Group therapy

In group therapy, a trained professional, sometimes two, works with several people at once. It’s a way of running therapy rather than one kind of therapy, and many approaches work in groups. It usually costs less than one-to-one sessions, and on average it helps about as much. If your first thought is that you couldn’t talk in front of other people, that’s a fair thing to raise with the group leader before you join.

What happens in a group

Groups vary a lot, and many lean one of two ways.

Structured groups work through a set program, much like a class. A leader teaches a skill, the group practises it, and there’s usually something to try during the week. The skills group in dialectical behaviour therapy (DBT) is one example. Many groups in Cognitive behavioural therapy (CBT) A structured, practical form of talking therapy. It's built on a simple idea: what you think affects how you feel, and both affect what you do. More in the jargon decoder (CBT) work this way too.
Process groups are less structured. Members talk about what’s going on for them, and what happens between people in the room becomes part of what the group looks at. Psychodynamic and interpersonal groups often run this way.

Some groups are closed, which means the same people start and finish together. Others are open, and people join and leave along the way.

How much you say is up to you. Other group members aren’t bound by professional privacy rules. That’s why groups usually agree ground rules at the start, and why it’s worth asking how privacy is handled before you join.

A therapy group is run by a trained professional. A peer support group is run by people with lived experience, and it’s a different thing.

Who it tends to suit

A group can be a good fit if you’re working on something skills-based, or if you’d like to hear from other people dealing with similar things. It can also suit you if you want to keep going with therapy and can’t afford more individual sessions.

If you’re already seeing someone, ask whether they run a group. Some therapists do, sometimes in the same Approach (modality) The kind of therapy someone uses, such as CBT or psychodynamic therapy. You'll also see it called a modality. More in the jargon decoder they use one to one.

For some long-running difficulties, a group may work better alongside individual sessions than on its own. One large trial tested this with schema therapy, for people with long-standing, intense emotional and relationship difficulties (Arntz and colleagues, 2022). Over two years, some people had mostly group sessions. Others had group and individual sessions together. The combined version helped more than the best other treatment each site could offer, and more than the mostly-group version. The mostly-group version didn’t clearly do better than that other treatment. More people also stayed with the combined version.

If what you’re dealing with goes back a long way, ask whether individual sessions could run alongside the group.

What the evidence says

A review of 67 studies compared group and individual therapy directly. On average, people did about as well in a group as they did one to one (Burlingame and colleagues, 2016). That held most clearly when both formats offered the same treatment, to similar people, for the same number of sessions. People were no more likely to drop out of a group, and no less likely to improve. Where the two formats weren’t matched, results tended to favour whichever format the researchers themselves preferred.

Some comparisons are thinner. For people dealing with the after-effects of trauma, groups helped more than no treatment. How they compare with individual therapy hasn’t been studied much yet (Schwartze and colleagues, 2019).

The relationships in the group matter too. Across 55 studies, people who felt more connected to their group, and to the people leading it, tended to improve more (Burlingame and colleagues, 2018). That mirrors what’s known about the relationship with an individual therapist, which why who you see matters more than what they do explains.

A well-run group is a real option in its own right. The questions under choosing a group below are a good place to start looking for one.

Getting it in Australia

A group session usually costs less than an individual one. Without a Mental Health Treatment Plan, you pay the group’s fee yourself.

With a plan from your GP (general practitioner) For most people, where getting help starts. A GP can write a Mental Health Treatment Plan, prescribe medication and refer you on, and some are trained to deliver a small number of structured therapy sessions themselves. More in the jargon decoder , Medicare Australia's public health insurance scheme. For mental health, it gives rebates on sessions with psychologists and some other professionals, usually through a Mental Health Treatment Plan. More in the jargon decoder gives a Rebate The amount Medicare pays back towards a session. It comes back to you after you've paid, so what you pay yourself is the fee minus the rebate. More in the jargon decoder on up to ten group sessions a calendar year, separate from and on top of the ten individual sessions. How to get a Mental Health Treatment Plan covers the plan itself. For a group to be rebated, it has to have four to ten people, and each session has to run for at least an hour.

Psychologist Someone trained to assess mental health problems and treat them with therapy. It takes at least six years of study and supervised practice, and they're registered with Ahpra, the national regulator. Psychologists can't prescribe medication. More in the jargon decoder can run rebated groups, and so can Mental health social worker A social worker with an extra mental health accreditation. They're trained in therapy, and in the practical things around it, such as housing, money, family services and the systems people get stuck in. More in the jargon decoder and occupational therapists. Medicare doesn’t cover Counsellor Someone trained to help people talk through and work on difficulties. The title isn't protected in Australia, so it's worth checking a counsellor's training and registration. Medicare doesn't give a rebate for counsellors. More in the jargon decoder or Psychotherapist Someone trained in therapy, often for longer-standing patterns. Like counsellor, the title isn't protected in Australia, and Medicare doesn't give a rebate for psychotherapists. More in the jargon decoder , and that includes their groups. Who does what sets out the difference between these professions.

Rebated group sessions by video are only for people in smaller country towns and remote areas, and you have to be at least 15 kilometres by road from the therapist. In a city, a regional centre or a larger country town, a rebated group has to be attended in person.

Closed groups often start on set dates, so there can be a wait for the next one. If you’re 12 to 25, headspace A national youth mental health service for anyone aged 12 to 25, with centres around Australia and support online and by phone. It's free or close to it, you don't need a referral or a parent, and you can book it yourself. More in the jargon decoder is free or close to it, and your local centre can tell you whether it runs groups. Free and low-cost options covers other ways to keep costs down while you look.

Choosing a group

Who runs it, and what their training is.
Whether it’s open or closed, and how many people are in it.
Whether there’s a meeting first, so you can ask questions before the first session.
How privacy is handled between members.
Whether individual sessions run alongside it.
What happens if you miss a session.

If things are difficult right now, Lifeline is on 13 11 14, the Suicide Call Back Service is on 1300 659 467, and Kids Helpline is on 1800 55 1800 for anyone aged 5 to 25. In an emergency, call 000. Crisis and emergency support has the full list.

Where next

If you’re still working out whether you want therapy at all, what therapy actually is covers the basics. Would I benefit from therapy? helps you work out whether therapy is worth a try.