What is the difference between a process group and a support group?

About Maria Gray, LMFT, NMP, Certified Group Psychotherapist:

I’ve been involved with the group therapy world for over 15 years, and I attend group therapy conferences every year both in California and nationally.  

I started to focus on my group therapy training by joining the Group Psychotherapy Association of Los Angeles (GPALA), and participating in their events in Culver City. I also have served on the GPALA board for four years.  

Support groups are often focused on a specific theme/issue like grief and loss, eating disorders, addictions. These groups can be led by therapists, but usually they are led by a member of the group.

There are many types of support groups. 12-Step groups like Al-Anon offer both in-person and online meetings in greater Los Angeles, and Alcoholics Anonymous has numerous daily meeting times available throughout Santa Monica and the Palisades. Narcotics Anonymous, Adult Children of Alcoholics, and Women for Sobriety are other types of support groups. 

These groups are led by members as opposed to a trained professional.

When a support group is led by a peer instead of a professional, the group is not considered to be treatment, although there are still many benefits to attending this type of format.

According to the Mayo Clinic, support groups offer a chance for peer-to-peer emotional support, where you can both learn from others who are in a similar situation and share your own knowledge and experiences. 

The aim of group therapy is to help you put your thoughts and feelings into words, and to notice your own personal patterns of interacting in relationships.

Group therapy sessions are led by a trained psychotherapist and you also get the benefit of peer-to-peer support. 

The main distinction between group therapy and support groups is that since group therapy is led by a professional, each member of the group receives treatment.

For example, as a certified group therapist, I have professional training that allows me to observe members of the group and how they interact. This provides valuable feedback for both in-person sessions in my Santa Monica office, and even works online for my California-wide (and New York & Texas) groups.

The therapist can then share their observations and ask questions. This leads each member to learn more about themselves, including their triggers, their behaviors, and their patterns.

Various scientific studies have found that group therapy is equal to individual therapy in terms of treatment outcomes. 

In fact, there are some situations where group can actually offer more benefits, especially due to the interpersonal and relationship building skills that participants have the opportunity to develop.

Learn more about
the benefits of group therapy

There are many different types of group therapy.

Process groups are centered on what members are experiencing in the present moment. This type of group therapy helps members unotice what they are experiencing in the moment, put their thoughts and feelings into words, and improve their relationships with others.

You’ll gain a sense of self-awareness, especially in how you react in social situations. This can support you in building healthier relationships with partners, colleagues, family, and friends.

Skills development groups offer members various coping skills that support their mental health and everyday life. Since individuals are learning, there is more of a leader focus in this type of group. 

According to a publication by the Treatment Improvement Protocol, the focus may be on conflict resolution, relapse prevention, meditation, or other cognitive skills.

Psychoeducational groups are similar to skills development groups in that it’s focused on the therapist sharing knowledge with group members. 

While skills can be learned in psychoeducational group therapy, the TIP notes that the goal here is to learn more about the how and why of certain mental health issues.

Process Groups vs Support Groups: Both are Beneficial

Now that you understand the difference between these three types of groups, you can decide which is right for you. It may even be that attending individual therapy along  with group therapy helps you achieve your goals faster.

If you’re ready to take the next step in understanding your underlying patterns and make long-lasting changes in your life, get more information on my group therapy offerings for California residents here. 

The Benefits Of Group Therapy for Los Angeles Residents

About Maria Gray, LMFT, NMP, Certified Group Psychotherapist:

I’ve been involved with the group therapy world for over 15 years, and I attend group therapy conferences every year both in California and nationally.  

I started to focus on my group therapy training by joining the Group Psychotherapy Association of Los Angeles (GPALA), and participating in their events in Culver City. I also have served on the GPALA board for four years.  

Why does group therapy work?

I’m such a firm believer in the benefits of group therapy because I’ve seen it first-hand with my own clients.

Group offers an opportunity to unpack childhood trauma.

Group therapy provides a unique opportunity: access to preverbal material, or your earliest trauma. That’s because therapy groups are similar to families.  You’ll get to explore the way childhood experiences impact your relationships in the present.

You’ll have the benefit of experiencing something called transference. This is an unconscious process where you interact with other members as though they were significant people from your past, such as your parents or siblings. 

You may find yourself replaying old relational patterns and emotional responses inside the setting of the group. You’ll have the benefit of experiencing multiple transferences, not just a single transference from the therapist, but seven or eight reflections.

There is a lot of healing that can come from working through your transferred feelings within the group. 

You may notice issues with authority, attachment patterns, or social anxiety – all within the safe container of the group. Within your reactions to criticism, or your ability to trust others, you can learn about your own patterns and begin to create a positive shift. This makes group therapy an unparalleled opportunity for personal growth.

The power of a group is that it mirrors your current relationships. 

As you notice how past experiences inform your current interpersonal relationships, you’ll have an opportunity to learn healthier ways of communicating with others in your present life. In group, you’ll learn how to put your thoughts and feelings into words, with the support of others. 

Whether you’re looking to improve your relationship with your boss, colleagues, friends, or family, you’ll be able to change your current pattern of behavior into something that supports your goals.

Eventually, this self-awareness helps you to enjoy healthier relationships.

Group therapy relieves feelings of isolation.

Additionally, you’ll form ongoing connections with other group members that can support you in your everyday experiences. 

Once you get to know your fellow group members, you’ll learn that there are others out there struggling with the same problems. You’ll see that you’re not alone, and you’ll be able to learn from others who are working on similar goals. Through this, you might find that you take on a new perspective on your own challenges.

Group Therapy Works Just as Well as Individual Therapy

Multiple research studies have shown that group therapy is just as effective as working one-on-one with a therapist. 

For example, an analysis of over 30 years of research on group therapy found that it is equal to other types of treatments for mental health.

This is true for many different types of concerns, such as anxiety, depression, social anxiety, illness, addiction, or grief.

Group Therapy in Los Angeles or Online for California Residents

Currently, I have several groups running, including an online women’s group, and three online mixed gender groups. Group therapy can be helpful if you are expereincing anxiety and/or depression, social isolation, or you are simply interested in improving your relationships with others. Some groups meet in-person for an annual check-in. 

Get the schedule here, and inquire to get started. 

DOES EMDR THERAPY WORK ONLINE?

About Maria Gray, LMFT, Certified EMDR Therapist:

I specialize in addictions and trauma, and am certified in EMDR. I enjoy using EMDR to help my clients expand into the lives they truly want for themselves. Many of my clients find that EMDR sessions help them uncover and discard patterns that are no longer serving them.

Is it better to do EMDR in-person or online?

New clients often ask me if I think EMDR and Brainspotting modalities work better in-person as opposed to online.  My answer is “It depends.”  Some clients feel more comfortable attending therapy sessions from the comfort of their own homes, or their preferred provider might be far away. At the same time, some of my other clients prefer to leave home and have their sessions in my office.

What matters most is that you are in a place that is accessible to you along with being quiet, private, and comfortable. If you feel secure in your environment, and comfortable with your EMDR provider you will be more likely to experience positive results. It’s important to remember that the therapeutic relationship is even more important than the treatment modality.

Does online EMDR actually work?

Not only have the clients who I see virtually noticed improvements in their mental health after remote EMDR sessions, but there’s science to back this up too.

In 2020, with the rise of online therapy due to the pandemic, a study looked at remote EMDR sessions over a 7 month period.  These sessions were conducted by trained therapists for clients who were dealing with PTSD, depression, anxiety, OCD, and phobias.  The results showed that virtual EMDR sessions were able to measurably reduce their symptoms.  

A 2022 research study conducted by Liou, Lane, Huang, et al revealed that both virtual and in-person EMDR sessions led to a significant decrease in general anxiety.

How should I get ready for a virtual EMDR therapy session?

 Here are some of the things that will help make any virtual session more effective.

1. Find a quiet, private, comfortable place to attend the session.

2. Make sure you have a good internet connection.

3. Check that your camera is working, stable (i.e. you’re not holding it), and can be positioned so that your therapist can see you clearly.

4. Give yourself at least ten minutes before the session to transition out of whatever activity you were doing before.

5. Check in with yourself about what you may be wanting from the time. If you are needing support around a difficult decision, you might prefer having some time to talk it through with your therapist as opposed to processing via EMDR or Brainspotting that day.

6. Consider your plans for after the session.

Interested in a virtual EMDR session?

I’m licensed in California, New York and Texas, and offer in-person EMDR sessions in Los Angeles and virtual EMDR therapy sessions in California, New York, and Texas. 

I’m certified by EMDRIA in EMDR and have completed both the Standard Protocol Training and Laurel Parnell’s Attachment based EMDR training.

References
Liou, H., Lane, C., Huang, C., Mookadam, M., Joseph, M., & Hecker DuVal, J. (2022). Eye Movement Desensitization and Reprocessing in a Primary Care Setting: Assessing Utility and Comparing Efficacy of Virtual Versus In-Person Methods. Telemedicine and E-Health, 28(9)

McGowan IW, Fisher N, Havens J, Proudlock S. An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid-19 pandemic. BMC Psychiatry. 2021 Nov 11;21(1):560. doi: 10.1186/s12888-021-03571-x. PMID: 34763697; PMCID: PMC8581955.

What's Your Vacation Policy?

Did you know that in Europe vacation time averages 20-28 days off a year plus holidays? How much time off do you take?

During my time in the corporate technology world, most companies offered a standard vacation policy consisting of two weeks of paid vacation time each year plus holidays; employees were entitled to another week after five years of employment. I didn’t use all my vacation time and my work hours often spilled into the weekends.

One of the many things I enjoy about working for myself is the flexibility I have to structure my life the way I want to. My schedule varies but I rarely work past 4:30 and on Wednesdays I finish early. At the end of the day, I need space so that I can reconnect to myself after giving so much to others. I treasure the summer evenings when the light allows me to take longer walks. These walks feel like a colander for my nervous system where the emotions, sensations, and thoughts from the day can seep out through the holes, so I have enough space to start over again the next day.

When I was an intern, my supervisor explained to me that he took six weeks off every year. One week was set aside for an annual group therapy conference and the rest was vacation time; I asked him how his clients reacted to him taking so much time off and he said that he made sure to inform them well in advance and that sometimes those conversations yielded rich clinical material. My beloved aunt, who also studied to be a therapist, warned me not to take too much time off because she was afraid my clients would leave if I did that. Fortunately, she was wrong about this.

In those early days of building my practice I couldn’t afford to travel, so I took some weekend trips and several “staycations” where I discovered new hiking trails close to home. I’d return to work feeling revitalized and I realized how crucial it was for me to take time away from the pressures of my day-to-day responsibilities. Now I schedule my vacation time in advance, and I have a separate savings account dedicated to my travel expenses.

In March I traveled to Utah, and I stayed in a neighborhood just outside of Salt Lake City called “The Avenues” where the houses were built in the early 1900s. The historic architecture, trees and hills felt like a blend of San Francisco and Vermont. Every night around 5:00PM people would gather at a 2-acre park where dogs were allowed to run off-leash. People were responsible with their dogs, and I felt comfortable letting my dog run around and chase his ball. The hiking trails were pristine, and dogs were permitted on alternate days. I had a fantastic time and obviously so did my dog! I am planning to retune next year.

Vacations are only one element of my time off policy. This year I took time off for bereavement leave when my dear aunt died. It was challenging for me to decide how much time off to take and when to take it. In hindsight I wish I had taken more days off during her final weeks, but I thought we’d have more time together. It’s been six weeks now since she died and although I did take some time off, I’ve found I’m very tired and that going to bed early helps.

I just received my jury duty summons, and it was a reminded me of the multitude of other situations where we might need time off and the importance of having some money set aside for those occasions. I hope this post has inspired you to think about your relationship to work and time off. Life is precious and none of us knows how much time we will be here, it’s important to me to enjoy it.

How I Won the Nervous System Trifecta- Walking, Meditation and The Love of an Animal

When I was growing up, my grandfather Charlie loved horses and he and my grandmother liked to dress up for an afternoon at the racetrack. During a Sunday dinner I heard him say that he had “won the trifecta” and I asked him what that meant. He explained that the trifecta was a bet in which he predicted the first three finishers in a race in the correct order. I loved my grandparents and I enjoy replaying my memories of our time together.

This article explores three ways my nervous system changed after I adopted my dog, spent more time walking outdoors and modified my meditation practice. I hadn’t bet on these benefits, but I feel like I won a health trifecta during a global pandemic.

When the lockdowns began in Los Angeles, one of my greatest concerns was being isolated from my yoga community, friends, and family. I’m an extrovert with the soul of an introvert, which means I feel energized when I spend time with other people, and I also require my solitude. Zoom meetings helped me stay connected but I really missed being with people in person.

In October of 2020, about six months into the Pandemic, after months of searching (that is another story), I adopted my dog, Davis; I did not anticipate the many ways that being a dog momma would impact my nervous system. Shortly after his arrival, my heart cracked open with love for this rescue puppy, even during his most stubborn moments.

My energetic dog requires three walks a day, and although my feet ached, I realized I felt more settled and relaxed. As a lifelong runner, I have experience with the “runner’s high” that comes about ten minutes into a run, when the endorphins kick in, but I underestimated the benefits of daily walking. The increase in my exercise was my first win. An investigation (Choi et al., 2019) conducted by researchers at Harvard Medical School confirmed that higher levels of physical activity and lower risk of depression go hand-in-hand. "On average, doing more physical activity appears to protect against developing depression,” Choi said in a statement. “Any activity appears to be better than none; our rough calculations suggest that replacing sitting with 15 minutes of a heart-pumping activity like running, or with an hour of moderately vigorous activity (like my dog walks), is enough to produce the average increase in accelerometer data that was linked to a lower depression risk.”

I walk my dog three times a day and each walk lasts between 30-45 minutes, with the morning walk being our longest. I noticed that once Davis was trained our walks became a time of reflection and play, and my pandemic grumpiness began to dissolve. My sense of isolation decreased as I met other dog owners on my walks. I like some of these dog owners better than others, and am not a big fan of people who allow their dogs to lunge toward us on retractable leashes.

After our walks, Davis returns to his bed where he snores peacefully until the mailman comes. Sometimes he gets up for water or a stretch and will stop by my desk for some affection. I notice his smell, the feeling of his soft fur and the look in his eyes when he wants my attention. In a 2001 study, Karen Allen, Barbara E. Shykoff, and Joseph L. Izzo Jr. found that increased social support through pet ownership lowers blood pressure response to mental stress; Davis’ mere presence lowers my blood pressure. My second win was increased social support.

The third aspect of my trifecta came through altering my meditation practice. In 1987, I learned a basic Insight Meditation practice, following my breath and coming back to my breath if I felt distracted. This practice served me well until 2019, when I found myself growing bored with meditation. A friend mentioned her TM practice, and although I was skeptical at first, I eventually decided to try it. Transcendental Meditation (also known as TM) is a mantra-based meditation practice that was developed in the 1950s. Students are taught to meditate twice a day for 20 minutes. I’ve been practicing for three months now, and I continue to feel calm with an improved capacity to observe my thoughts and feelings without being overtaken by them. I notice that I laugh more often and sometimes sing to Davis during our walks. I’m rarely able to practice twice a day, but once a day has made all the difference.

I encourage all my clients to walk or try some form of exercise that gets them outside and moving. Not everyone can own a pet, but for those who do, I suggest they notice and savor the impact on their senses. I recommend meditation to some of my clients and like to help them create a practice that works for them. I’m very grateful for the many gifts I’ve received during these last two challenging years and the positive impact on my nervous system. I’m thinking about trying pickleball next!