I hate groups. I can run a room, I can stand up and talk to two hundred people about the internet, and then go home and lie on the floor for a day. So the idea of sitting in a circle of chairs and talking about my feelings with strangers sounded like a punishment designed specifically for me.
I went anyway. More than once. And I'll be honest, it did something one-on-one therapy never did.
Here's the short version. Group therapy is usually 6 to 12 people meeting on a regular schedule with one or two trained leaders, often a psychologist or social worker. People talk about what's going on, listen to each other, and in a lot of groups you learn specific skills together (managing anger, anxiety, mood). Peer support groups are different: they're run by people who've lived the same thing, they're usually free, and nobody's a therapist. Both have their place.
What does a group therapy session actually look like?
It's less dramatic than TV. Nobody forces you into a trust fall.
Most sessions start with a check-in. Go around the circle, everyone says a sentence or two about their week. You're allowed to pass. Then either the leader teaches something (a skill, a worksheet, an idea) or the group talks about whatever came up. The last few minutes are usually a check-out.
There are rules, and good groups say them out loud on day one. What's said in the room stays in the room. Don't interrupt. Don't give advice unless someone asks. Speak about yourself, not about the person across from you. Those rules are what make it safe enough to say something real.
My first few sessions I either performed (funny guy, great insight, look at me) or I said nothing at all. Both were armour. The leader noticed, of course. They didn't push. They just waited, and the group waited, and eventually I said one true sentence and nobody flinched.
Is group therapy as good as individual therapy?
For some things, yes. And for some things it's better, because of what other people give you that a therapist can't.
The research on anger is a good example. A big meta-analysis of anger treatments summarised by the US Department of Justice's CrimeSolutions found moderate to large effects, and group and individual formats generally worked about as well as each other. That matters to me, because my anger has a name (a friend called it a robplosion almost twenty years ago) and I've spent years trying to get it under control.
For alcohol, the evidence for peer groups is strong. A 2020 Cochrane review of 27 studies found that AA and twelve-step facilitation did as well as other treatments on most outcomes and better on continuous abstinence. For mental health more broadly, peer support shows small but consistent benefits, mostly on hope and personal recovery. Small isn't nothing. When you're sinking, small is a rope.
What a group gives you that one therapist can't
Someone across the circle says your exact sentence.
That's what got me. A guy I'd never met described the thing I do (blow up, feel the shame, apologise too much, do it again) almost word for word. I'd always thought that was a private defect, something wrong with me specifically. Hearing it out of another mouth took a chunk of the shame away in about thirty seconds. Years of one-on-one work hadn't managed that.
You also get to be useful. For someone with low self-esteem, that's a big deal. You say something and you watch it land for someone else, and for a second you're not only the broken one in the room.
The autistic part: groups can wipe you out
I won't pretend groups are easy for an autistic brain. Several people talking, fluorescent lights, eye contact expectations, reading the room, waiting for your turn without knowing when your turn is. I'd leave exhausted, and some weeks the exhaustion cost more than the session gave me.
What helped:
- Smaller groups with clear structure. A skills group with a plan beats an open "let's share" group for me.
- Telling the leader up front that I have ASD and might not look at people.
- Online groups. Camera off at first if that's allowed. Less sensory noise.
- Planning nothing for the rest of the day.
If a group is wrong for you, that isn't a verdict on you. There are other formats.
How to find a group, and how to tell if it's safe
In Québec, start with your CLSC or call 811 (option 2, Info-Social). Relief (it used to be Revivre) runs self-management groups for anxiety, depression and bipolar disorder. The RRASMQ directory lists community mental-health groups by region, including peer support groups. For substances, NA Québec and SMART Recovery are the two big options; I compared them in NA vs SMART Recovery.
For emotions and anger specifically, Emotions Anonymous has meetings in French and English, in person and by phone or video, and Recovery International runs free peer meetings that include anger.
My own checklist, built from what reputable programs have in common (this is my opinion, not an official standard):
- A named organisation or a licensed professional behind it, with real contact info.
- Free, or clear fees. No "VIP tier", no retreat upsell.
- Stated rules about confidentiality and respect.
- They don't tell you to stop your meds or your therapy.
- They know what to do in a crisis and say so.
Walk out of anything that feels like a club with a secret, or that pulls you away from your family and friends.