When it comes to recovery from mental health disorders and addiction, you don’t have to do it alone. New formats and new research are supporting what we’ve long known: group therapy works. Here’s why.
Ask people what treatment for addiction and mental health looks like, and they will most likely describe a circle of group members introducing themselves one by one, before sharing tearful stories of their struggles.
While these depictions of the quintessential group therapy session might not be far from the truth, group therapy is much more effective than the clichés let on.
At our facilities across Canada, we have seen the impacts that group therapy can have on the long-term recovery of our patients struggling with mental health disorders and addiction. Group-based approaches include Cognitive Behavioural Therapy (CBT), Dialectical Behaviour Therapy (DBT), and Acceptance and Commitment Therapy (ACT). Research from around the world continues to back-up group therapy effectiveness and give insight into why it works.
We have also been at the forefront of bold new approaches to group therapy which make it even more accessible to Canadians during the pandemic or those who live in remote regions.
Here we explore the who, how, why and where of EHN Canada’s group therapy treatment.
Who group therapy can help treat
At EHN Canada, we use group therapy to treat an array of substance and process addictions and mental health disorders. This can benefit patients struggling with:
- Alcohol addiction
- Drug and prescription medication addiction
- Depression, bipolar disorder, and anxiety disorders
- Sex and love addiction
- Gambling addiction
- Post-traumatic Stress Disorder and Operational Stress Injury
- Obsessive Compulsive Disorder
- Eating Disorders
How group therapy sessions work
What you’ve seen is not far off from the reality. Groups of up to 12 participants are led by a therapist throughout the session. If there are more than 12 people, there is often an additional therapist to help facilitate the group.
A session can last from one to three hours, depending on the number of patients. And they usually occur at least once per week, more frequently to focus on multiple skills and topics, and are used in addition to a patient’s one-on-one therapy sessions.
During the group, a therapist will lead the conversation, exploring participants’ experiences and trauma associated with their addiction or mental health.
There are 5 different models of group therapy used to treat substance addiction with various focuses:
Psychoeducational Groups: teaching about substance abuse
Skills Development Groups: honing the skills necessary to break free of addictions
Cognitive–Behavioral Groups: rearranging patterns of thinking and action that lead to addiction
Support Groups: debunking each other’s excuses and support constructive change
Interpersonal Process Groups: enabling clients to recreate their pasts and rethink the problems that led them to addictive substances
Additional group exercises may include:
- Educational lectures, workshops, or outings
- Cultural or social outings or activities, including galleries, live music events and other performances
- Creative and expressive exercises including painting & drawing, writing, acting, and dance
- Wellness therapies such as yoga, Pilates, or acupuncture
- And peer support or self-help sessions
Why group therapy works
Group therapy alone may not rid a patient of their addiction or mental health disorder. But in combination with individual treatment, it can offer some positive results that change a patient’s outlook and offer the support needed to recover long-term.
Here are 5 reasons why group therapy is so powerful:
1. Group Therapy Is Cathartic
One way to release emotional pain is to talk about and process difficult emotions and experiences with others; specifically, learning to express emotion to others in a healthy way can have lasting positive psychological and physical health benefits.
2. Group Therapy Gives Hope
When a patient is stuck in life or hopeless about the possibility of successful treatment and recovery, one of the most powerful therapeutic processes is witnessing change in other peers in recovery. Seeing other people with similar issues make significant shifts or make positive changes in behaviour, promotes hope for the future and allows others to be open to the possibility that they also might change.
3. Group Therapy Shows the Universality of Experience
Once a patient’s experience is validated and accepted and they hear other group members disclose experiences or problems similar to their own, patients often feel a greater sense of closeness to others and the world around them. Closeness to others shatters the self-destructive behaviour of isolation and becomes an asset in a person’s ongoing recovery. It turns out that the cliché, “we’re all in the same boat,” packs a heavy therapeutic punch.
4. Group Therapy Fosters Belongingness
Even in relationships with families, friends, co-workers, or classmates, many addicts entering treatment have struggled with feeling a sense of true unconditional love or belongingness within a group context. Group therapy acts as a powerful corrective experience, providing disconfirming evidence to disarm negative core beliefs by providing a space for connection and belongingness.
5. Group Therapy Creates a Space for Interpersonal Learning
Addiction creates a world of isolation, chaos, and disconnection. Group therapy, however, offers a supportive space to learn how to communicate in a healthy manner, resolve conflicts, and speak vulnerably about emotion without the fear of judgement. For some individuals, this may be the first time in their lives that they have shared their emotions and experiences honestly with peers.
(Read more about how group therapy can be so powerful here.)
What does the research say?
While there is plenty of on-the-ground, qualitative evidence, there is also quantitative evidence that supports group therapy’s effectiveness. A recent systematic review of 902 publications and 30 studies found that:
- Mindfulness-based interventions appear to be as effective as existing evidence-based treatments for substance use disorders at reducing the frequency and quantity of alcohol and drug use, substance-related problems, craving for substance use, and at increasing the rate of abstinence
- There are positive results in patients with concurrent depression and anxiety, and a decrease in psychiatric distress
- Participants display more control of stressful situations that may have previously led to their substance use
Where can group therapy take place?
While group therapy sessions were once limited to facilities or informal settings, technology has changed that.
For those living in rural parts of the country, attending group therapy sessions each week is not always an option. And others, who have commitments to family or careers, cannot take the time required for intensive in-person treatment. We are also living through a once-in-a-lifetime (hopefully) pandemic, which is making it impossible or risky for groups of people to gather.
So how is group therapy possible with these barriers? EHN Canada has been expanding our unique Intensive Outpatient Programs to provide patients with comprehensive online treatment from wherever they are.
This virtual, in-home option is available to those struggling with depression, anxiety, substance addiction, behavioural addictions, and workplace trauma. And it offers a combination of individual and group therapy sessions through EHN Online (Powered by Wagon).
Our Intensive Outpatient Program offers:
- 8 weeks of therapy, including 8 hours of virtual group sessions and 1 hour of individual counselling per week
- 10 months of online aftercare to stay on track
- The Wagon app to help set goals, track progress, and monitor triggers
- Access to a team of strong clinical experts, specifically trained in online counselling
- And the flexibility and convenience of therapy from the comfort of home
But is online therapy as effective?
While internet-based therapy is a rather new offering, there is already strong evidence that it is just as—or even more—effective than in-person options.
A trial in the Journal of Effective Disorders found that “internet-based intervention for depression is equally beneficial to regular face-to-face therapy. However, more long-term efficacy, indicated by continued symptom reduction three months after treatment, could be only be found for the online group.”
The Cureus Journal of Medical Medicine’s study “showed that [Internet-based] CBT is effective in the treatment and management of various psychiatric disorders such as depression, GAD and social anxiety, panic disorders, phobias, addiction and substance use disorders, adjustment disorder, bipolar disorder, and OCD.”
And even smartphone-based options, like the one we offer through our Wagon App, already have the support of many medical researchers. MHealth’s 2018 study found that, “Given the global shortage of psychiatrists and the lack of mental health care access in rural regions, apps have emerged as a viable tool to bridge the mental health treatment gap.”
So, why choose group therapy treatment?
Group therapy can help:
- Reduce stigma and normalize client experience
- Improve interpersonal effectiveness skills
- Promote social skills and combats isolation
- Lead to post-treatment peer support
- And increase accountability and client engagement
And further research has shown across-the-board benefits of group therapy:
- Cost-saving alternative to individual therapy only
- Higher-than-average completion rates
- Improved outcomes in treating anxiety, substance use, PTSD, compulsive sexuality and depression
- Gains made during treatment are maintained during post-treatment period
Think you or someone you know might benefit from group therapy?
If you are interested in enrolling yourself in one of our programs, or in referring someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.
- 1-800-387-6198 for Bellwood Health Services in Toronto, ON
- 1-587-350-6818 for EHN Sandstone, in Calgary, AB
- 1-800-683-0111 for Edgewood Treatment Centre in Nanaimo, BC
- 1-888-488-2611 for Clinique Nouveau Depart in Montreal, QC
- 1-866-860-8302 for virtual outpatient support, available wherever you are
 “Substance Abuse Treatment: Group Therapy.” Treatment Improvement Protocol (TIP) Series, No. 41. Center for Substance Abuse Treatment. https://www.ncbi.nlm.nih.gov/books/NBK64223/
 Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial.” Substance Abuse, Prevention, and Policy. 15, 51 (2020). https://doi.org/10.1186/s13011-020-00293-3
 “Internet-based versus face-to-face cognitive-behavioral intervention for depression: A randomized controlled non-inferiority trial.” Journal of Affective Disorders, Volumes 152–154, January 2014, Pages 113-121. https://www.sciencedirect.com/science/article/abs/pii/S0165032713005120?via%3Dihub
 “The Effectiveness of Internet-Based Cognitive Behavioral Therapy in Treatment of Psychiatric Disorders.” Cureus Journal of Medical Science. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5659300/
 “Do mental health mobile apps work: evidence and recommendations for designing high-efficacy mental health mobile apps.” MHealth. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5897664/