CBT for Group Settings vs. Family Settings


In the field of mental health, the use of CBT is to eradicate a mental health disorder through the application of various strategies that help to deal with individual thoughts, feelings and emotions that are maladaptive, out of control and negatively influence behavior. CBT also helps in the treatment of individual challenges so that clients can learn how best and illness or disorder which affects the daily functioning of a client can be overcome. CBT is widely accepted as it can be applied in a wide range of settings such as individual, group and family. This paper compares the application of CBT in group versus family settings and discusses some of the most frequent challenges that are likely to be encountered in using CBT in group settings. A description of some of the most effective strategies for using CBT in groups will also be provided. CBT for Group Settings vs. Family Settings

Comparison on the Use of CBT in Groups vs. Family Settings

When using CBT in group settings, participation in sessions of therapy is often by two or more people. The clients may have something some commonality such as the mental health disorders or the symptoms that cause difficulty in efficiently performing activities of daily life. In other cases, clients may fail to have some commonalities (Agazarian, 2018). Group settings may involve one or more therapist and it can be applied to clients with a wide range of disorders such as substance use, management of anger or eating disorders. As noted by the American Psychiatric Association (2013), it may occur in professional settings, at homes, public places or places of worship. In group settings, CBT serves to improve the self-awareness of clients, change motivation, enhancing self-esteem and trust and to eliminate feelings of isolation in knowing that others face similar challenges. The members are often willing to participate and remain open in talking about their challenges and problems. CBT for Group Settings vs. Family Settings

In comparison, in family settings, members are commonly united by blood or family relations. Family members willingly propose to provide a client with emotional, physical, psychological and financial support for quick recovery (Smith, et. al., 2017). Besides, in family settings, CBT is best applicable for situations that result to grief, anger, stress and conflict. It also examines the interaction patterns that exist between family members in the identification and alleviation of problems (Smith, et. al., 2017). Both the family members and the therapist provide strategies that help to reframe how issues are viewed.

Challenges Counselors Might Encounter When Using CBT in Group Settings

One of the most notable challenges of CBT in group settings are chances of re- victimization which may happen through listening to the stories provided by other victims. Re-victimization may cause a relapse of maladaptive behaviors and symptoms which interfere with daily social, work and physiologic functioning (Agazarian, 2018). Another challenge is that of lack of confidentiality where clients discuss the lives and problems presented by other participants outside the sessions of therapy. Lack of confidentiality is a major contributor to fear in clients such that, they may fail to openly share their problems with others (Agazarian, 2018). As a result, there is a high likelihood that some symptoms/ problems will fail to be addressed, leading to poor health outcomes.

Highly Effective Strategies in CBT for Groups

As the group facilitator, a mental health nurse has the role of ensuring that therapy groups are highly effective and that they benefit each participant. One of the most effective strategies is outlining group norms and guidelines which detect and guide communication, behavior and participation (Safak, et al., 2014). These guidelines ought to explain the roles of each member that will make the group to be highly effective. As recommended by Safak, et al., (2014), there is also the need to educate participants on the importance of maintaining confidentiality and how positively this will impact health outcomes.


CBT has proven to be a highly effective strategy in the management of mental health disorders in family, individual and group settings. The major difference in group and family settings is that, in the former, clients may be known or not known to each other but may have commonalities in symptoms or mental health problems. In group settings, CBT serves to improve the self-awareness of clients, change motivation, enhancing self-esteem and trust and to eliminate feelings of isolation in knowing that others face similar challenges. CBT for Group Settings vs. Family Settings

On the contrary, in family settings, participants are commonly united by blood or family relations and CBT serves to examine the interaction patterns that exist between family members in the identification and alleviation of problems. Re-victimization and lack of confidentiality are the major problems that might be encountered by mental health counselors in group settings. However, these problems might be addressed through having group norms and guidelines and educating group participants on the negative and positive impacts of maintaining confidentiality.


Agazarian, Y. M. (2018). Group-as-a-whole systems theory and practice. In Systems-Centered Practice (pp. 79-116). Routledge.

Agazarian, Y. M. (2018). The visible and invisible group. Routledge.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Smith, M. M., McLeod, B. D., Southam-Gerow, M. A., Jensen-Doss, A., Kendall, P. C., & Weisz, J. R. (2017). Does the delivery of CBT for youth anxiety differ across research and practice settings?. Behavior therapy, 48(4), 501-516.

Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Türkçapar, M. H., Kuru, E., & Yücens, B. (2014). The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225–233. Retrieved from http://www.turkpsikiyatri.com/CBT for Group Settings vs. Family Settings

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