Group therapy is common in substance use treatment but remains far less common in broader mental health care. Psychologist Dennis Morrison says limited training, payment policies and paperwork — not necessarily patient outcomes — help explain the divide.
Morrison, chief clinical officer for the behavioral health technology company Eleos Health, said research has found group therapy can produce results comparable to individual therapy for many, though not all, mental health needs. He previously led the Centerstone Research Institute and said group therapy was his preferred approach when he worked directly with patients.
“Getting group therapy is not a second-class type of treatment,” Morrison said. “It is not inferior to individual therapy.”
Morrison said most therapists train primarily to work with patients one-on-one. Group therapy accounted for about 10% of his graduate training, he said. Unless clinicians seek additional experience leading groups, they may be less likely to recommend the approach.
Payment systems can also discourage group treatment. Morrison offered a hypothetical example in which an insurer pays $100 for an individual session but only $20 for each patient in a group. The therapist might earn the same amount for the hour while completing separate documentation for every group member.
That can make individual care easier for clinicians to manage, even though a group can serve more people at once.
The gap could matter more as mental health providers prepare for reductions in federal Medicaid spending under the tax-and-spending law enacted in 2025. Morrison expects the changes to leave providers serving people who lose coverage while receiving less reimbursement.
He said those financial pressures could lead more providers to consider group therapy, but payment and paperwork would still need to make the approach practical.
Group therapy is not appropriate for every person or condition. Morrison said patients interested in it can ask a therapist or intake worker which groups are available and whether the format fits their needs.
Groups can also meet by video, potentially expanding access in rural areas where reaching a therapist may require a long drive. Morrison said telehealth works well for some patients, while others prefer in-person care.
Video sessions can make body language and other nonverbal cues harder for a therapist to observe. Still, Morrison said, distance should not leave rural patients without care.
“If you live in a rural environment where it’s a two-hour drive to get in to see a therapist, it’s better to have the telemedicine services than to have no services,” he said.
Guest
- Dennis Morrison, chief clinical officer, Eleos Health
