In the pandemic, Angela Lundberg’s mental health plummeted.
Initially, Lundberg, who is also a freelance writer, worried about “sharing my personal life with strangers,” but she says she decided to give group therapy a try. “I was desperate to feel better,” she says, and group therapy has helped.
Since 2019, America’s mental health needs have climbed. “More than four out of 10 adults, 43 percent, told a Census Bureau pulse survey in November 2020 they suffered from anxiety or depression,” The Washington Post reported last year. From late August 2020 through Feb. 1, 2021, according to the Centers for Disease Control and Prevention, Americans reported “symptoms of an anxiety or a depressive disorder increased significantly,” from 36.4 percent to 41.5 percent.
Unfortunately, many mental health professionals are too busy to accommodate the rising demand, says Vaile Wright, the senior director of health-care innovation at the American Psychological Association (APA). “We had a shortage of providers before the pandemic began, and it’s even worse now,” Wright adds.
One possible solution, she says, is to find more innovative ways to reach people, including telehealth, support groups and group therapy.
For some, the idea of group mental health care might generate worries. A 2021 study found that social anxiety, anger from others and fear of humiliation kept people from trying it.
But a 2021 meta-analysis found that group therapy for mood disorders such as depression and bipolar disorder were more effective than individual therapy and could be just as curative as taking medication.
Groups also foster benefits that individual therapy cannot, says psychologist Nicole Cammack, a clinical advisory board member for Sesh, a mental health platform that offers therapist-led support groups. “Not everyone is comfortable opening up right away, even to their own therapist,” Cammack says. In a group, however, people can hear from others facing similar struggles.
What is group therapy?
Like individual therapy, group therapy is led by a mental health professional, such as a psychologist, social worker or psychiatrist, trained to provide “competent group therapy,” Wright says.
Group therapy is often structured around a specific theoretical orientation. For instance, research shows that cognitive-behavioral therapy can help alleviate social anxiety. In contrast, interpersonal groups can help address relationship concerns including asking for help, expressing emotions and working through conflict.
Lundberg’s group met three times a week via Zoom for several months. “The main benefit was being part of a caring group of people,” she says. “I looked forward to seeing them each week, and it helped me feel less alone.”
Lundberg, who has an autoimmune illness and worried about becoming seriously ill if she caught covid-19, the disease caused by the coronavirus, says the group therapist taught coping skills such as mindfulness, breathing work and self-care tools that have been clinically proved to help manage stress and symptoms of depression and anxiety.
Another potential takeaway is that group therapy gives members the chance to receive feedback from many individuals. “This can lead to a broader perspective to solving life’s troubles,” Cammack says.
But although groups offer many positives, Wright cautions that they are not the first line of treatment for people having thoughts of self-harm or in a crisis. In those cases, group therapy might be used in conjunction with individual therapy, she says.
What is a peer support group?
Unlike group therapy, peer-led groups are not managed by a mental health professional. Instead, they’re led by people who have faced challenges the group members are also experiencing.
After her mother died many years ago, Barri Leiner Grant, 56, a certified grief coach in Chicago, played host to a group event for motherless daughters. “I realized that we don’t ‘get over’ grief; we learn to live with the loss,” Grant says. Recognizing the need for more support, Grant was inspired to start “the Memory Circle,” a grief group for anyone coping with loss.
Even though peer-led groups such as Grant’s don’t deliver psychotherapy, they can still soothe emotional pain and ease stress. One study found that these groups can increase resilience and help people feel more empowered and hopeful about the future.
Although each peer group differs, Wright says the underlying goals tend to be similar. “Peer support seeks to validate people’s emotions, help them feel less alone and create community,” she says.
In her groups, Grant does not set out to change anyone’s beliefs or behavior: “We do not join together to fix one another, but to hold space and time to experience grief.”
Teri Brister, the chief program officer for the National Alliance on Mental Illness (NAMI), says peer groups can be a good fit for anyone looking for personal support and to learn from others.
How to find a group
Health-care professionals including doctors and nurses can provide peer support and group therapy referrals. Online directories run by Psychology Today and the American Group Psychotherapy Association provide lists of therapy groups.
Nonprofit organizations such as NAMI offer peer-led groups for people living with mental illness. And for new parents in search of support, Postpartum Support International provides support groups for mothers struggling with postpartum depression and anxiety.
Before signing up for a group, Wright recommends reviewing your health insurance and, because group therapy is not always covered by insurance, inquiring about costs upfront. Lundberg’s group was offered through the University of Minnesota as part of an intensive outpatient program; most hospital-based programs accept insurance.
Telehealth companies including Sesh and Circles provide support groups, but it’s important to read the fine print. Cammack says Sesh operates on a confidential platform, but not all telehealth apps follow these guidelines.
“In the U.S., there’s no regulatory body overseeing mental health apps, making it hard to determine what’s ‘good’ and what’s not,” Wright says.
To ensure confidentiality, check out whether your health information is sold, and if there’s a data breach, what recourse members have.
Also, ask who leads a group and whether they’re a trained mental health professional, Wright suggests. In some but not all cases, support groups (not peer groups) will be led by therapists.
If group-based mental health seems like a good fit, try a few sessions. Pay attention to how the interactions between the therapist and the other group members feel. Witnessing other people’s suffering often presents an opportunity to extend empathy and altruism to someone else, which can also be healing, research shows.
In the end, Lundberg says her experience was invaluable.
“Before covid-19, I never pictured myself trying group therapy or seeing a psychiatrist,” she says. “However, it was a great source of support at a very unpredictable and frightening time.”