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Group Therapy for Obsessive-Compulsive and Related Disorders

Matthew D. Jacofsky, Psy.D., Melanie T. Santos, Psy.D., Sony Khemlani-Patel, Ph.D. & Fugen Neziroglu, Ph.D. of the Bio Behavioral Institute, edited by C. E. Zupanick, Psy.D.

Research has demonstrated the effectiveness of group therapy in the treatment of obsessive compulsive and related disorders (Gilliam, et al., 2011; Van Noppen, Pato, & Rasmussen, 1998; Wilhelm, et al., 1999).

group therapy sessionThere are several types of beneficial groups. First, there are treatment (or therapy) groups. A mental health professional (therapist) leads this type of group. However, the therapist's role is to facilitate discussion among group members, rather than to direct, lead, or teach. Therapy groups may have a specific focus such as exposure and response prevention therapy or cognitive therapy. Regardless of the specific focus, the needs of the group members set the tone, content, and pace of the group. In this type of group, members learn from each other, aided by the therapist's support and guidance.

A second type of group is a skills-training group. These groups are also led by a mental health professional. However, the therapist is more active and directive. The therapist's role is to teach, train, and coach group members to develop and practice new skills. These groups are generally very structured and each meeting has a specific learning objective and a defined agenda.

Skills training groups are often used for mindfulness training and breath and relaxation training. Mindfulness training teaches people how to quiet their mind. This reduces anxiety by focusing attention on the present moment in time. Mindfulness training is a key component of certain types of therapy such as ACT. Breath and relaxation training is often necessary before participation in exposure and response prevention therapy. It is intended to counteract the physiological symptoms of anxiety by consciously controlling breath and relaxing muscles.

A third type of group is a support group. These groups may or may not be led by a trained professional. The emphasis in support groups is to meet with others struggling with similar conditions or circumstances. Group members offer each other encouragement, hope, and support. These groups tend to be informal and may not meet as frequently as treatment-oriented groups.

The decision about when to begin group therapy is an important treatment decision. In some cases, group therapy may be counter-therapeutic if it is begun too soon in the recovery process. For example, consider a person with an obsessive-compulsive disorder who has just begun their recovery journey. If they were to attend a therapy group for exposure and response prevention, they may become frightened and highly anxious upon hearing group member discuss their own experiences. As a result, they might prematurely rule-out this type of highly effective therapy. With careful planning and preparation, the addition of group therapy as can be extremely beneficial.