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It is difficult to determine how effective group therapies are.
This is because:
- Not all people with a mental disorder are the same. For example, people with depression can have different severity of depression ranging from mild to severe. Also, different depressions have different causes.
- Complicating factors such as: other mental disorders (comorbidity), physical and environmental factors, such as domestic violence, stressful workplace, and financial issues.
- Since therapy last for several months, positive experiences that help patients improve may not be related to the therapy itself.

Yalom (2005) stated that it is much more difficult to evaluate the effectiveness of group therapies than individual therapies due to numerous variables that cannot be control ouside and within the therapies. Thus, it is important to compare studies through longitudinal studies that utilize placebo control groups and double blind assessment.

Jacobsen - argues that group therapy is just as effective as other types of therapy
McDermott (2001) - carried out a meta-analysis where in 43/48 studies, clients improved because of group therapy.
Toseland & Siporin (1986) - reviewed 74 studies comparing group and individual therapy. In no cases were indivudal therapy were found to be more effective than group therapy.

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Directive therapy - therapist identify faulty thinking patterns and help the client change the way they're processing information.

Non-directive therapy- client determines on their own what their problems are and how they should be resolved

Strength
- CBT clients have lower relapse rates than those treated with drug therapy
- Focus on the specific thinking patterns or concerns of the client.
- The client receives attention and support

Limitations
- no difference in the effectiveness of CBT and drug treatment.
- CBT does not address the past experiences of the client nor the potential biological nature of the disorder
- CBT focuses more on current symptoms than the causes of the disorder
- Ethical concerns
- Based no individualistic culture rather than collectivistic

Effectiveness studies
- The relationship between the client and the therapist is an important factor in therapy (Bennun & Schindler, 1988).
- It is not possible to know whether therapy has any effect on one's recovery (Eysenck, 1952).
- Spontaneous remission: disorder disappear in the same way we eventually recover from a cold. Hence, longitudinal studies with placebo control groups and double-blind assessment are important in therapy sessions.
- Difficult to evaluate because not all depression is the same (mild to severe, different cause, etc.), there are complicating factors, and positive experiences are hard to separate from the actual therapeutic techniques over time.
- Outcome Based Studies - studies that test for the effectiveness of the therapy by seeing how many patients are eventually symptom-free --> inappropriate and should be replaced with process-based research (studies that look at the changes in the behavior of the client over time, recognizing how many variables can affect client's mental health).

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Validity Testing - Clients defend their thoughts and beliefs by giving concrete evidence to support their argument. If failed to provide objective evidence, the faulty nature is exposed.
Cognitive Rehearsal - Clients are asked to imagine a difficult situation they have encountered in the past, and then work to cope with the situation. This helps the clients cope with the situation in the future through cognitive rehearsal.
Homework - Homework (ex. journaling, reading articles, etc.) is assigned to help encourage self-discovery and reinforce insights. Clients are also asked to monitor their own behaviors.

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- Attrition: clients stop coming to sessions. They don't feel like they need to cancel because "there are people there"
- Problems with confidentiality since other group members can share what they heard outside of the meetings.
- Group dynamics, conformity and social hierachies can have negative outcomes. It is important to recognize these factors

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He is known to be the father of cognitive therapy. Below is a video that describes his techniques.

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The Blueprint of Cognitive Behavior Therapy

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- More cost-efficient
- Meeting similar people can boost self-esteem and make people fell less "different"
- Listening to others help people understand and learn new ways to deal with problems
- Encouragement and emotional support between the group members
- Clients don't have to be dependent on the therapist alone
- Help clients to work on social skills and interactions

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Bolton et al (2003) - A cross-cultural study on group therapy

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Bolton et al (2003) - A cross-cultural study on group therapy

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Aim: to study the role of group therapy on depression in rural Uganda.

Procedure:
- 30 villages were selected randomly; 15 were randomly assigned to have men studied and the other 15, women
- Adult villagers who were believed by themselves and other villagers to have depression-like illnesses were interviewed
- A total of 284 participants (108 men and 116 women) took part in the group therapy
- 8 of 15 male villages and 7 of the 15 female villages were randomly assigned to the receive group therapy (the intervention groups) or be the control groups.
-  They were assigned interpersonal psychoteraphy 90 minutes each session. This took place every week and lasted for 16 weeks.

Results:
- There was a reduction in severity of depression by 17.47 points for the intervention groups and 3.55 for the control groups

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- Goal: to identify and dispute irrational and maladaptive thoughts known as cognitive distortion.
- Clients find out which thoughts are associated with depressed feelings and correct them.
- Based on client's interpretations and inferences affect their thinking and behaviors (ex. depressed people focuses more on their failures).
- Therapist notes down client's daily successes and refocuses the client's attention to good attributes.

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- Aim: to identify and correct faulty cognition and unhealthy behaviors

Ellis usage of a confrontational approach
- He challenges the "beliefs" that an individual has which influence their behaviors.
- Role-playing situations that had caused them anxiety is used.
- Ellis then asked his clients to feel the emotions that they experienced and how they would behave.
- Clients were then asked to imagine disputing and replacing those self-defeating beliefs with rational alternatives, as a way for them to reduce negative emotions and visualize themselves acting appropriately

Shame attacking exercises
- Shame is an emotional reaction that prevents us from achieving mastery, gaining pleasure and satisfaction, acting assertively, sharing intimacy, and living life fully.
- Shame results in low self-esteem and worthlessness
- Ellis argued that shame is a schema through how we see ourselves and our relationship with others
- Clients are asked to take non-threatening risks and to realize that the outcome is not harmful. This helps reduce feelings of shame that influences the client's behaviors.

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Factors therapists consider when running group therapy

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Factors therapists consider when running group therapy

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1. Whether or not the group is cohesive.
- members of a group therapy should have some common characteristics (similar age, life experience, disorders, cultural identity, socioeconomic status.)

2. Any characteristics that can exclude a member from the group.

3. Confidentiality

4. Cultural factors that can affect whether or not a group therapy can be successful.

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- A form of psychotherapy used when treating depression.
- Focuses more on how an individual currently process information, and how that affects their behaviors
- Duration: 12-20 weeks
- Clients are assigned outside tasks to help them practice coping strategies and monitor their own behaviors

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Group therapy uses many of the same techniques as individual therapy, but it is done with more people in the room. CBT (cognitive behavioral therapy) and other techniques are used to help individuals within the group to cope with the problems in life that they face.  Group therapy asks members to share about personal experiences, take risks in activities, brainstorm strategies, givefeedback on role playing and engage in trust building activities.

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- A process through which clients work one-on-one with a trained therapist in a safe, caring, and confidential environment.
- Clients are encouraged to explore their feelings, beliefs, or behaviors, work through challenging or influential memories, identify aspects of their lives that they would like to change, better understand themselves and others, set personal goals, and work toward desired change