Q: I'd like to learn more about therapy groups. Can you explain their therapeutic value and what skills are required to run them that are different from those of an individual therapist?

A: After many years as a group therapist, the main distinction I see between individual and group work is that clients tend to talk about relationship problems in individual therapy, whereas they inevitably exhibit them in group therapy. In a group context, a therapist can more easily and directly see what goes wrong interpersonally for a given client. In the presence of others, clients may exhibit isolating patterns, become self-protective, or engage in off-putting behaviors, all too often without even being aware of them.

Dave was a pleasant young man who came to see me for depression and social isolation. He'd suffered several important losses—his wife divorced him and then he lost his job—and was stuck in a stressful family situation of caring for a chronically ill relative. Through individual treatment, he grieved for his losses, and his mood improved; however, he couldn't seem to develop social relationships, and he remained lonely. Friendships seemed to begin well, but never deepen. Neither he nor I was sure why, as he was bright and, when encouraged, a warm, forthcoming person.

After he joined a group that I lead, however, I began to understand what was holding him back. When other group members candidly shared their…