The Growth of Group Therapy

Written by Andrew Brinker and Jordyn Hronec, News Editors at The Point Park Globe
Illustrations by Eli Savage, Staff Illustrator at The Pitt News
June 14, 2019

Gabby Ritterson, 19, from Old Bridge, New Jersey, attended group therapy for two years due to ongoing experiences with mental illness.

Grace McAfee, 19, from the North Hills of Pittsburgh, attended several group therapy sessions with her immediate family in an attempt to sort out issues among themselves.

Keith Paylo, Point Park University's Dean of Students, describes the university counseling center's group therapy programs as more of an offer to students, rather than a push towards a new counseling method, citing the effectiveness of the group model in situations both on and off college campuses.

Group therapy is also often used to treat serious addictions. In fact, as of 2017, the Alcoholics Anonymous organization, a popular provider of group therapy for individuals battling addiction, estimated that approximately 2.1 million people actively utilize their services.

On the collegiate level, the use of group therapy is also expanding quickly. But the explanation for this growth is mixed.

The Center for Collegiate Mental Health at Penn State conducted a survey in 2016 regarding the demand of mental health services on college campuses, the results of which were published in the Journal of College Student Psychotherapy. The survey found that usage of college-provided mental health services was up 38.4% (29.6% of which was student usage). This was compared to a 5.6% increase in tuition over a five-year period.

The article also detailed a study conducted at an unnamed university in the mid-Atlantic region, that aimed to discover whether group therapy programs could save "clinical" time. The university's counseling center ran seven different therapy groups over the course of the semester. Groups included sexual assault survivors, members of the LGBTQ+ community, and students interested in mindfulness. Between the two semesters that were observed, the study revealed that group therapy did not definitively save time or improve efficiency.

But group therapy - at least at the collegiate level - appears to be the way of the future.

On college campuses in the Pittsburgh region, several counseling centers are expanding their programming to include group therapy. This includes Robert Morris University, Duquesne University and Point Park University.

Graphic by Dara Collins, Editor-Elect of The Point Park Globe

The University of Pittsburgh and Carnegie Mellon University have particularly intricate existing group therapy programs that include multiple specialized groups. Some Pitt students, however, feel as if they are being pushed into group therapy rather than being allowed to meet with counselors one-on-one. In an interview with the Pitt News in April, Pitt's new counseling center director, Jay Darr, said the idea that Pitt's counseling center is forcing students into group therapy is a "myth."

"And, a student can always come back, and say, 'Hey, this sort of combination of services is not working,' so they can come back during our walk-in hours, or during their scheduled appointment, and meet with a clinician and say, 'hey, can we talk about adjusting some things?' or the clinician can say, 'Hey, I can see that this is not working for you. Let's talk about adjusting what's best for you,'" he said.

Kurt Kumler is the current director of counseling services at Point Park University. Kumler previously served as the executive director for counseling and psychological services at CMU. Under Kumler's direction, the Point Park University counseling center has shifted to include group therapy in its list of services, which also includes individual therapy and outbound referrals.

"We did have a lot of student input, which is something I'm always interested in seeking," Kumler said, regarding the establishment of the group therapy program at Point Park's counseling center. "It was kind of real-time, about mid-way through last semester, where a lot of students were coming in for counseling. And we didn't have enough space or enough therapists, so this would be a relatively standard idea to try and offer additional services that can touch more students"

Kumler stated that about midway through the Fall 2018 semester, demand for counseling services was higher than what the center was able to provide. During this time, the center began to offer additional services, including group therapy.

"It worked out pretty well, and we actually grew the program this semester to offer two different times to meet. We changed up the location, with a general guess that that may make it easier for some folks to think about giving it a try. And we're running that just to see how it goes."

Graphic by Dara Collins, Editor-Elect of The Point Park Globe

Adding group therapy to the menu of services offered by a counseling center is a "real-time strategizing effort", that is currently rising to popularity among universities nationwide, according to Kumler.

But Ritterson, who utilized Point Park's counseling services during the fall semester of 2018, said that the existing program was more harmful to her than helpful.

"I did not gain one thing," she said. "It was a waste of my time and a waste of my effort. I put too much trust in the university and in the program."

Ritterson detailed a lack of availability, ineffective therapists and a limited time period with a counselor per student as her main issues with the school's program.

On Pitt's website, there are details regarding their group therapy programs and what students should expect upon joining.

"Group counseling/therapy provides an opportunity to be part of group of six to eight students who meet regularly over the course of one academic term to share concerns, explore personal issues, and learn new skills under the guidance of one or two group leaders/facilitators," the website reads.

The website also lists different specialized groups that students can join.

"Each term, we offer a variety of general therapy groups, therapy groups for particular populations (e.g., graduate students, women, men, LGBTQIA+ students), and therapy groups for particular issues/problems (e.g., depression, anxiety, self-esteem, stress management, family issues, substance abuse problems, history of sexual assault)," it states. "We also offer educational workshops on a variety of topics. Group therapy participants are asked to commit to attending group therapy sessions regularly for the duration of the group."

The Point Park University counseling center also provides information regarding group therapy programs on its website.

"Group therapy helps group members experience new ways of thinking, feeling and behaving," the website reads. "A main focus in group therapy is your process of relating to other group members. This work can involve group members developing trust, building intimacy, or working through conflicts together."

The website also highlights the importance of confidentiality in a group setting.

"As group therapists facilitate a safe and confidential environment, group members are able to give support, offer feedback, help raise awareness of interpersonal patterns, and help address difficulties," it states. "Like other forms of therapy, what you get out of your group experience will depend largely on what you invest into it."

Keith Paylo, Dean of Students and Vice President of Student Affairs for Point Park, worked with Kumler to implement the new program.

"I think that there is definitely a place for group therapy," Paylo said. "I think there's definitely a place for individual counseling sessions as well. But I just believe that group counseling is effective in areas where students feel the benefit of the support of others."

Even though the method of therapy used is most often situational, Paylo made it a point to highlight the positives of group therapy.

"Peer support is a big benefit," Paylo said. "You're sitting in a group therapy session and the light bulb goes on that says 'I'm not alone.' There are other people that are experiencing the same exact or very similar thing that I am and in many things in life, that's good to know."

But the growing practice also has its negatives. As Paylo acknowledged, appropriate time division is a recurring issue.

"You're going to have that person who always raises their hand and monopolizes the time," Paylo said. "In an atmosphere such as this the person's level of anxiety probably is at its highest because you are starting to share very personal things. And so human nature, you start to talk a lot and you start to ramble."

In McAfee's experience with the group therapy model, time restrictions were a prevalent issue. While the therapy aided her and her father's relationship by creating an environment for them to listen to each other, her and her stepmother's relationship became more strained.

"It was mostly just my stepmom talking for 45 minutes, and then my dad and I talked about how she took up most of the time for 5 minutes, then we'd leave," McAfee said. "I feel like if there's someone in group therapy who wants to talk mostly, then they will. It was mostly just her spewing words for 45 minutes...It was a damper on my and my stepmom's relationship, because when I gave feedback it wasnt really respected.

Ritterson, in her personal experience, also saw issues with the model.

"I found myself asking these therapists one day, what makes you qualified to talk to us about depression, anxiety, Tourette's, OCD,  self harm, eating disorders - what makes you qualified?" Ritterson said. "It wasn't specialized. And I felt like they're trying to target so many issues, but there's no way to talk to 12 or 13 kids in an hour, and get through all of their issues."

Despite its drawbacks, universities continue to shift towards group therapy, while putting less emphasis on one-on-one resources. Paylo indicated that resources and cost required for individual therapy partially accounted for Point Park's introduction of group therapy.

"You're never going to be able to match the needs of what is coming to us with the services that are available," Paylo said. "This is just where we're at in society today. There is a much bigger ask than there is the ability to meet those needs for that ask. What group therapy can do is get an individual a quicker response and therapy than waiting for a one-on-one. One-on-ones take a lot more time."

But for some, while the idea of group therapy may appear to be objectively effective, their experience has proven to them that the group concept's fatal flaw lies in its execution.

McAfee is a current student enrolled at the Community College of Allegheny County's North campus. Although CCAC does not currently offer group therapy through its counseling centers, McAfee has participated in family group therapy with her father and stepmother. McAfee said that she did not find the group therapy setting to be effective.

"When I went, especially because it was family therapy, and for my family, I feel like it was forced feedback," McAfee said. "Because there's this stigma where you go to therapy and things have to be immediately solved or there's something else wrong. So I don't feel like the feedback I received was helpful."

McAfee, who has also experience extensive one-on-one counseling, recognizes group therapy's potential to be time-saving, whether it be at the cost or benefit to the patient.

"Sharing my feelings with my family in the room was one of the most awkward things ever," McAfee said. "I feel like there's this stigma around groups. With group therapy, you can sit down a bunch of kids and give them some vague topic and let them hash it out. Because one-on-one counseling is time consuming."

McAfee is not alone.

Ritterson, a Point Park University student, also had a negative experience with group therapy.

"The idea, in my mind, of group therapy is to make you feel like you're not alone and to learn from other people," Ritterson said. "And these people have definitely had an impact on my life, like the other people that I was in therapy with, but they didn't make you feel less alone."

According to Ritterson, while peer support is beneficial, a fundamental issue of the practice lies in the therapists.

But Ritterson, echoing the reasoning of Paylo and Kumler, did find some elements of the group dynamic appealing.

"It [the group] made me realize that there was more wrong with me than I thought," Ritterson said. "When these people [other group members] would say they were bad, they were feeling the same exact things as me, and I'd be like 'oh, okay,' like that actually is really bad. It helped me work on myself more because I realized a lot of underlying factors."

But ultimately, at least for Ritterson, the extended list of cons of group therapy outweigh the potential positives. Since her experience in a group environment, the college freshman has only participated in therapy in a one-on-one setting; and she plans to keep it that way.

"It [individual therapy] was all around better," Ritterson said. "I benefited so much more because I found my one therapist that made me feel really good. I feel like group therapy could be more helpful than it is, and I get why colleges are moving in that direction, but at least in my experience, the execution of it really made it something bad to me. They need to work out the kinks before they make this big push."