In a recent article by Oliver Burkeman in The Guardian entitled, “Therapy Wars: The Revenge of Freud”, the author cites current research supporting the effectiveness of long-term psychotherapy, over the darling of quick-fix gurus and insurance companies, Cognitive Behavioral Therapy,( CBT).  While extolling psychoanalysis, the author has nary a word about group psychotherapy.  I wondered why.  While it is difficult to measure the efficacy of such a subjective treatment modality of individual therapy, it is exponentially more difficult to measure the efficacy of group therapy, and for good reason.  One key variable that is usually missing in the equation is that of the frame of treatment. The frame of treatment refers to the nature of the professional relationship of doctor / patient ( how do they know each other and what do they know) and in group therapy the frame is expanded to include the nature of the relationships between members as well (how do they know each other and what do they know). The security of the frame is important in determining the effectiveness of treatment, both  individual and  group therapy  for both ethical and clinical reasons, as I point out in my book , Emotional Incest in Group Psychotherapy–A Conspiracy of Silence.  When most studies  of group therapy assume the frame is a given, a substantial error factor is added to the equation.  This makes it impossible to know for certain just how powerful a healing modality group therapy is (or isn’t).

Another, and even more disturbing factor, may be the disdain for group therapy that exists in the profession.  There seems to be an attitude that running groups doesn’t take any particular skill or training. Junior colleagues, that work in mental health agencies, have told me that administrators of these organizations have ordered them to do group without any prior training nor experience. They were simply told:” It’s a money maker.”   This “anybody can run a group” mentality is dangerous and has led to iatrogenic treatment reactions among trusting group members. In one case known to me, for example,   a  colleague who only practiced individual therapy, said that he was going to start a therapy group .  When I questioned the wisdom of starting a group without ever having been a treatment group member nor having any training in group, he reassured me that it would work out fine.  He said that he was reading a book on how to run a group ( I imagined that it was”Group Therapy For Dummies”–put eight chairs in a circle and get a box of tissues).  While he was able to convince eight of his private patients to join the group, it folded in less than a month. One effect of this is to forever turn people off to group,  further contributing to the general public’s negative assessment of its value.                                                                                                       Since 1990’s, The American Group Psychotherapy Association has established criteria for certifying group psychotherapists (CGP). Like any credential, it is a necessary but not sufficient indicator of a leader’s fitness to practice. As with any business, caveat  emptor always applies.