Group therapy is an evidence-based psychotherapy method that helps solve many problems, including relationship issues and personal difficulties. People come to the group to cope with grief, trauma, chemical addiction, anxiety, and depression. One of the most well-known and influential types of group therapy is the cognitive-behavioral therapy group. Compared to other theories, the cognitive-behavioral approach is preferable because it focuses on mental processes: how people perceive, think, remember, learn, solve problems, where they direct their attention.
According to the cognitive approach, working only with a person’s behavior is inefficient in solving their psychological issues. First of all, you need to identify beliefs, ideas, and thoughts that make them act destructively or feel uncomfortable, get rid of them, and only then work on the behavioral aspect. Moreover, one of the basic concepts of behaviorism is positive and negative reinforcement. Positive reinforcement, or encouragement, is applied when the individual has done the right thing and helps to reinforce the desired form of behavior. Negative reinforcement implies an adverse reaction to the undesirable behavior of the trainee. As a rule, the first form of reinforcement is used in CBT: it works faster clearly indicates what needs to be achieved.
Group Counselor and CBT
As a group counselor, cognitive-behavioral theory influences the decision of the formal sessions. The therapy includes not only group exercises but also homework and visualization. Moreover, group therapy affects the counselor to take a direct part in the discussion. This makes it easier to work with patients who can be stiff and neutral towards other people. CBT is a technique that highlights a person’s unconscious motivations, transfers them to a conscious level, helps to change beliefs and behavior that cause neurotic and other pathological conditions. CBT combines two scientific psychological approaches: cognitive and behavioral (behavioristic). The first states that thoughts and beliefs cause psychological problems and neuropsychiatric disorders, stereotypes of thinking acquired during life. The second argues that human behavior can be changed by encouraging desirable forms of action and not reinforcing undesirable behavior.
Features of CBT
A feature of CBT is its carefully developed theoretical basis, which was formulated based on the long-term follow-up of many patients. To date, the world has accumulated hundreds of studies, meta-analyses, and systematic reviews that confirm the effectiveness of this method for the treatment of affective disorders, personality disorders, various types of addiction, and some psychotic disorders. CBT can be used both as monotherapy and in combination with drug therapy. The structure of group sessions (classes) is usually defined in treatment protocols.
However, there are a number of its features that are not given enough attention. CBT groups should be closed, the composition of participants must be constant, and new patients cannot join after the first session. This is primarily because the CBT process involves teaching cognitive techniques and acquiring skills by patients in strictly sequential order with a frequency of meetings of at least one time per week (Carrion et al., 2018). It happens because learning cognitive techniques can only occur with a relatively short break between sessions, but the duration of the sessions should remain limited in time; the number of participants in the group should not exceed 8-10 people. After the intensive weekly psychotherapeutic work phase, it is important to continue holding more infrequent support sessions. These sessions are necessary to maintain the result and prevent relapse.
Development of Psychological Problems
When prescribing group treatment and its type, it is necessary to understand the nature of the development of psychological problems. The causes of problems can be divided into endogenous factors. Endogenous factors include genetic predisposition, intrauterine developmental disorders, early childhood developmental disorders, and immunological and metabolic disorders. Somatic diseases that affect the state of the brain due to insufficient blood supply, autointoxication, or hormonal imbalance are also the causes of difficulties in perceiving the world. The causes of mental problems are often combined, including stress, trauma, and adverse family history (Patel et al., 2021). Thus, the psychotherapist must evaluate the importance of each of these factors. Exogenous factors include intoxication, traumatic brain injury, infectious processes, radiation exposure, and acute or chronic emotional stress. Physicians consider mental and behavioral disorders as multifactorial diseases. Even if the root cause of a mental problem is a well-defined circumstance, a person’s condition still depends on many factors.
Elimination of Psychological Problems
CBT is considered short-term therapy, but the course duration depends on many factors. About ten sessions are needed for a specific request, such as a phobia or difficulty falling asleep. However, this format involves the solution of only one problem within the framework of group therapy. The course will last from a few months to a year for multiple issues and more complex conditions. The treatment of personality disorders will require even longer work and will solve specific problems in terms of group work on fears. An indispensable component of therapeutic measures is psychological counseling. Regular meetings with a psychologist are aimed at helping the patient understand their disease and its causes, learn how to reduce stressful conditions, overcome emotional problems, control their thoughts and actions, and control behavior. The course of psychotherapy usually lasts several months, or more is prescribed individually in a group of patients or relatives.
The Role of the Group Process
Group processes within group CBT, playing a unique role, significantly affect its effectiveness. Such a phenomenon as “self-disclosure” of one’s negative thoughts, interpretations of events, and people’s behavior, which is necessary for practical cognitive work, is possible in conditions of a significant level of group cohesion and trust (Schmidt et al., 2019). Some studies have also shown that patients perceive group processes as an essential therapeutic experience and that group process factors significantly affect the dynamics of improvement in the well-being of members of the therapeutic group (Goldberg et al., 2019). Typically, the implementation of CBT in groups begins by providing patients with a cognitive model of mental disorder, such as cognitive models of depression (Sunnhed et al., 2020). Particular attention is paid to the encouraging provisions that, with the help of psychotherapy, each of them will learn techniques with which they can change their thinking to a more adaptive one. Thus, it will positively affect the emotional state and help reduce symptoms of depression.
Thus, the method of CBT is effective and helps people to understand themselves better. It helps patients accept themselves and realize that they are not alone in their problems. Moreover, for many group members, there is a rare opportunity to share their deep feelings, which they were previously embarrassed to express or met with misunderstanding from family members or friends. In addition, often after the first meeting, participants experience surprise and a sense of relief from the fact that people of very different gender, ages, social statuses faced the same problem and turned to identical treatment methods. The emerging sense of cohesion creates a favorable atmosphere for proper cognitive and behavioral techniques and contributes to the development of mutual assistance, support, altruism between group members.
References
Carrion, C., Folkvord, F., Anastasiadou, D., & Aymerich, M. (2018). Cognitive therapy for dementia patients: A systematic review. Dementia and Geriatric Cognitive Disorders, 46(1-2), 1-26. Web.
Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Kearney, D. J., & Simpson, T. L. (2019). Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: A meta-analysis. Cognitive Behaviour Therapy, 48(6), 445-462. Web.
Patel, R., Ezzamel, S., & Horley, N. (2021). Improving access to cognitive behavioural therapy groups for postnatal women following partnership work: A service evaluation. Advances in Mental Health, 19(2), 127-138. Web.
Schmidt, I. D., Pfeifer, B. J., & Strunk, D. R. (2019). Putting the “cognitive” back in cognitive therapy: Sustained cognitive change as a mediator of in-session insights and depressive symptom improvement. Journal of Consulting and Clinical Psychology, 87(5), 446. Web.
Sunnhed, R., Hesser, H., Andersson, G., Carlbring, P., Morin, C. M., Harvey, A. G., & Jansson-Fröjmark, M. (2020). Comparing internet-delivered cognitive therapy and behavior therapy with telephone support for insomnia disorder: A randomized controlled trial. Sleep, 43(2), 245. Web.