Blake has worked in the mental health field since 2002 educating and inspiring hope on the journey toward recovery.
Strategies for Counseling in Group Therapy
When someone has a mental illness, teaching them coping techniques and methods of self-management may help them to stay well. People are complicated creatures, so finding group topics that address all group members' individual needs can be a challenge.
Depending on your group's demographics, you will have to decide what topics will be most appropriate. Consider whether you want to offer your group a basic understanding of the illness, coping skills, or a safe place for expression.
It is important to take your environment into account. Are you assigned to an inpatient or outpatient office, working in a church or community center, or meeting someone in their home? Mental health topics will vary in usefulness for different populations. You must also prioritize your group's needs according to the appropriate length of treatment.
Primary Topics for Mental Health Group Therapy
Here are primary group topics that can be broken down into smaller, more specific subtopics. Choose one and whittle it down to shape your clients' needs:
- Health and Wellness
- Personal Control
- Values and Beliefs
- Safety Planning
- Mental Health Systems
- Chemical Dependency
In the following paragraphs, you will be presented with specific subtopics under each primary topic. Some subtopics are interrelated and span more than one category.
Health and Wellness
These are just a few of the topics you might teach under the "Health and Wellness" category:
- Sleep and Rest Patterns: Your clients are likely to have sleep problems that exacerbate their mental illness. Sleep deprivation, in turn, causes more sleep problems, and is a cycle that they will need to learn to prevent. Teach your clients various ways to get the right amount and quality of sleep.
- Exercise: As obvious as it may seem, exercise is one of the best things you can do for your mental health. Stress levels are reduced with exercise. Teach your clients how to make exercise a part of their stress reduction plan.
- Nutrition: People who have mental illness may have all kinds of things influencing their appetite, from the illness itself, to the side effects of medications, etc.. Educate patients on nutritional needs and how to properly fortify the body.
- Medication Education: Patients on psychiatric medications will need to be educated on side effects and how to deal with them. It is most important that the patient maintains their medication regimen. Accessing medicine, or even just remembering to take it, can be a challenge for some.
- Recognizing Warning Signs: Certain signs help warn patients of an impending crisis or episode, but they will not be able to catch these signs if they haven't learned how to recognize them. Teach your clients how to identify personal warning signs and help them develop a protocol for intervention.
These are just a few of the topics you might teach under the "Personal Control" category. Some of these topics will overlap with other primary categories:
- Anger Management: This is an obvious topic when you have patients who are unable to control their emotions. Teach anger management before teaching "Relationships" groups; anger has to be under control first. Include identifying anger triggers, warning signs, and coping skills, especially when teaching kids about controlling anger.
- Stress Management: Teach your patients about stress and what function it serves. Next, teach your group about all of the negative effects of stress if not managed correctly. Advise your patients on how to handle stress healthily without going over the edge; teach stress management techniques for work and home.
- Personal Hygiene: Hygiene is often neglected when a person is not thinking correctly. It can become less of a priority and should be addressed in some populations of patients. Teaching this delicate topic will require some tact on your part.
- Impulse Control: Impulses are what get us in trouble, but the mentally ill can have lowered inhibitions. Unfortunately, this can happen naturally, and it can be next to impossible for the person to control impulses. Help patients cope with impulses and teach them to make conscious, well-thought-out choices.
- Cognitive Behavioral Therapy or Rational Behavioral Therapy: The premise behind CBT and RBT is that if you change your thinking, you can ultimately change everything. Thoughts lead to feelings, which lead to behaviors. This is a great way to treat negative thought patterns such as catastrophizing, black and white thinking, or other irrational thinking.
These are just a few of the topics you might teach under the "Relationships" category:
- Assertiveness: Assertiveness is a trait that anyone can practice and benefit from. It's a life journey to make it a habit to communicate actively and respectfully. Teach your patients how to communicate assertively even when others are not assertive. Teach them a concrete and effective communication strategy.
- Boundaries: Boundary setting is similar to assertiveness. Use visuals and role-playing as examples to get your patients to see the importance of setting healthy boundaries and respecting others.
- Conflict Management: Conflict with family members and others can be a source of great stress that leads to crises. Teach your clients to problem-solve in appropriate and productive ways. Managing conflict through compromise or collaboration will provide alternatives to acting irrationally. A specific group focused on how to deal with the many types of bullying can be especially beneficial for youth.
- Grief, Loss, and Forgiveness: Patients are sometimes hurting from things that have recently happened in their lives. Teach them how to grieve and how to forgive others, even when it is difficult.
- Parenting Skills: As with anyone, people with mental illness can benefit from parenting skills that help reduce the stress of being a parent. Learning how to say "no" to kids and how to reduce conflict with teenagers are examples of helpful topics.
Values and Beliefs
This category can be underrated, even though it allows the patient to be motivated to learn. Use these group themes when patients appear unmotivated:
- Goal Setting: Goal setting is an important part of living life to the fullest. It may be beneficial to allow patients to set their own daily goals, as well as long-term goals.
- Values, Beliefs, and Goals: Teach your patients how core values and beliefs can determine their behavior. Allow your clients to acknowledge their own values and have them set a goal that aligns their behaviors with their values and beliefs.
Safety planning involves anything that can keep a patient safe in a time of crisis. Here are some subtopics to address:
- Warning Signs: One important way to decrease recidivism is to teach your clients what mental health warning signs are, how to recognize these potential signs and symptoms, and how to get the support they need to stay safe by creating an action plan.
- Identifying Support: Your clients may not know that they have more support than they think. Identifying these support systems will give them the option to react constructively when faced with challenges. Support systems can be both internal and external.
- Discharge and Safety Planning: When it's time to discharge your patients or clients, you want to send them away with a clear plan for staying safe and well. Create a group that focuses on what's next. Help them see a way to manage their lives successfully outside of your care.
Mental Health Systems
The mental health system can suck you in and spit you out. Navigating the system can be a challenge, so help your clients know how to use mental health services in the best way possible. Here are some subtopics to address:
- How to Talk to Your Doctor: Your patient may only have a few minutes with the psychiatrist. Teach your clients what to ask, what to tell the doctor, and how to get the information they want across. Use mock scenarios for best results.
- How to Get Support: Support can involve many things, from getting help from a family member, to talking to the pharmacist about side effects. Clients will likely benefit from knowing what options they have for getting help from the mental health care system.
If you run a chemical dependency inpatient or outpatient program, you will likely cover several main topics. These subtopics are useful for clients and patients who are struggling with chemical dependency:
- 12 Steps: This program includes education about the 12 steps of AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) recovery programs. Be sure to explain how each step is different and how people usually progress through the steps. Provide AA/NA books for independent education.
- Dual Diagnosis: Drive it home that many mental illnesses are co-morbid conditions that lead to self-medicating with alcohol. Explain how alcohol can make mental illness worse and consider making a diagram of the correlations on a whiteboard.
Leading Mental Health Groups
When you get the chance to lead a mental health group, you may face some challenges, behaviors that will distract others, and outright defiance that may cause problems. There are, however, things you can do to help yourself so that your patients get the most out of the group.
This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
beth on June 03, 2020:
looking for ideas
Michelle Scoggins from Fresno, CA on November 03, 2014:
Great resource Blake. Working in the mental health field myself it surely is interesting and multifaceted - you never know what you may get. Group therapy is very helpful with many populations and certainly a resource I will use.
Blake Flannery (author) from United States on October 24, 2014:
I agree that sometimes mental illness is perceived as intellectual disability. That's why it's important to take your audience into account when planning mental health groups. Cognitive Behavioral Therapy is a challenging and effective treatment that requires intellect to some degree. I think that's why it's one of the best things to teach anyone, regardless of mental health status. If you're human, you can benefit from it.
Darcie French from BC Canada on October 23, 2014:
This is great, except .. I am left with the feeling that folks with mental illnesses are also perceived to have intellectual disabilities. I have bipolar and often feel like I am being "molly coddled" into "behaving" by the higher ups in the field.
Cyndy Adeniyi from Georgia on January 22, 2014:
I provide group therapy to detained youth. I'm always on the lookout for something that will capture their attention. I think your suggestion of groups on how to deal with the mental health system would transfer nicely to the juvenile justice system. Thanks for the well written article.
EPman from Queens, New York on November 13, 2010:
Good information. I'm glad you address the benefit exercise can have on the psyche.
peaceboy on September 18, 2010:
i am astarting a relationship group. what kind of boundry role plays would you suggest
pax on September 16, 2010:
Great staff,I'm an intern in a psychiatry ward,been struggling to start a group work. This information is very useful
rekha on June 25, 2010:
great article.i have been looking for something like this for so long
Kim Harris on June 18, 2010:
Great hub, Blake. I saw a couple more that look interesting too....will have to come back to them soon. In response to Drew above, DBT has been shown to help with that a lot. I like how organized this hub is. It's easy on the brain at this hour of night.
Blake Flannery (author) from United States on June 17, 2010:
I am sure some veterans are going through more than we can imagine. I hope they get the services they need before and after returning to their families.
My guess is that their treatment will be ongoing. You can't just fix everything in a day of therapy or by giving someone a magic pill. Especially if you are talking about trauma, it could take some time to heal. I wish them the best.
Barbara from Stepping past clutter on June 17, 2010:
Blake, I heard on the radio this morning that the military has difficulty working with and figuring out mental health issues of returning soldiers and that suicide is rampant (as it was with Vietnam). I wonder how you perceive this problem.
Blake Flannery (author) from United States on June 14, 2010:
Probably if you are having patients come back, then you should work on safety/discharge planning, recognizing warning signs, preventing relapse, getting help in the mental health system, personal control.
You should look into other factors such as medication compliance and follow up treatment compliance and remove any barriers that exist for the patient.
drew on June 14, 2010:
what topics of education material would you suggest for someone todo for pt's who frequently go back into the mental health ward
schoolgirlforreal on June 10, 2010:
More employees like you are needed. You really 'think out' your strategies. Curious as to your job exactly. Thanks for caring ! :-)
Blake Flannery (author) from United States on June 10, 2010:
Yes, EnLydia Listener, that is my calling to make a difference currently. I generally like people, so it's a good fit right now.
EnLydia Listener on June 10, 2010:
This was interesting information...Are you a professional in the mental health field? I rated this up.