Cognitive behavioral therapy: group settings versus family settings

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 Cognitive behavioral therapy is one of the most common go-to treatment approaches. This approach is known for focusing on changing unhealthy thoughts and behaviors to improve emotional wellbeing by learning coping strategies and putting them in use. Its use ranges from depression to addiction. With addiction, for example, it is estimated that about 50% of individuals who suffer from addiction, have cognitive deficits as well, according to Aharonovich et al. (2018, p. 800). 

 This approach can be used in individual psychotherapy or group/family psychotherapy. In group CBT, the purpose is to make progress toward goal while reviewing treatment skills and learn how to apply those skills into practice. Group sessions are usually a couple of times a week and treatment goes on for about 3-4 months. Its effectiveness is proved in DeViva et al.’s study that proves the most effective CBT treatment option for insomnia is group psychotherapy (2018, p. 294). In family therapy, communication skills can be strengthened. It involves exploring roles, rules, and behaviors and how those can affect everyone in the family.  It is usually one session a week for about 1 hour. An example of successful CBT family therapy is Selles’ et al. (2018) study which proves improvement in treating OCD in children (p. 116). 

 Two challenges encountered by therapist during group treatment are boundaries and fear. Some participating members might not understand or might choose not to follow boundary rules. Other members might not fully participate or engage in treatment due to fear of being exposed or judged. An example of this during my clinical rotation was a family member who did not engage in the sessions because he felt he did not need to “expose my problems with a stranger”. Whatever the case might be, I truly believe CBT is one of the most effective approaches in the field. 


Aharonovich, E., Hasin, D.S., Nunes, E. V., Stohl, M., Cannizzaro, D., Sarvet, A., … Genece, K. 

 G. (2018). Modified Cognitive Behavioral Therapy (M-CBT) for Cocaine Dependence: 

 Development of Treatment for Cognitively Impaired Users and Results from a Stage 1 

 Trial. Psychology of Addictive Behaviors, 32(7).

DeViva, J. C., McCarthy, E., Bieu, R. K., Santoro, G. M., Rinaldi, A., Gehrman, P., & Kulas, J. 

 (2018). Group Cognitive-Behavioral Therapy for Insomnia Delivered to Veterans with 

 Post-Traumatic Stress Disorder Receiving Residential Treatment is Associated with 

 Improvements in Sleep Independent of Changes in Post-Traumatic Stress Disorder. 

 Traumatology, 24(4). 

Selles, R. R., Belschner, L., Negreiros, J., Lin, S., Schuberth, D., McKenney, K., … Stewart, S. 

 E. (2018). Group Family-Based Cognitive Behavioral Therapy for Pediatric Obsessive 

 Compulsive Disorder: Global Outcomes and Predictors of Improvement. Psychiatry Research, 260, 116-122.



Cognitive Behavioral Therapy: Group Settings Versus Family Settings

Cognitive behavioral therapy (CBT) is a psychosocial intervention that can treat a wide variety of mental health conditions.  This approach can be used in treatment with individuals, groups, and families, this method has gained popularity over the years due to evidence-based research, and it’s known effectiveness (Wheeler, 2014). CBT teaches clients to recognize their dysfunctional thought processes and to become more aware of feelings and situations that can trigger negative thinking (Bjornsson et al. 2014). CBT, when used in groups, can be used for clients that suffer from addiction in a self-help group format. In CBT group work, individuals can openly express to other individuals struggles that they are facing during this time other group members can relate to one another, this creates one of Yalom’s therapeutic factors known as universality (Nichols, 2014).

CBT can also be used in families or couples as well. The family setting is typically smaller than the group setting. In family CBT the clients already have a relationship with one another and may have difficulty relating to each other due to conflict and typically includes children with their parents. When working with children the therapist will focus on teaching youth and their parents’ specific skills. CBT in family treatment can assist in helping the family function better as a whole. CBT in the group setting can be more cost-effective versus individual treatment and gives mental health providers the opportunity to increase the availability of evidence-based treatment to the community (Wergeland et al., 2014). 


Bjornsson, A. S., Bidwell, C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz, K. L., … Craighead, W. E. (2011). Cognitive-Behavioral Group Therapy Versus Group Psychotherapy For Social Anxiety Disorder Among College Students: A Randomized Controlled Trial. Depression and Anxiety, 28(11), 1034-1042.

Nichols, M. (2014). The essential of family therapy (6th ed.). Boston, MA: Pearson.

Shayan, A., Taravati, M., Garousian, M., Babakhani, N., Faradmal, J., & Masoumi, S. Z. (2018). The Effect of Cognitive Behavioral Therapy on Marital Quality among Women. International journal of fertility & sterility, 12(2), 99-105.

Wergeland, G. J. H., Fjermestad, K. W., Marin, C. E., Haugland, B. S.-M., Bjaastad, J. F., Oeding, K., … Heiervang, E. R. (2014). An effectiveness study of individual vs. group cognitive behavioral therapy for anxiety disorders in youth. Behaviour Research and Therapy, 57, 1–12.

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse (2nd ed.). New York, NY: Springer Publishing Company.

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