As humans, we are social creatures with personal histories based on the various groups that make up our lives.
Childhood begins with a family of origin group and then progresses to groups for education, social activities, shared interests/hobbies, and work.
Group therapy can be traced back to Joseph Pratt. In 1905 he was teaching education classes on hygiene for patients struggling with tuberculosis (Pratt, 1907). Pratt noticed that patients who regularly attended presentations and interacted in groups afterward remained optimistic and courageous and had fewer symptoms and better recovery than those who did not.
Pratt (1907) believed that the emotional connection and support led to increased hope and physical improvement.
Group therapy activities provide emotional connection, education, support, encouragement, and guidance that can improve mental, emotional, and physical wellbeing. In this article, we will list various group therapy activities to use in your practice.
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There are several factors that should be considered as a therapist or leader begins to perform activities in group therapy. A needs assessment is essential to determine the purpose of the group and the specific activities, format, and structure that will follow.
Is this group open or closed? Is it designed to treat specific conditions or ailments such as post-traumatic stress disorder, addiction, or a specific mental health issue? Who makes up the group regarding age, gender, race, religion, etc.?
A pre-group orientation is helpful to identify individual patterns of group members and their history of interpersonal relationships (Whittingham, 2018).
The initial orientation will help build a positive emotional bond and working alliance with and among clients. Informing clients about the nature of group therapy and reviewing group agreements, logistical information, and assumptions can help group members feel safe, connected, and more engaged in group activities (Whittingham, 2018).
3 Therapy Group Activities for Adults
There are many activities to incorporate into group therapy for adults.
The activities should reflect the goals and composition of group members as well as the theoretical approach used by the group leader or therapist.
Best narrative therapy group activities
Narrative group therapy is an existential approach to therapy and allows clients to take ownership of their story by sharing it and rewriting it (Clark, 2014).
It provides space between an individual and their lived experience so they can separate problems from their life. Some narrative therapy activities that can be done in group settings include:
1. My life story
Clients are asked to identify five to 10 chapter titles for their life and briefly explain each. They can share these stories with other group members, which helps reinforce the idea that the past is in the past and the future is an opportunity for new beginnings.
2. Statement of position map
A statement of position map is an opportunity for clients to identify a problem, map out the effects of the problem across all areas of their life, and explore how the impacts of this problem deeply affect them.
As clients do this individually, they can share the effects of the problem with group members, which offers support and validation.
3. Expressive art storytelling
Expressive art storytelling can be made into a group activity by having members take part in expressive art together. An example would be to have group members individually draw or paint to the sound of music in a way that depicts their personal story for a specified amount of time. After the session, clients share the meaning of their art with other group members.
Warm-up activities in group sessions help clients build connections, reduce anxiety and defensiveness, and can shift focus to specific topics of discussion. These activities can be used for nearly any age group and for any specific purpose.
1. Two truths and a lie
In this activity, clients will each get an index card to write down three things about themselves. Two of them are true, and one is a lie. Members will go around the room stating the three pieces of information, and other members of the group must guess the lie.
2. Give me a minute
Members of the group will each get an index card with a topic on it (any random topic will do). Individuals talk about the topic for one minute. This fun activity allows members to open up, get creative, and express ideas and opinions about specific topics.
3. Desert island
Ask clients to think about being trapped on a desert island. They may bring one luxury item, one entertainment item, and one survival item. Have members share what they would take with them. This is often a revealing activity that can help members get to know one another.
Best Group Activities for Anxiety and Depression
According to the Kaiser Family Foundation, an independent source for health policy research, approximately one-third of US adults struggle with anxiety and depression.
Group therapy can provide a supportive and cost-effective way to treat symptoms and underlying causes of these debilitating mental health conditions.
1. Affirmations
This is an effective group activity for both anxiety and depression once a (closed) group has been a cohesive unit for several weekly sessions. It is important for group members to know one another to some degree.
A sheet of paper is passed out to each member, and they will write their name on the sheet. The paper is passed around so that other members can write positive affirmations directed to the member. This activity can be uplifting for individuals struggling with depression and decrease levels of anxiety.
2. Healthy brainstorming
This activity is based on Cognitive-Behavioral Therapy (CBT), behavioral activation, and goal setting. Each member of the group writes down a goal they would like to accomplish to improve mental health, such as diet, exercise, sleep, mindfulness, etc.
Members write down as many goals as they would like and pass the ideas around. Once the list is complete, the group can brainstorm practical ways to implement behaviors that will help achieve these goals.
3. Thought replacement
This positive thought replacement worksheet is based on CBT and can be used in a group setting. Each member can write down or identify a negative automatic thought they typically have. The member sitting next to them will come up with a positive replacement thought.
Thought identification and replacement is a cornerstone of CBT, which is an evidence-based treatment for both anxiety and depression (Wolgensinger, 2015).
This video expands on how useful group therapy can be for anxiety and depression.
Group therapy for anxiety & depression - Vanier College Television
2 Activities for coping with loneliness
Loneliness, grief, and loss are very much related to both anxiety and depression.
Group therapy activities can be very beneficial for individuals struggling with loneliness. They can provide a sense of connection, belonging, and shared interests (Shapiro & Gans, 2008). The following activities are a few examples.
1. Person to person
Members of the group will get two to five commands that they must perform as a pair. The last command is always “person to person” and everyone, including the person giving the commands, will have to scramble to find a new partner.
The “odd person out” gets to go into the middle of the group and provide the next set of commands.
The game begins with the person in the center (initially the facilitator) giving instructions such as: “hand to head” and the pairs must put a hand to a head. The facilitator can then say: “elbow to knee,” and the pairs then have to put an elbow to a knee, as well as keeping the hand to the head.
After a few more commands, the facilitator says, “person to person,” and everyone finds a new partner, except for the new person who begins calling out commands.
This activity forces interaction between members, which can help decrease feelings of loneliness and isolation.
2. The interview activity
Participants are paired and asked to interview each other to identify areas of commonality in their lives. Potential areas include education, family, likes, dislikes, professional interests, responsibilities, hometown, etc.
Each pair is asked to report to the group on three commonalities discovered. This activity helps individuals feel more connected and provides a sense of belonging.
2 Helpful activities for grief and loss
Bereavement groups provide members benefits for individuals dealing with grief and loss. They can help normalize the impact of grief, provide a safe, nonjudgmental space for the individual, and help participants discover resources and coping strategies.
According to Alan Wolflet (2004), group activities for grief and loss should help members with the six needs of mourning. These include acknowledging the reality of death, moving toward the pain of loss, remembering the person who died, developing a new identity, searching for meaning, and continuing to receive support from others.
1. Triggers
In this activity, the group identifies and discusses common triggers for their particular loss (what stimulates negative emotions such as sadness). Group members and leaders can then suggest different coping strategies they could use when feeling triggered.
2. Shared positive experiences
Have clients each bring in an item, object, or picture that represents a fond memory of the individual they are grieving. Members can take turns sharing the memory and how it affects them today.
4 Positive Psychology Activities for Improving Mental Health
Group therapy provides a uniquely rich environment and powerful setting that can improve mental health. We are hardwired for attachment and groups, which are potent sources of change for the central nervous system, brain, and emotional wellbeing (Denninger, 2010).
2 Activities for building healthy relationships
Healthy relationships are crucial for mental health and wellbeing. These activities can help build healthy relationships and improve personal emotional wellness.
1. Role-play
Role-play can be a great activity for acting out and resolving conflict in a healthy way. Members of the group can take on specific characters and role-play effective discussion, healthy ways to deal with stressful emotions, and setting boundaries. Role-play scripts can be an ideal tool to facilitate such sessions.
2. Effective communication
This effective communication worksheet teaches clients about effective communication techniques.
In a group session, members can practice each of the techniques with a partner and reflect on areas of strength and weakness. These can be discussed in session and continually practiced in subsequent meetings.
Best exercises for learning to let go
Learning to let go of negative thoughts, feelings, beliefs, and the need for control can lead to improvements in mental health.
1. Visualization
Have group members visualize what their lives would look like if they could let go of what was holding them back or what they were holding onto. After doing the visualization individually, have group members share about the experience.
2. Radical Acceptance
This worksheet on radical acceptance can be completed individually inside or outside of a group session. Members can share their responses with the group and reflect on what they learn about themselves and from one another.
Mindfulness Activities for Your Group Sessions
Research has demonstrated that mindfulness leads to improvements in nearly every aspect of mental health (Sundquist et al., 2015).
Mindfulness group therapy allows individuals to come together in a group setting to develop and practice mindfulness skills and draw benefits from the shared experience with others.
1. Mindful eating
A mindful eating activity can be done with any food but is often done with an almond, raisin, or orange slice.
Each member will take one of the above and be guided through a mindful eating session. Participants will examine the food item, smell it, taste it without chewing, slowly chew, slowly swallow, etc. Participants can share about the experience after it is completed.
2. Mindful breathing
Participants are asked to either close their eyes or stare down at the ground in front of them.
A mindful breathing script may guide them as follows: Take a moment, bring your awareness to your breath. Notice if you are breathing out of your mouth or your nose. Notice the length and quality of the breath. Notice the movement of your body as you breathe. Continue to focus all your attention on your breath and only your breath. If your mind wanders, gently bring your awareness back to your breath. Allow this focus to continue for five minutes.
3. Mindful yoga class
Yoga is a mindful activity that is great for groups. It is best led by a trained yoga instructor who can guide group members through breathwork and gentle movements.
3 Activities for Personal Growth and Self-Esteem
The particular psychotherapeutic conditions a group provides are ideal for creating personal growth and improving self-esteem. Groups can establish a safe, trusting interpersonal environment that allows members to gain new skills and experiences.
Additionally, groups can help dis-confirm faulty memories, beliefs, and assumptions that are the basis of low confidence, self-doubt, and fear that inhibit growth.
Neural networks that hold implicit experiences (leading to these faulty thinking patterns and beliefs) can be triggered and reframed when other group members bring their own struggles and experiences to the group (Badenoch & Cox, 2010).
These group activities can be applied to group settings to improve personal growth and self-esteem.
1. I Will Survive
This worksheet can be applied in a group setting. It helps clients notice their strengths, past successes, and ability to grow and overcome challenges.
2. The worth jar
Group members decorate a glass jar and fill it with notes or trinkets that represent their personal worth and value.
These might include inspiring quotes, small objects that symbolize strengths or accomplishments, or letters from loved ones. Members will share the jar with the group and explain the significance of the items.
3. The “I am” activity
Have group members write down a list of positive affirmations about themselves starting with “I am.” Examples include “I am compassionate” or “I am enough.” They will share their affirmations with other group members.
Our article on Self-Esteem Therapy provides more ideas to improve self-esteem and growth activities that can be applied to both individual and group therapy sessions.
4 Helpful Closing Session Activities
Closing group sessions is just as important as opening them with introductions.
Closing activities should highlight important aspects and reinforce any themes of the session. These activities help to unite group members and encourage them to work on themselves outside of the session before the next meeting.
1. Coping sheet
Create a coping cheat sheet summary card that group members can keep with them between sessions. This card can have a list of three to 10 coping skills that they can use when they are struggling. Examples could be breathing, counting, calling a friend, calling a hotline, listening to a song, or pausing.
2. Share an affirmation
Have group members end the session by going around the room and sharing a take-home affirmation they learned or recognized during the meeting.
Ending activities for your termination session
Closing group therapy treatment is the phase of group development known as termination (Levine, 2011). This is often one of the most difficult aspects of group structure and development. A group leader must evaluate either subjectively or objectively (or both) how the group members have progressed and whether goals have been met (Levine, 2011).
A variety of group activities can be incorporated in the termination phase to assist in this process and help group members transition out of group therapy.
1. Group motto
Have group members collaborate and come up with a group motto based on the goals and outcome of the group sessions.
2. Leave your mark
Do something creative and have the group come up with a piece of artwork collaboratively. They might use thumb or handprints to create a picture or use individual talents to contribute to a mixed-media piece of art.
The final product can be discussed and remembered as members leave the group.
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PositivePsychology.com offers a wealth of therapy resources that can be used and applied in group settings.
The GROW With Your Team worksheet specifically helps with group development, team cohesion, and learning to set and achieve common goals. This can be a wonderful activity to use to start a group because it allows members’ active participation in accomplishing objectives and the healing process.
Group therapy can be a fun way to improve aspects of mental and emotional wellbeing. The Empathy Bingo worksheet is an interactive way for group members to learn about empathy, develop healthy relationships, and practice self-compassion.
Group therapy has a nearly 100-year-old history and has branched into many aspects of the contemporary world. As social creatures, we learn from and depend on groups to survive, thrive, and grow as individuals.
This complex, intense interpersonal experience can be filled with powerful interaction and meaningful activities. Many of these group therapy activities are highlighted in this article.
Therapy provided in a group setting can be a powerful way to improve any area of emotional and mental wellbeing. It is a wonderfully unique experience in that every group and session is different and dynamic.
Group therapy provides a cost-effective alternative to individual psychotherapy. It brings people with similar needs together in a supportive, encouraging, and validating way.
What are mental health activities?
Mental health activities include any activities that stimulate growth and change, and challenge clients to explore and improve mental and emotional wellbeing.
How can I make group therapy more fun?
Group therapy is most effective and enjoyable when members connect and collaborate. Creating a supportive environment and keeping group members engaged with the specific topic and with one another makes group sessions fun.
References
Badenoch, B., & Cox, P. (2010). Integrating interpersonal neurobiology with group psychotherapy. International Journal of Group Psychotherapy, 60(4), 462–481.
Clark, A. (2014). Narrative therapy integration within substance abuse groups. Journal of Creativity in Mental Health, 9(4), 511–522.
Denninger, J. W. (2010). Commentary on the neurobiology of group psychotherapy: Group and social brain. International Journal of group Psychotherapy, 60(4), 595–604.
Levine, R. (2011). Progressing while regressing in relationships. International Journal of Group Psychotherapy, 61, 621–643.
Pratt, J. H. (1907). The organization of tuberculosis classes. Medical Communications of the Massachusetts Medical Society, 20, 475–492.
Shapiro, E., & Gans, J. (2008). The courage of the group therapist. International Journal or Group of Group Psychotherapy, 58(3), 345–361.
Sundquist, J., Lilja, A., Palmer, K., Memon, A., Wang, X., Johansson, L., & Sundquist, K. (2015). Mindfulness group therapy in primary care patients with depression, anxiety and stress and adjustment disorders: Randomised controlled trial. The British Journal of Psychiatry, 206, 128–135.
Whittingham, M. (2018). Innovations in group assessment: How focused brief group therapy integrates formal measures to enhance treatment preparation, process and outcomes. Psychotherapy, 55, 186–190.
Wolfelt, A. (2004). Understanding your grief: Support group guide: Starting and leading a bereavement support group. Companion Press.
Wolgensinger, L. (2015). Cognitive behavioral group therapy for anxiety: Recent developments. Dialogues in Clinical Neuroscience, 17(3), 347–351.
About the author
Dr. Melissa Madeson, Ph.D., believes in a holistic approach to mental health and wellness and uses a person-centered approach when working with clients.
Currently in full-time private practice, she uses her experience with performance psychology, teaching, and designing collegiate wellness courses and yoga therapy to address a range of specific client needs.
As humans, we are social creatures with personal histories based on the various groups that make up our lives.
There are many activities to incorporate into group therapy for adults.
According to the 
Research has demonstrated that mindfulness leads to improvements in nearly every aspect of mental health (Sundquist et al., 2015).
Closing group sessions is just as important as opening them with introductions.
