Psychiatry: treatments
Group therapy
Group therapy treats several people together with one or two therapists, using the group itself as a source of support, feedback and learning. Psychiatrists learn group principles because groups are used widely in wards, rehabilitation and addiction services.
Depth by stage, Pre-U → Consultant (details)
What is it?
In group therapy, usually 6 to 12 people meet regularly with a trained facilitator. Members discover they are not alone, learn from each other's experiences, and practise new ways of relating in a safe setting. Groups can be time-limited and structured, such as a CBT group for anxiety, or more open and exploratory.
Groups are common in Malaysian psychiatric services: ward community meetings, relapse-prevention groups in addiction services, skills groups in dialectical behaviour therapy, carers' support groups and day-care rehabilitation activities.
Psychiatrists also experience group dynamics daily in multidisciplinary teams, so understanding how groups work helps both treatment and teamwork.
Why does a psychiatrist need it?
Groups are an efficient way to deliver treatment where specialists are few, and some benefits, such as peer support and reduced shame, happen best in groups. Psychiatrists may run groups, refer patients to them, or need to understand group processes in wards and teams.
What level is expected at each stage?
Scale: 1. Aware → 2. Understands → 3. Applies → 4. Masters / Teaches. What the levels mean.
- Pre-UNot expected
- Pre-clinicalNot expected
- ClinicalAwareMay observe a ward or day-care group during the psychiatry posting.
- HousemanshipNot expected
- Medical officerAwareJoins or co-facilitates ward or rehabilitation groups.
- Psych traineeUnderstandsUnderstands theory and may co-lead a supervised group; often attends a reflective group.
- Specialist / consultantAppliesUses group principles in service design, team leadership and staff support groups.
What are the key topics?
Theory
- Yalom's therapeutic factors: universality, instillation of hope, altruism, cohesiveness, interpersonal learning, catharsis
- Stages of group development
- Group roles and difficult members
- Group-analytic ideas (Foulkes) and Bion's basic assumptions
Types of groups
- Psychoeducational groups
- CBT and skills groups (including DBT skills training)
- Supportive and self-help groups (e.g. mutual-help fellowships in addiction)
- Psychodynamic and interpersonal groups
- Therapeutic communities
- Carer and family groups
Running a group
- Selection and preparation of members
- Setting rules: confidentiality, attendance, boundaries
- Co-therapy and supervision
- Managing conflict, silence, dropout and crises
- Ending a group
- Measuring outcomes
Group dynamics in services
- Ward atmosphere and community meetings
- Multidisciplinary team dynamics
- Balint groups and staff reflective practice
How is it learned and assessed?
- Observation during undergraduate postings and day-care or rehabilitation units
- Co-facilitation during MO and trainee years, often with psychologists or occupational therapists
- Theory examined in MMed (Psychiatry) and MRCPsych written papers
- Reflective or Balint group attendance commonly encouraged during training
Typical textbooks and resources
- The Theory and Practice of Group Psychotherapy — Irvin D. Yalom & Molyn Leszcz
- Introduction to Psychotherapy — Bateman, Brown & Pedder (group chapter)
- Seminars in the Psychotherapies — Royal College of Psychiatrists
Titles are widely used examples; editions change. Use university libraries or legitimate purchases.
Common questions
Is group therapy as good as individual therapy?
For many problems, such as depression, anxiety and addiction, structured group therapy works about as well as individual therapy and lets more people be helped. Some people prefer individual work, and the choice depends on the person and the problem.
Is what I say in a group kept private?
Groups agree rules of confidentiality at the start, and facilitators enforce them. Members are asked not to share what others say outside the group.