Support groups: The pros and cons as a complement to therapy

Clients often seek therapy to address maladaptive behaviours which are negatively affecting their lives and the lives of those around them. Among these behaviours are substance use, gambling, procrastination, binge eating and cheating on one’s relationship partner.

For some of these issues, support groups are available to further help clients with their challenges and struggles. These groups typically involve meetings among several people who are dealing with a particular issue. Among the most notable of these support groups are Alcoholics Anonymous, Narcotics Anonymous, Gamblers Anonymous and Sex Addicts Anonymous.

My experience in having worked in therapy with many clients who have attended such groups is that they can be helpful but are necessarily so. In the following sections, I will discuss these pros and cons of support groups as a complement to therapy.

Pros of support groups

There are many potential advantages of support groups. As a therapist, I think the most notable benefit to clients is that attending these group meetings regularly reminds them of the importance of using skills and strategies to stay on track with their issues. As such, these groups can be an excellent complement to therapy in which they learn such skills. Some groups extend this support to the assignment of ‘sponsors’ who act as mentors to new members in being accessible regularly for one-on-one support and guidance.

As the name indicates, support groups also give people support of various kinds which can also help them to continue using skills to stay on track with their issues. Getting respect and empathy from people struggling with the same issue can be huge in lessening shame which can detract from staying on track in addressing the issue.

Hearing about other people’s struggles with the issue normalizes the struggles one faces in dealing with that issue and, in turn, makes it less likely one will give up in the face of such struggles. Further, hearing the successes of other group members provides hope that one can succeed oneself in addressing the issue. This benefit is enhanced when one hears of group members successfully applying skills and strategies which one has been learning in therapy.

Cons of support groups

I also think that there are several potential disadvantages of support groups. These include:

(1) Some of these groups appear to send a message that the person dealing with issue has little to no control over the issue. I think that this message may detract from the person learning that they can exert control over the issue by learning and applying skills and strategies.

(2) Some of these groups appear to measure progress in a manner which may lead to undue stress for the person managing the issue. That is, they may focus on the number of days (or weeks, months and years) that that the person last engaged in the behaviour which they are trying to address. For example, in certain of these groups the members regularly announce to other members how long they have stayed sober in terms of alcohol use.

Although I think it is wonderful to be proud of how long it has been since last engaging in the behaviour, focusing on this as a measure of progress can add to one’s stress in dealing with the issue in a manner similar to a baseball player on a hitting streak or a sports team on a winning streak. Keeping the streak going as the focus of progress can be daunting at times.

In addition, the person may experience additional stress by considering the consequences of not keeping the streak going as akin to ‘going back to square one’. And if the person does indeed break the streak by engaging in the behaviour, however briefly, the demoralized feeling they experience may lead them to choose to engage in the behaviour to the same degree as before they made efforts to begin addressing it.

I favour instead measuring progress by focusing on how proficient the person is at using skills to address their issue rather than on how long it has been since they last engaged in the problematic behaviour. This focus on process rather than outcome reduces stress in dealing with the issue by letting the person concentrate on what is within their control.

I also favour measuring results-based progress in less black and white terms than how long it has been since the person last engaged in the problematic behaviour. This entails measuring how often the person stayed on track during the last week as well as how effectively they used each of the skills during that time period. This way of measuring progress allows for the person to feel good about the progress they’ve made even if they’ve engaged in the problematic behaviour during that time period. In turn, this way of assessing progress makes it easier to focus on getting back on track following engaging in the behaviour as well as learning from the ‘slip’ in order to prevent making it in the future.

Weighing the pros and cons of support groups

I firmly believe that the pros of attending support groups as a complement to therapy outweigh the cons in addressing an issue. However, it is important to maximize the potential benefits of the pros while also taking steps to decrease the potential negative effects of the cons.

For example, to maximize the benefit of being reminded to stay on track with one’s issue it is important that the person attend support group meetings regularly rather than occasionally or sporadically. To maximize the benefit of emotional support derived from these groups it may be necessary to attend several meetings before you come upon a group whose members are a good fit for you.

I think the best way to decrease the potential negative effects of the cons is to attend therapy alongside attending a support group. Your psychologist can help you counteract the negative effects of messages which you may encounter in certain support groups. That is, they can help you to view yourself as having control over your issues by using skills and strategies and they can help you to measure the progress you are making in a more effective manner.

May you benefit from support groups by bumping up the pros and ameliorating the cons,

Dr. Pat