Cognitive-Behavioral Therapy (CBT) is one of the most studied psychotherapies. Its uniqueness stems from the use of cognitive and behavioral therapeutic approaches to fix a problem. It is a short-term, goal-oriented therapy, that focuses on fixing unwanted patterns of thinking or behavior and changes false, distressing beliefs, because it is often not only the things and situations themselves that cause problems, but the importance that we attach to them too (Institute for Quality and Efficiency in Health Care [IQWiG], 2016).
CBT use in group and family settings have some similarities. Both therapies utilize a therapist who is the main conductor towards pointing out issues that families have between each member and problems that individuals in groups may have in common with others (Landa et al., 2016). Both serve to help point out each other interpersonal problems, which has caused them to over-generalize triggers in their minds and behaviors. Also, in group and family therapies, the sessions focus on current problems, not problems from the past. There is a small insight into what could have led up to the current issue, but the main idea is to help each group or family member help themselves, in order to see positive change and combat negative stressors (Landa et al., 2016).
From my own personal experiences, group and family CBT sessions do share these similarities. I have noticed that families are much easier at opening up about their dysfunction because everyone is familiar with each other, whereas, in group sessions, there is more hesitancy from fear of judgment. An example of this was with a group of patients who had Major Depressive Disorder (MDD), a few weeks ago that I helped lead, when asked an open question like “ What causes you all to think so negatively about your life,” most of the clients in the group session did not want to answer, or said they do not want to hear what others think. Compared to the families, I have interviewed who lay everything on the table, because they do not know what else to do. One family when asked “What do you think is causing your son, to be so distant from you.” Both the mother and father felt comfortable talking about their family because there was a set foundation already in place.
A challenge when using CBT in group therapy is the differences in personalities. Since the group’s members may not know each other personally, one may take something that is said out of context. Studies show that clashes in personalities occur often in group settings when there is a difference in viewpoints or opinions based on what an individual said, this results in disputes between group members who have different ethical morals or beliefs (Biggs et al., 2020). Another challenge is being comfortable. It can be very hard for someone to have to speak their personal business with a group of people they do not know. It leads to anxiety and a lack of return to therapy sessions. Research shows that dropout rates for group therapy are between 30-60 percent with 42 percent of dropout happening after the second session (Simon et al., 2012).
Biggs, K., Hind, D., Gossage-Worrall, R., Sprange, K., White, D., Wright, J., Chatters, R., Berry, K., Papaioannou, D., Bradburn, M., Walters, S., & Cooper, C. (2020). Challenges in the design, planning and implementation of trials evaluating group interventions. Springer Link, 21(116). https://doi.org/10.1186/s13063-019-3807-4
Institute for Quality and Efficiency in Health Care. (2016). Cognitive behavioral therapy. Informed Health. https://www.ncbi.nlm.nih.gov/books/NBK279297/
Landa, Y., Mueser, K., & Walkup, J. (2016). Development of a group and family-based cognitive behavioral therapy program for youth at risk for psychosis. Early Interventions in Psychiatry, 10(6). https://doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5685498/
Simon, G., Ding, V., & Savarino, J. (2012). Early Dropout from Psychotherapy for Depression with Group- and Network-model Therapists. Administration and policy in mental health, 39(6), 7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3708590/