Group Therapy for Eating Disorders

Recovering from an eating disorder is no easy task and often requires professional treatment due to how unique and complex they can be for each individual. Ideally, someone would have a complete treatment team of professionals who specialize in eating disorders including a therapist, registered dietitian, medical doctor and sometimes a psychiatrist.

Many individuals also benefit from being in a group setting. It can be helpful to hear someone else discuss their issues and realize that you are not alone in how you feel. Getting feedback from a peer who has walked in shoes similar to yours is often easier to hear than that same feedback from a professional or loved one. Helping other people, and subsequently yourself, can increase self-esteem and build a sense of connection, belonging, and meaning.

If you are interested in participating in a group, there are different options that can help in the recovery journey. Keep reading to learn about the types of therapy groups available to you. See our page focused on support groups and 12-step groups for additional options.

Therapy Groups

Therapy groups are run by professionals in the field as opposed to support groups where oftentimes they are led by peers who are also working on recovery. These groups meet in therapy settings and usually have an out of pocket cost or may be covered by insurance. There is generally a contract when you join a therapy group that highlights the need for your consistent attendance, confidentiality guidelines, along with important group rules that govern how the sessions will be run. Requiring attendance allows for the group to be more connected and work together as a unit. Some groups will require that you are also in individual therapy in order to join the group.

Levels of Care for Groups

  • Outpatient Group – This is usually a group that meets once a week in a professional setting.
  • Intensive Outpatient Group – This is a higher level of care for those who would benefit from more support than once a week. It is often a group that meets 3-5 times a week, usually for multiple hours. It will have a mix of psychoeducational and process groups. Many programs offer meal support with this.
  • Partial Hospitalization Group – This is the next level of care for those who would benefit from a full day of group and meal support, but they do not sleep at the facility like they would at an inpatient or residential treatment center.

Common Types of Groups Offered for Eating Disorders

  • Psychoeducational Group – The focus is on teaching information on a specific topic which may include understanding the development and function of an eating disorder, the harms associated with them, and coping skills like mindfulness, distress tolerance, and boundary setting.
  • Process Group – The focus is more on the experience of the group itself and on thoughts and feelings that arise during the group. A therapist may facilitate the group discussion but rather than being taught something by the leader, the learning often comes from other members of the group who will share in a discussion of the topic.
  • Open Group – An open group allows members to join at any time. This means the group attendance can change over the course of time as people transition in and out of the group when they are ready. This can be helpful as some members who have attended the group for a while can help guide the newer members while new members can bring useful insight to the group as they may be earlier in recovery.
  • Closed Group – A closed group means the group will run for a specific amount of time with the same members. No new members will be allowed to join during the course of the group. This can be helpful because the group can develop meaningful connections with one another and they may get a sense of completing a journey together as they started and ended at the same point.

Specific Outpatient Therapy Groups May Include:

  • Cognitive Behavioral Therapy (CBT) groups are a combination of psychoeducation and process. The group focuses on changing a person’s belief systems about themselves and their world through working on the flawed beliefs and values, particularly around weight, shape, self-worth, and self-image. CBT is a structured form of therapy which helps people obtain better control of their thoughts, feelings, and behaviors. This type of group often uses worksheets to help look at the thoughts they struggle with and ways they can rephrase them, or what behaviors they can change to work towards their goals.
  • Dialectical Behavioral Therapy (DBT) groups are more psychoeducation than process, but there is a process that happens in these groups as well. In these groups, the work is focused on both thoughts and behaviors to help a person to better cope with painful feelings. DBT has its foundation in mindfulness practices and teaches group members about practicing mindfulness, creating the ability to regulate emotion, tolerating distress, and becoming more effective in interpersonal interactions and relationships. DBT may also require participation in individual therapy.
  • Acceptance and Commitment Therapy (ACT) helps people to accept the full range of feelings and thoughts that come with being human and committing to take action on the things that matter most to them. It is founded on the idea that most of the psychological distress we experience is caused by our avoidance of particular experiences, body sensations, or thoughts. This form of therapy helps people to observe, recognize, and accept their experiences, thoughts, and feelings while creating thoughts that would be more helpful. It allows individuals to open up their psychological flexibility, be present, and do what matters by aligning their behaviors with their values in order to build a full and meaningful life.
  • Interpersonal Therapy (IPT) is centered around creating better experiences relationally to others and improving overall social functioning to help decrease a person’s distress. This form of therapy focuses on current relationships. It acknowledges that there is inner conflict within a person, but this is not the focus, as other therapies might.
  • Expressive Therapy is a group of therapies that combine the creative process with psychology to help bring about healing. It comes in many forms such as art therapy, drama therapy, dance therapy, and music therapy. You do not have to be good at any of these art forms to benefit from this modality, you just need to be willing to participate. Art therapy is the most easily found expressive therapy in an outpatient setting. Expressive therapy can be very powerful and taps into another part of a person that talk therapy alone may not reach. For people who do not love to talk, expressive therapy can allow them an outlet for healing.

Cost

Therapy groups range in price depending on the amount of hours, specialization, and location. If you have insurance, you may want to contact your insurer to determine if group therapy is covered and if so, what the coverage entails. Do you have out-of-network benefits that will cover a portion of a group if it is not run by someone in your insurance network? Insurance is also a great place to start if you are looking for a therapy group. You can ask them if they have any groups listed for eating disorders in the network.

How to Get Started

If you find a group you would like to join, reach out to the individual or organization running the group. If you haven’t found one, it may be a good idea to contact a local eating disorder therapist or eating disorder treatment clinic for recommendations. They will likely be aware of good options in the area or online. They may also suggest completing a full evaluation so they can give their best professional recommendation for the type of group and level of care.

The Alliance For Eating Disorders Awareness has a directory of eating disorder treatment options.

Use Psychology Today to find a group near you.

 

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References

Polivy, J., & Federoff, I. (1997). Group Psychotherapy. In Handbook of Treatment for Eating Disorders (2nd ed., pp. 462–475). The Guilford Press.

Team, G. T. E. (n.d.). Group Therapy. Retrieved September 9, 2019, from https://www.goodtherapy.org/learn-about-therapy/modes/group-therapy.

About The Author

Sarah Blake is a social worker in private practice in Columbia, MD, where she specializes in working with eating disorders and women’s issues. Prior to starting her own practice, she worked for 15 years as a therapist in both eating disorders and mental health treatment facilities and offices. She works with individuals ages 14 and up, helping them to find positive solutions to life’s challenging problems.

Written – 2020