Group Therapy vs. Support Groups: What's the Difference?

Group therapy is a form of mental health treatment led by a licensed clinician, where a small number of people meet together to work on shared concerns. A support group is different: it is usually peer-led, free or low-cost, and focused on mutual encouragement rather than clinical treatment. Both can be useful, but they serve different purposes and carry different expectations around confidentiality, structure and cost.

What group therapy actually is

Group therapy is psychotherapy delivered in a group setting. A licensed therapist — a psychologist, clinical social worker, counselor, marriage and family therapist, psychiatrist or psychiatric nurse — leads the group. The therapist sets goals, guides discussion, teaches skills and manages the group process. Groups can be open (new members join at any time) or closed (the same members stay for a set number of sessions). They may be condition-specific, such as groups for people with depression, anxiety or PTSD, or focused on a particular skill set, such as dialectical behavior therapy (DBT) skills training.

Group therapy is one of several formats of therapy; others include individual, couple and family therapy. The types of therapy explained page covers the main approaches, including CBT, DBT and EMDR.

What a group therapy session looks like

How long and how often a group meets varies by group, and many groups run longer than an individual session; ask the leader before joining. The therapist opens the session, may check in with each member, and then guides the group through a discussion or skill practice. Members are encouraged to share their experiences, give feedback to one another and practice new ways of interacting. The therapist keeps the group safe and on track, and may follow a structured curriculum — for example, in a DBT skills group, members learn mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation skills.

DBT was developed by Marsha Linehan, originally for suicidal behaviors and for people with borderline personality disorder. Standard outpatient DBT has four modes: individual therapy, skills training (often in a group), phone coaching in the moment, and a consultation team for the therapists. A DBT skills group is a structured class-like setting where members learn and practice skills; it is usually combined with individual DBT therapy. For more on this approach, see what dialectical behavior therapy involves.

Support groups and peer specialists

Support groups are gatherings of people who share a common experience — such as grief, caregiving, addiction recovery or a mental health condition — who meet to offer mutual support. They are often facilitated by a peer, not a licensed clinician. Peer specialists are people with lived experience of mental health or substance use challenges, in stable recovery, trained to support others. They are not therapists. Support groups may be run by nonprofit organizations, hospitals, community centers or online communities. They are typically free or low-cost and may be drop-in. The focus is on sharing experiences, reducing isolation and practical coping, rather than clinical treatment or diagnosis.

Group therapy vs. support groups: a comparison

Who leads each type and what to ask

Group therapy is led by a licensed clinician. You can ask about their license, their training in group therapy, and whether they follow a specific approach. It is reasonable to ask how the group is structured, what the goals are, how progress is assessed, and what the confidentiality rules are. The therapist should explain the limits of confidentiality — for example, that they may disclose information if required by law or to prevent serious harm, and that mental health professionals are mandated reporters of child abuse and neglect in many states. Group members are usually asked to keep what is shared in the group private, but that is an honor-system agreement, not a legal obligation.

Support groups are often led by peers or volunteers. It is fine to ask who facilitates the group, whether they have training, and what the group’s norms are around privacy. Peer specialists are not therapists and do not provide clinical treatment.

How group therapy fits with individual therapy

Group therapy can be used on its own or alongside individual therapy. Some people attend both: individual therapy for personal exploration and group for skill practice and peer feedback. The choice depends on the person’s needs, preferences and what the clinician recommends. Goals of treatment, and how long and how often to meet, are discussed by the patient and therapist together.

Cost and insurance for group therapy

Group psychotherapy can be covered by insurance. Medicare Part B covers outpatient mental health care, including individual and group psychotherapy, from psychiatrists and other doctors, clinical psychologists, clinical social workers, clinical nurse specialists, nurse practitioners, physician assistants, and — since January 1, 2024 — marriage and family therapists and mental health counselors. After the Part B deductible ($283 in 2026), a person pays 20% of the Medicare-approved amount for visits. Medicaid coverage for group therapy varies by state. Under the federal parity law, many private plans that offer mental health benefits must keep copays, deductibles and visit limits for them, group therapy included, generally no more restrictive than for medical and surgical care; the law does not require a plan to cover mental health at all, and small employers’ group plans (fewer than 51 employees) and retiree-only plans are exempt. Check with your plan about coverage and whether the group leader is in-network.

Support groups are usually free or low-cost. For people without insurance or with limited budgets, low-cost and free therapy options can include support groups, employee assistance programs, and community clinics.

How to find a group

• Ask your primary care provider or current therapist for a referral to a group therapy program.
• Use SAMHSA’s FindTreatment.gov to search for state-licensed mental health treatment, which may include group therapy.
• Contact your health insurer for a list of in-network group therapy providers.
• Look for support groups through national organizations focused on your concern, community centers, hospitals or places of worship.
• Employee assistance programs (EAPs) may offer short-term counseling or referrals to groups.
• University training clinics sometimes run therapy groups supervised by licensed professionals.

What goes wrong: common mistakes and limits

One common misconception is that a support group is the same as group therapy. They are not interchangeable: a support group does not provide clinical treatment, and a peer facilitator is not a licensed therapist. Another mistake is assuming that group therapy offers the same privacy as individual therapy. In group therapy, the therapist has professional confidentiality obligations, and group members are asked to keep things private, but the therapist cannot control what members share outside the group. It is worth asking about confidentiality before joining.

Some people worry that group therapy is less effective than individual therapy or that it is a second-best option. Group therapy is a legitimate treatment format with its own benefits, such as peer feedback and practicing social interaction. However, it is not for everyone; some people prefer individual therapy, and some concerns are better addressed one-on-one. If a group does not feel like a good fit, it is reasonable to talk with the leader or look for another option.

Another limit: not all groups are led by licensed clinicians. A group advertised as “therapy” should be led by a licensed professional; if it is not, it may be a support group. It is fair to ask about the leader’s credentials.

If you are in crisis or having thoughts of suicide, in the US call or text 988 (the 988 Suicide & Crisis Lifeline) or call 911 in an emergency.