Individual vs. Group Therapy: Differences & Costs

Individual and group therapy are both crucial components of a sustainable recovery. Learn how The Recovery Village integrates both individual and group therapy into our treatment programs.

In comprehensive recovery programs, individual and group therapy are integral components of treatment. These two approaches are not at odds with each other. Instead, the skills and insights gained in individual sessions complement those of group therapy and vice versa. Effective treatment plans often utilize both therapeutic approaches along the entire course of recovery, from residential treatment to aftercare.

There are, however, significant differences in the content, style and delivery of individual therapy vs. group therapy. Understanding how each of these modalities works can help make the differences between individual therapy and group therapy feel more navigable.

Individual Therapy

You are probably aware that programs that help provide recovery from substance use disorders utilize therapy so that individuals can explore the psychological underpinnings of addiction. Studies show that more and more people are utilizing mental health care options, like psychotherapy, for self-improvement. But how does psychotherapy work on the roots of addiction and substance use?

In individual therapy, a client works with a mental health professional — a therapist, social worker, allied health professional, psychologist or psychiatrist —  in private sessions to acquire self-knowledge, insight and a stronger sense of identity. Professionals are responsible for creating the frame of therapy: where and when therapy will be conducted, what the responsibilities of the client and professional are, which approach to therapy will be used and how progress will be measured.

Since individual therapy allows clients to talk about uncomfortable emotions, thoughts or behaviors with their therapist, confidentiality is of critical importance. The therapist is ethically bound not to disclose any identifying information about a client or details of what is shared with them in therapy. The only exceptions to this mandate are situations where:

• A client is in imminent danger of self-harm
• A client appears likely to harm someone else
• A client cannot take care of basic needs like shelter, food or clothing
• A court order (meaning an order directly from a judge) compels the therapist to submit records or testify

Sessions of individual therapy are held on a one-on-one basis, usually in a therapist’s office. However, individual therapy can also take place in a meeting room, classroom or outdoor environment if privacy can be reasonably assured. A typical individual psychotherapy session lasts from 50 minutes to an hour. Frequency of therapy depends on the client’s needs, but most programs require that the client attend at least one individual session each week.

Individual therapy sessions are structured according to both the needs of the client and the therapist’s areas of comfort and expertise. Some styles of therapy have the patient talk about whatever comes to mind. These therapies are designed to help patients gain insight into how their past experiences influence their present behaviors. Other types of therapy examine how emotions and beliefs influence behavior or help patients become less judgmental about their own thoughts.

Individual therapy sessions can touch on many topics, but most therapists will focus on the subjects that are currently preoccupying the client, such as:

• Recovery progress
• Barriers to sobriety
• Interpersonal relationships
• Cravings and withdrawal symptoms
• Integrating new coping mechanisms
• Goals for the near future

A therapy session will often end with the client and therapist working together to set goals for the days ahead. These goals might include staying sober for a certain number of days, attending a specific number of meetings or trying a new recovery activity. In some recovery programs, therapists use a therapeutic approach called contingency management to motivate their clients. In exchange for achieving a certain number of sober days or reaching another personal goal, clients may receive tokens or other tangible rewards.

In modern therapeutic approaches, the therapist refrains from directives, judgment, criticism or condemnation of the client. Instead, the client and therapist team up to help the client take on the work of recovery. More recently developed therapies like motivational interviewing and integrative therapy stand in stark contrast to classic therapies, as they use less confrontational approaches and give clients more agency.

A therapist’s credentials should meet the requirements for the state or national board that oversees health professionals. All therapists should hold some form of licensure or certification, in addition to specialty credentials in specific topics, like substance abuse treatment. In a program dedicated to treating co-occurring disorders, or the existence of a mental health condition combined with substance use disorder, therapists must be cross-trained in mental health services and substance abuse treatment for therapy to be effective.

Pros and Cons of Individual Therapy

The benefits of individual therapy can have an outsized effect on a client’s life; such benefits often last much longer than the therapy itself does. Among the many advantages of individual therapy are the ability to:

• Communicate feelings and emotions
• Identify defense mechanisms
• Gain insight into troublesome patterns of behavior
• Create appropriate boundaries
• Maintain accountability for one’s behavior
• Increase self-awareness, self-efficacy and self-sufficiency
• Build trusting, healthy and safe adult relationships

Individual therapy is generally more expensive than group therapy and can be more subject to the effects of personal bias. It also requires individual therapists to extrapolate: the therapists must use the feelings generated in their interactions with clients to gain insight into how one client’s beliefs impact that client’s relationship to others.

Group Therapy

Group therapy gives people in recovery the opportunity to learn new coping techniques, practice their communication skills, and gain hope and strength from their peers. For many who have experienced the ravages of addiction, their primary interpersonal relations have been reduced to interactions with dealers and other people who use drugs. In group therapy, they can meet men and women like themselves who are facing the same struggles with substance use disorders.

Even though groups often form around a common circumstance, group therapy offers a wealth of input from diverse member experiences. The life experiences some members share can help others understand their own situations in a new way. Many profound connections are formed in group therapy, where individuals learn how to develop trusting, sober relationships with others.

In group therapy, multiple clients meet in a session led by a trained mental health professional. Sessions can last one to two hours, depending on program structure. In some programs, clients observe speaking time limits to ensure full group participation. Other programs give the therapist latitude in determining fairness in the amount of speaking time per client. In a residential treatment program, group sessions are typically held daily. Topics vary depending on the format of the meeting, but common subjects include:

• Education on addiction (termed psychoeducation)
• Managing stressful or triggering situations
• Managing difficult emotions, like shame, loneliness, guilt, anger or resentment
• Managing cravings and withdrawal symptoms
• Living with grief and emotional trauma
• Dealing effectively with a relapse if it does occur
• Practicing assertiveness
• Forming and maintaining boundaries and healthy relationships
• Codependency
• Managing medications
• Dealing with mental illness, such as depression, anxiety, social phobias, bipolar disorder and other psychiatric disorders

It is the therapist’s ultimate responsibility to ensure that group therapy provides a safe, supportive environment where clients can discuss painful memories and emotions, celebrate their successes and share their setbacks in recovery. These sessions reinforce one of the most important messages of rehab: that no matter what the outcome of treatment may be, the client is not alone when experiencing difficulties with addiction.

The therapeutic techniques for interacting with an individual client are different from the methods for leading a group. For group therapy to be effective, the leader must have specialized training in conducting group therapy sessions and managing group dynamics. Group therapy should be led by a licensed or certified mental health professional trained in substance abuse treatment. The leader may be a counselor, therapist, psychiatrist, psychologist, nurse practitioner or other credentialed specialist who has been trained in both substance abuse treatment and group therapy techniques. The American Group Psychotherapy Association provides training and guidelines for group therapists, as well as certification in group therapy techniques.

Group therapy is a different experience than self-help support groups or mutual support groups. In mutual support groups like Alcoholics Anonymous or Narcotics Anonymous, meetings are led by members of the community rather than by trained professionals. In mutual support groups, such as 12-step groups, members are invited to share their “experience, strength and hope” without the expectation that the content or technique must be scientifically validated. Though the structure of mutual support groups can sometimes be quite formal, group members in this setting typically have more autonomy in their choice of format and subject. By contrast, group therapy is led by a trained professional, follows professional guidelines and standards, and aims to maximize the benefit of the therapy for all clients.

Pros and Cons of Group Therapy

Group therapy derives its benefit from our natural need to relate to others. Group work allows the client to develop new relational skills, build trust in others and earn trust from others. In group settings, clients can practice their communication skills, learning how to talk and listen effectively and how to set healthy boundaries with others.

A significant consideration in group therapy is that it is subject to group dynamics. These dynamics take time to establish and properly modulate to provide a safe and effective experience for all group members.

Overlapping Therapeutic Modalities

Many of the most effective forms of addiction treatment can be undergone as individual or group therapy. Some of the most common of these treatment modalities include:

• Cognitive Behavioral Therapy: Cognitive behavioral therapy (CBT) is one of the most widely used evidence-based modalities in the field of addiction treatment. In CBT, therapists help clients change problematic behaviors by helping them identify the negative, unproductive thoughts that lead to them. Originally developed to treat patients with severe depression, CBT is one of the most well-studied psychotherapeutic treatments for drug addiction and alcohol use disorder. Cognitive behavioral therapy has been demonstrated to be effective at helping recovering clients learn new coping skills and reduce their risk of a relapse.
• Dialectical Behavioral Therapy: Dialectical behavior therapy (DBT) was developed in the 1980s to help patients with emotional volatility and chronically suicidal feelings manage their lives more productively. Today, the therapeutic techniques of DBT have been successfully applied to the treatment of substance use disorders and other conditions. DBT helps patients by enhancing their motivation to change, helping them build self-acceptance and reducing the urge to abuse drugs or alcohol. Based on the practice of mindfulness, DBT can relieve anxiety and depression by teaching clients how to relax in the moment. Through simple mindfulness exercises, clients can learn how to cope with destructive urges and hard-to-control emotions. Clients who undergo DBT experience less bleak, all-or-nothing worldviews — seeing the world in shades of gray, and thus increasing their chances of a successful recovery.
• Motivational Interviewing: Also known as MI, motivational interviewing is a therapeutic technique that permits patients to feel undecided about their decisions. Like DBT, MI helps patients deal with ambivalence. In MI, the therapist partners with the client to encourage and inspire them to be sober on the client’s own terms. MI takes a positive, nonjudgmental stance on addiction treatment, addressing addiction as a chronic condition that can be managed rather than as a moral failing.
• Relapse Prevention Training: Learning how to reduce the risk of return to using is one of the most critical goals of rehab. Relapse prevention training (RPT) focuses on teaching the client practical coping skills to deal with triggers and stressors of everyday life. RPT groups may continue to meet in the aftercare phase of recovery to provide support for clients who have rejoined the community.

Which Is Better For Me?

Fortunately, group and individual therapy are not mutually exclusive. They are both integral parts of almost all recovery programs. If you’re considering the benefits of group therapy vs. individual therapy, you will need to take into account factors specific to you, such as:

• Personal preference
• Personal needs
• Strength of support
• Cost
• Desire to improve interpersonal relationships
• Need for accountability

Comparing The Effectiveness Of Individual vs.Group Therapy

Researchers have compared the effectiveness of group therapy vs. individual therapy for decades. Studies tend to reach the same conclusion: there is no functional difference in overall outcomes in group therapy and individual therapy participation. That means that group therapy and individual therapy are equally effective.

However, group therapy is usually more cost-effective, since it typically is less expensive than individual therapy. Group therapy is also typically more effective than individual therapy for the treatment of conditions that are affected by social interaction, like interpersonal problems, obesity or social phobias; conversely, individual therapy is the preferred treatment for conditions where one-to-one trust relationships may be critical, such as in the treatment of psychotic disorders or the treatment of specific phobias.

Individual and Group Therapy in Combination

There is no treatment modality that can “cure” the disease of addiction. To achieve recovery on a mental, physical and spiritual level, a program must include a combination of therapies. In addition to individual and group therapy, advanced treatment programs offer medication therapy, nutritional therapy, exercise therapy and expressive therapies. Holistic stress reduction practices like yoga and meditation are also included in a comprehensive treatment plan.

A truly effective treatment plan merges the strengths of individual and group therapy to give the client the best chance at healing. Individual therapy sets the stage for an in-depth exploration of the client’s experiences in treatment, while group therapy offers new opportunities for education, mutual support, and connection.

The treatment plans at The Recovery Village are tailored to the needs of our clients. We promote overall wellness through a powerful combination of individual therapy, group therapy, experiential therapies, nutritional counseling and more. To learn more about our advanced approach to recovery, contact a representative today.

Editor – Megan Hull

Megan Hull is a content specialist who edits, writes and ideates content to help people find recovery. Read more

Medically Reviewed By – Dr. Kevin Wandler, MD

Kevin Wandler holds multiple positions at Advanced Recovery Systems. In addition to being the founding and chief medical director at Advanced Recovery Systems, he is also the medical director at The Recovery Village Ridgefield and at The Recovery Village Palmer Lake. Read more