Online Group Therapy: How Virtual Group Therapy Works

Group therapy online allows you to participate in therapy sessions with a small group of people from the comfort of your own home. Licensed therapists or qualified mental health professionals lead these groups, which offer education, skill-building, and peer support. Whether a mental health professional has suggested group therapy to you or you’re curious about online group therapy because you feel like you could benefit from increased social support and accountability, group therapy can be supportive for many people.

In this article, we’ll cover how online group therapy sessions work. We’ll also discuss what happens in a typical session, who can benefit, and what to consider about cost and insurance. 

What is online group therapy?

Online group therapy lets you join sessions from home using secure videoconferencing software. Every other aspect of online group therapy works the same as in-person group therapy. 1 or 2 trained counselors or therapists lead a small group of you and your peers through the group therapy program. What this looks like depends on the focus of the group, but it might include learning about a mental health condition (psychoeducation), learning and practicing coping skills, and sharing your experiences and support with other group members. 

How online group therapy works

Before starting online group therapy, you’ll usually meet one-on-one with the facilitator initially to ensure that group therapy is a good fit for you. If you choose to get started, you’ll meet regularly with the group and your facilitator. Most groups have 5-15 members who connect via secure videoconferencing software. Groups may meet once a week or once every two weeks, with sessions lasting about 60 to 90 minutes.

Some groups are closed, meaning they have a set start and end date, and the members remain the same throughout. Other groups are open, meaning participants can choose when to join and leave. As a result, the group membership may change over time.

What happens in an online group therapy session

A facilitator leads group therapy and guides the discussion. Sessions usually start with a quick check-in. Group members share how they’re doing and may update the group on homework from the previous session or their progress toward any goals they’ve set. After that, most of the session focuses on the main activity or discussion. Depending on the group type, this might include learning a new skill, practicing a coping strategy, or sharing feedback and support in a group conversation. The session ends with a recap of the key points and possible goals or homework for the next session.

Types of online group therapy

Online group therapy groups can focus on a specific modality, such as dialectical behavior therapy (DBT) or cognitive-behavioral therapy (CBT). They might also focus on a specific condition or life event.

DBT skills groups

In DBT skills groups, you’ll focus on developing skills in four core areas of DBT, including mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. These groups function similarly to an education class, where you’ll learn a new skill, practice it, and leave with homework for the next session. DBT was created to support people with borderline personality disorder, but it is also often recommended for people who experience intense emotions, have difficulty managing distress or stress, or experience challenges in their relationships.

CBT-based groups 

CBT groups use cognitive behavioral therapy (CBT), which focuses on the relationship between thoughts, emotions, and behaviors. In these groups, you’ll learn skills such as identifying and challenging unhelpful thoughts, gradually exposing yourself to situations that trigger anxiety, and scheduling small, rewarding activities to help improve low mood. Over time, new experiences and ways of thinking can change people’s unhelpful core beliefs about themselves, others, and the world. CBT groups are commonly recommended for people managing anxiety, depression, stress, or post-traumatic stress disorder (PTSD).

Process groups

Process groups focus on current interactions among members. They explore interpersonal dynamics, emotions, and communication patterns. Members may also discuss past experiences if doing so helps them understand what's happening in the group or in their relationships. 

The goal of process groups is to learn more about how your communication and behavior affect others. They can also help with developing a sense of belonging and acceptance. Compared with other group therapies, process groups are more flexible, with group members often deciding on topics rather than the facilitator. Process groups also tend to be longer term, usually running for at least six months. 

Condition-specific groups

Condition-specific groups can be for individuals who share a common condition or for the friends and family members of individuals with a specific condition. This might include depression, anxiety, obsessive-compulsive disorder (OCD), or borderline personality disorder (BPD). In these groups, you’ll learn more about the condition, including its symptoms and treatment. You’ll also learn coping skills and share support with your peers. 

Groups for people stabilizing after a crisis

Many crisis stabilization programs recommend participating in a support group after completing the program. Online support groups can be safe, supportive places to check in regularly, share experiences, and receive support. Connecting with others who understand what you’ve been through can also help you feel less alone as you continue your recovery. 

Benefits of online group therapy

Along with the benefits of group therapy, virtual group therapy offers unique benefits, including:

• Accessibility: Because you can connect from your own home, it can be more convenient to attend group therapy, especially for those with busy schedules.
• Lower cost: Group therapy may cost less than individual therapy because the cost of the session is shared among group members. Online group therapy can also reduce overhead costs associated with in-person sessions, which may make therapy more affordable for group members.
• More diversity: Because of the nature of online group therapy, it can be easier to connect with individuals who have a similar experience to you, especially if you live in a less-populated area.
• Reduced social anxiety: For people nervous about group therapy, connecting from home can increase their comfort level. This can help them engage more actively in sessions.

These benefits are combined with the benefits of group therapy, including increased self-worth and self-awareness, developing new skills, improved social skills, reduced isolation and stigma, and increased hope. 

Is online group therapy effective?

Yes, research suggests that online group therapy is effective. Research summarized by the American Psychological Association (APA) suggests that group therapy can be as effective as individual therapy for a range of mental health concerns. In some situations, group therapy can be even more effective because it reduces stigma and increases solidarity. This seems to hold true whether group therapy is offered online or in person.

For example, a 2019 review published in the Journal of Telemedicine and Telecare found that video teleconference groups have similar outcomes to in-person groups. However, effectiveness can vary by individual, group type, and condition being treated. 

Is an online therapy group right for you?

A clinician can help you determine if an online therapy group is right for you. Online groups may be a good fit for people whose needs can be safely and effectively addressed in a group setting, particularly those who want peer support while learning evidence-based skills.

However, people experiencing an acute mental health crisis, significant safety concerns, or symptoms requiring intensive monitoring may need a higher level of care than an online therapy group can provide. This higher level of care might include a virtual intensive outpatient program (IOP). IOPs are structured, intensive programs that include group therapy, individual therapy, and skill-building. Some programs also offer medication management.

Privacy and confidentiality in virtual groups

In any group therapy, group members are expected to respect one another’s privacy and confidentiality. However, this can be more difficult in virtual therapy because you’re not all in one private, controlled environment. For this reason, it’s recommended to look for a group with clear privacy rules for members. This includes connecting from a private location and using headphones to prevent others from overhearing the conversation.

Cost and insurance for online group therapy

Online group therapy is typically more affordable than individual therapy. Some providers may also offer virtual group therapy on a sliding scale, where the amount you pay is adjusted based on your income.

Many insurance providers do cover group therapy, especially when it is tied to a mental health diagnosis. However, it’s best to check with your insurance provider, as coverage varies by plan and location.

How Willow Health can help

Willow Health offers group therapy led by licensed mental health professionals that use evidence-based approaches, such as CBT and DBT. Virtual group therapy tracks include Wellness & Recovery, Coping with Depression, and Coping with Anxiety.

Frequently asked questions

Do I have to turn my camera on?

Whether you have to turn your camera on depends on the rules of the specific group. Some groups may ask you to turn on your camera for engagement, safety, and accountability. Others let you keep it off to help reduce anxiety.

Do I have to talk in group therapy?

No, there is no pressure to talk in group therapy, and you are always in control of how much you share. That said, talking in group therapy can be greatly beneficial, and starting off with even minimal participation can help you build your comfort level over time so you can share more and get the most out of the experience. 

How many people are in an online therapy group?

Most online therapy groups contain 5-15 peers as well as the group facilitator. 

Is online group therapy covered by insurance?

Yes, online group therapy is often covered by insurance, especially with a mental health diagnosis. However, coverage varies by plan, so it’s best to check directly with your insurance provider. 

Can I do group therapy and individual therapy at the same time?

Yes, many people do group therapy and individual therapy at the same time. Group therapy helps you learn skills and get support from peers. Individual therapy can provide more opportunities for in-depth work, let you explore topics you may not feel comfortable sharing in a group, and offer more focused support for your individual goals.

Is online group therapy as effective as in-person?

Yes, research shows that virtual group therapy can work as well as in-person therapy. However, its effectiveness can depend on the type of treatment and individual circumstances. A mental health professional can help you decide if group therapy could be an appropriate treatment for you. 

Sources

Gentry, M. T., Lapid, M. I., Clark, M. M., & Rummans, T. A. (2019). Evidence for telehealth group-based treatment: A systematic review. Journal of Telemedicine and Telecare, 25(6), 327–342. https://doi.org/10.1177/1357633X18775855 

Pappas, S. (2023, March 1). Group therapy is as effective as individual therapy, and more efficient. Here's how to do it successfully. Monitor on Psychology, 54(2). https://www.apa.org/monitor/2023/03/continuing-education-group-therapy 

Substance Abuse and Mental Health Services Administration. (2021). Telehealth for the treatment of serious mental illness and substance use disorders (Publication No. PEP21-06-02-001). U.S. Department of Health and Human Services. https://library.samhsa.gov/sites/default/files/pep21-06-02-001.pdf