By Sara Veillon, M.S., LPC, NCC Founder & Licensed Professional Counselor | Mental Health Counseling Group Published: June 12, 2026 | Last Updated: June 12, 2026

One of the things I notice when I talk to people about group therapy is that they almost always picture the same scene: a circle of folding chairs, someone introducing themselves by first name only, fluorescent overhead light. Most of them are picturing AA or NA, which makes sense because that's the version of "group" that gets the most screen time. Clinical group therapy isn't that, or at least isn't only that. It's a small group of people, usually six to ten, who meet regularly with a licensed therapist to work on what they're working on, with the rest of the group as both witnesses and participants.

A lot of clients are surprised, often pleasantly, by how powerful it is. This post is about what group therapy actually does that individual therapy doesn't, who tends to do well in groups, and what a first group session usually looks like.

How Is Group Therapy Different From Individual Therapy?

In individual therapy, the relationship is between you and the therapist. The work happens through that one relationship: how the therapist reflects you, where they push, where they hold steady. In group therapy, the relationship is between you and the whole room. The therapist guides the process, but the active ingredients also include the other clients. You hear how someone else struggles with a problem you thought only you had. You watch someone receive empathy and notice that you'd been refusing the same thing for yourself. You learn how you come across to other people, in real time, from people who don't know your story.

That last piece is the part that's hard to get from a book or a podcast. Most of us have blind spots about how we land with others, and most of those blind spots don't show up in individual therapy because the dyad is too small a sample. The group widens the mirror.

What Does the Research Actually Say About Group Therapy?

It's strong, and it has been for decades. The American Group Psychotherapy Association and the American Psychological Association both classify group therapy as an evidence-based treatment with outcomes comparable to individual therapy across a range of conditions: depression, anxiety, social anxiety, grief, substance use, trauma, eating disorders, and more (Burlingame et al., 2016). A 2016 meta-analysis published in Psychotherapy pooled outcomes across 252 studies and found no significant difference in effectiveness between group and individual modalities for most conditions, with some conditions (notably social anxiety) showing particular benefit from group formats (Burlingame, Strauss, & Joyce, 2013).

That's not to say group is interchangeable with individual therapy. They tend to do different work. But "individual is real therapy, group is the budget version" is not what the evidence supports.

Who Tends to Do Well in Group Therapy?

A few patterns stand out in my practice.

The first is people who feel isolated in their problem. Whether it's grief after a specific kind of loss, the experience of being a new mother, a particular trauma, or an identity-based experience (LGBTQ+, neurodivergent, first-generation), one of the most common forms of suffering is the belief that you are the only one. Group therapy short-circuits that belief in a way nothing else does, because you walk into a room where you are clearly not the only one.

The second is people who struggle with interpersonal patterns. If your therapy goals involve how you show up in relationships, the group becomes a live laboratory. You can practice setting a limit, accepting praise, expressing anger without exploding or withdrawing, asking for what you need. The other members give you feedback in real time. You can't get that level of practice in a one-on-one room.

The third is people whose finances or schedule make weekly individual therapy hard. Group therapy is typically more accessible per session than individual work, and many groups meet at consistent times that are easier to plan around. That accessibility shouldn't be dismissed as a lesser reason; it's often what makes the difference between getting care and not.

The fourth is people who've reached a kind of plateau in individual therapy and are ready for a different mirror. A common arc in my practice is individual therapy, then group, then back to individual, or a combination. The two formats feed each other.

When Is Group Therapy Not the Right Fit?

There are situations where I steer clients away from group, at least initially. Active crisis, where someone needs more individual stabilization first. Severe interpersonal difficulty that would dominate the group and damage the work for everyone else. Active addiction without sobriety in place. Very recent trauma where the client doesn't yet have the regulation skills to be in a multi-person room without flooding. A specific situation where confidentiality risk is high (a small professional community, for example, where two members might know each other outside the group). In any of those cases we start with individual and revisit group readiness later.

The intake process for any group I run includes a one-on-one screening conversation before the group starts. That's not a gatekeeping exercise. It's making sure the client and the group are a good fit for each other, because a poorly-matched group damages everyone in it.

What Does a First Group Session Actually Look Like?

Most groups I've been part of start with the therapist setting the frame: confidentiality expectations, agreements about how members will speak to each other, what kinds of things go in and don't go in. The first session usually has a brief check-in from each member: name, what brings you to the group, what you're hoping for. Some groups use a structured prompt; others stay more open. The therapist's job is to track the room, make sure no one dominates, make sure no one disappears, and gently guide the work as it emerges.

A lot of first-session anxiety dissolves within about twenty minutes. Clients often report afterward that they felt much more met than they expected, and much less judged than they'd worried they'd be. That said, the first few sessions can feel awkward. Group dynamics take a few meetings to settle, and the most meaningful work usually comes after the early period of figuring out the room.

Can Group Therapy Be Done Over Telehealth?

Yes, and many groups now operate that way. The research on telehealth groups has caught up with the research on telehealth individual therapy: outcomes are comparable, satisfaction is high, and the practical advantages (no commute, broader geographic catchment) often improve attendance. Some kinds of group work translate better to video than others. Highly verbal, talk-driven groups translate well. Embodied work (movement, somatic exercises) sometimes does better in-person. We work with both formats at Mental Health Counseling Group, and group offerings rotate based on demand.

Frequently Asked Questions About Group Therapy

How many people are in a typical group? Most clinical groups run six to ten members, with two therapists for larger groups. Smaller is more intimate; larger gives more diverse feedback. We aim for a size that fits the kind of work the group is doing.

Will I have to share things I'm not ready to share? No. Group therapy isn't a confession booth. You decide what to bring and when. Most groups have an explicit agreement that participation is voluntary, and a good therapist tracks the room to make sure no one is being pressured.

Is group therapy confidential? The therapist is bound by the same confidentiality standards as individual therapy. Other group members agree to confidentiality as part of joining, but they are not licensed clinicians and the confidentiality is a social agreement rather than a legal requirement. This is part of why screening matters.

Can I do individual and group therapy at the same time? Yes, and it's often a powerful combination. Your individual therapist and your group therapist can coordinate (with your consent) to make sure the work is aligned.

How do I find a group that fits? Mental Health Counseling Group offers different group formats based on demand. You can book a consultation to talk about what kind of group might fit, or contact our Katy office to ask about current openings.

Talk With a Counselor

If group therapy sounds like something worth exploring, book a consultation and we'll talk through what you're looking for. We offer individual counseling, family counseling, and rotating group programs across our Katy office and via telehealth across Texas. Our FAQ covers logistics.

About the Author

Sara Veillon, M.S., LPC, NCC is the Founder and Licensed Professional Counselor at Mental Health Counseling Group. She specializes in EMDR, trauma-focused therapy, and couples and family work, and she co-hosts the This Might Be Triggering podcast with Jennifer West.

Read more about Sara → · Book a session

Sources

  • Burlingame, G. M., Seebeck, J. D., Janis, R. A., Whitcomb, K. E., Barkowski, S., Rosendahl, J., & Strauss, B. (2016). Outcome differences between individual and group formats when identical and nonidentical treatments, patients, and doses are compared: A 25-year meta-analytic perspective. Psychotherapy, 53(4), 446–461. https://psycnet.apa.org/record/2016-32256-005
  • Burlingame, G. M., Strauss, B., & Joyce, A. S. (2013). Change mechanisms and effectiveness of small group treatments. In M. J. Lambert (Ed.), Bergin and Garfield's handbook of psychotherapy and behavior change (6th ed., pp. 640–689). Wiley.
  • Yalom, I. D., & Leszcz, M. (2020). The theory and practice of group psychotherapy (6th ed.). Basic Books.
  • American Psychological Association, Division 49 (Society of Group Psychology and Group Psychotherapy). Resources on evidence-based group psychotherapy. https://www.apadivisions.org/division-49

Photo by Dorota Trzaska on Unsplash.