Exploring why group therapy remains underused
When people think of psychotherapy, they often imagine a one‑to‑one conversation between a patient and a therapist. Yet for more than a century, group therapy has offered a communal path to mental health that remains underused. In a January 14 Vox article, writer Eleanor Cummins profiles Christie Tate, who as a young lawyer felt overwhelmed by loneliness, bulimia and suicidal thoughts. After years of individual therapy failed to ease her suffering, a friend suggested she join a small group. There, guided by a therapist, five or six strangers met weekly to share their experiences and reactions. Tate found that hearing others voice similar feelings and receiving candid feedback on her own behaviour broke through her isolation. Group dynamics revealed patterns she had missed, such as withdrawing when ashamed or pursuing partners who could not meet her needs. Over time she learned to express her desires and develop healthier relationships.

Despite such success stories, only a small fraction of private practices in the United States offer group options. Many people are not aware that group therapy exists, and some assume that sharing time with others diminishes the benefits. Members practise listening, empathy and setting boundaries. For those grappling with shame or loneliness, seeing peers navigate similar struggles reduces stigma and fosters connection. Group sessions are also significantly cheaper, often costing half to two‑thirds as much as individual therapy. Research shows that for conditions such as depression, anxiety, eating disorders and chronic pain, group approaches can be as effective as one‑on‑one counselling, especially when therapists skilfully facilitate discussions.

Roots in history and prospects for the future
Group therapy has deep roots. In 1905, Boston physician Joseph Pratt gathered tuberculosis patients to track their conditions and observed that mutual support improved outcomes as much as medical advice. After World War II, psychoanalyst Wilfred Bion developed theories about group dynamics while treating traumatised veterans, helping to establish group therapy as a serious therapeutic modality. Yet group work never entered the mainstream of psychotherapy, partly because culture emphasises individualism.

Advocates say change may be coming. Hashtags like #TherapySpeak have normalised mental health conversations, while telehealth platforms make it easier to assemble diverse groups. Growing clinician shortages and the rising cost of one‑to‑one therapy encourage people to consider alternatives.

Successful groups rely on structure. Therapists set ground rules, screen participants and ensure everyone has a chance to speak. Confidentiality agreements build trust, and participants commit to attending regularly. While concerns about privacy and conflict persist, experienced facilitators know how to guide challenging discussions. Participants learn to disagree respectfully, recognise how their behaviour affects others and ask for support. When the COVID‑19 pandemic forced many groups online, therapists discovered that virtual spaces could also foster intimacy.

Cummins argues that wider adoption of group therapy could address multiple issues: easing access to care, building community and improving outcomes across demographics. She notes that many prospective patients simply do not know the option exists. For group therapy to reach more people, clinicians must receive training to lead groups, insurers must cover the sessions and mental health advocates must highlight stories like Tate’s. As loneliness, anxiety and depression continue to rise worldwide, a collective approach to healing may complement individual work. Group therapy is not a cure‑all—participants must be willing to be vulnerable and patient—but for those who cannot afford or cannot find one‑to‑one therapy, it offers a powerful alternative that turns shared time into shared insight.