, or visit the CSGP website at www.CSGP.org.