Why mental health group composition matters

Jan 17
7 min read

When it comes to mental health, groups have emerged as powerful interventions for healing, growth, and self-discovery. They provide individuals with a supportive community, allowing them to connect with others who share similar struggles and aspirations. However, there is some research that suggests the success and effectiveness of groups may rely, at least in part, on the composition of the group itself. 

Here we will explore why group composition matters in mental health skills acquisition and provide insights into how we, here at Therahive, select participants and compose groups for optimal results.

The Importance of Group Composition

Renowned psychiatrist, psychotherapist and author Dr. Irvin D. Yalom, in his groundbreaking work on group therapy, highlighted the significance of group composition in helping participants achieve their therapeutic goals. He emphasized that a well-composed group can foster a sense of universality, cohesion, and interpersonal learning among its participants. This shared experience can lead to profound personal growth. 

  1. Shared Experiences and Universality: When individuals in a group can relate to each other's experiences, it creates a sense of belonging and validation. Knowing that others have faced similar challenges and emotions helps to alleviate feelings of isolation and promotes a sense of universality. This shared connection enables members to support and learn from one another, fostering empathy and understanding among group members.

At TheraHive, all our groups begin with an Orientation Session before our courses formally start. These are structured to surface shared experiences and to start relationships on the right foot right from the start.

  1. Cohesion and Group Dynamics: The dynamics within a therapy group play a pivotal role in facilitating progress. The level of trust, openness, and collaboration among members significantly influences the group's efficacy. A harmonious and cohesive group fosters an environment where participants feel safe to share their thoughts and emotions, encouraging deeper exploration and growth.

TheraHive Orientation sessions set the tone to establish relationships among participants and build, and support, healthy group dynamics from the start. They also include a review and discussion of the social norms that allow our students to trust and rely on each other as they advance through the program. 

  1. Interpersonal Learning and Feedback: One of the key benefits of group programs is the opportunity for interpersonal learning. Group members can observe and reflect on how their thoughts, behaviors, and communication styles impact others. Through feedback and insight from fellow members, individuals can gain valuable perspectives, challenge self-defeating patterns, and develop healthier coping mechanisms.

At TheraHive, coaches guide interpersonal learning to ensure that every student has the opportunity to share feedback in the group setting—and our coaches even model how to manage discussions so that nobody monopolizes the time, and everyone gets time to share their reflections and learning.

Selecting Group Members

When it comes to selecting participants for groups, several factors should be considered to ensure a balanced and supportive environment. Here are some key considerations:

  • Homogeneity vs. Heterogeneity: It’s important to strike the right balance between participants who share similar experiences or challenges (homogeneity) and those with diverse backgrounds and perspectives (heterogeneity). Homogeneity can enhance understanding and validation, while heterogeneity can promote learning and broaden perspectives.
  • Screening Process: A thorough screening process is crucial regardless of group composition to assess each individual's needs, goals, and suitability for the group. This can help prevent potential conflicts or imbalances within the group.
  • Size of the Group: The optimal size of a therapy group can vary depending on the nature of the program and the specific goals. Smaller groups may allow for more intimate and focused interactions, while larger groups can offer a wider range of perspectives.
  • Stage of Change: Assessing the readiness and motivation for change among potential participants is essential. Ensuring that group members are at similar stages of change helps to maintain balance and focus within the group, preventing potential frustration or stagnation.

At TheraHive, we strive to find the right balance of shared experience and diverse backgrounds—which we discover through our application and admissions interview process. We interview every student as part of our enrollment process. And we believe the optimal group size for learning mental health skills is between 6 and 10 students.

Facilitating Groups

Once participants have been selected, group leaders must monitor group interactions and adjust as necessary. Here are some dynamics to look for:

  1. Strengths and Challenges: Pay attention to the balance of individuals who bring different strengths and challenges to the group. This helps group leaders foster a supportive and empathetic atmosphere, where members can learn from each other's experiences and provide mutual support.

    We train TheraHive coaches to be attentive to participants’ strengths and challenges while facilitating group discussions. Knowing who to call on, when, and for what is a powerful way of building trust and connection between group members. 
  2. Facilitating Cohesion: Consider the potential compatibility between group members in terms of personalities, communication styles, and willingness to engage in open and honest dialogue. A cohesive group can enhance trust and cooperation, which are essential for meaningful progress.

    Building on the above, TheraHive coaches are always looking for potential conflicts within groups. In most cases, such conflicts present opportunities to use and practice skills. That said, our coaches also have the latitude to adjust the group composition and transition students to another class that would provide a better fit.
  3. Addressing Power Dynamics: Pay attention to power dynamics that may emerge within the group, such as imbalances in authority or influence. Encourage equal participation and ensure that everyone's voice is heard and respected.

    As with the above, TheraHive coaches are trained to be on the lookout for power dynamics that are not productive. There are also often opportunities to leverage such dynamics to teach skills. And, in cases that cannot be resolved with skills, coaches have the flexibility to transition students to a more complimentary class. 
  4. Managing Diversity: Embrace diversity in terms of age, gender, cultural background, and life experiences. This can enrich the group's collective knowledge and understanding and create the opportunity to learn from others' differing experience while challenging biases and assumptions.

    As an example, an early TheraHive group included students across a wide age range. When we see this, we ensure that there are at least a couple of students of similar age in the group. In this case, we had two 60+ students who expressed concern about being in a group with other students that were the age of their children. As it turned out, this became valuable for them because they were able to develop insights into their relationships with their children though these younger group members who were of a similar age as their children. And because they were a pair, they were able to share and explore these insights together.

Groups can be transformative spaces for individuals to heal and grow. And group composition and facilitation play a vital role in the success of group programs, thus enhancing outcomes. Selecting participants thoughtfully, maintaining balance and cohesion, and managing diversity within the group can lead to enhanced empathy, collaboration, interpersonal learning, and personal development. Creating a group environment that nurtures trust, connection, and support builds resilience and paves the way for profound personal growth. Ultimately, a well-composed therapy group can become a catalyst for positive change and a source of profound healing for its participants.

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