Is It Normal for Group Therapy to Mix Teens with Adults?

Is it common practice for group therapy to mix teenagers and adults? I had my first group therapy meeting today for social anxiety and was surprised to see there were three teenagers in a group of six. (The three adults ranged in age from 25 to 45.) The psychiatrist addressed this age difference but affirmed that we are all experiencing the same issues. I'm unsure if I should continue this therapy since I cannot relate very well to half the group. —Mixed Feelings
Dear Mixed Feelings,

Therapy groups are formed around a common interest to promote cohesiveness, a central factor in the strength of the group. Generally, this central factor includes common life experiences as well as a common issue. Social anxiety is certainly an issue that affects all ages.

The group you’ve joined has three teenagers and three adults (ages 25-45). As you mentioned, generally groups of adolescents are kept separate from adult groups; this was addressed by the psychiatrist leading the group, but you do not write if there was any discussion around this issue. Discussion is a vital part of group therapy, as it is in individual treatment. I have questions about the group, and if there was a real discussion. Will the split ages split the group? Has good two-way communication been established?

Did everyone in the group start at the same time? It might be easier to have a discussion where everyone is equally new, although your questions should be addressed in any case. Was the group invited to share reactions, questions, and thoughts? There might have been a discussion, but in your questions you say that the “psychiatrist addressed” the age difference. Does that simply mean he or she mentioned it, and then the subject wasn’t taken up by group members? If there was no discussion including all members of the group, then there was not much dialogue and the question must still be addressed.

Will you meet for a certain number of weeks, months, or is this left open-ended? Will people be joining the group as you go along? Will group members have a say in this? At this time, the group is evenly split. This would change by the addition of one other member.

One factor in creating a group is homogeneity, which includes age. Homogenous groups are generally easier to manage from the group leader’s viewpoint and also show greater and quicker improvement than heterogeneous groups.

Are there external factors affecting the group leader, in this case a psychiatrist? The psychiatrist might have invited different age groups to attend so that enough people would participate to make a group.

To help you make your decision, I thought you might like to know some facts about group therapy, as explained by Irvin Yalom in his book, The Theory and Practice of Group Psychotherapy. Yalom is a pioneer in group therapy who identified what makes group therapy work.

Here is a list of five important factors:

1. Universality: Shared feelings and experiences. Members of your group have similar experiences pertaining to social anxiety, for example, but the age difference will have an effect here.
2. Altruism: Group members help each other, which has a powerful effect. Will the older members be able to help the younger members? Will the younger members accept help? Will their help be valued by the older members? Helping and being helped by group members is a powerfully curative experience.
3. Instillation of hope: If people in your group have been members for different lengths of time, then someone who has been working longer might be a good role model for a new member. The older members in general might be good role models for the adolescents.
4. Corrective recapitulation of the primary family experience: Sometimes people in therapy groups feel as though the group members are like members of their own families. This happens in a group where everyone is about the same age, but also in a group like yours, where the generations are a split. In this case the family experiences might feel a bit too real, which could hinder optimal group functioning.
5. Cohesiveness: This is the most powerful and elementary factor affecting the group. Each member of the group has to feel that he or she belongs in the group and is accepted and validated. This might be a problem in the group that you described.

If you like, you can think about these points and see what your answers are, or even bring them to the group, first consulting with the group leader as to the policy regarding outside references, which might be experienced as interference.

Thanks for asking this interesting question. I hope this helps you decide what to do.

Kind regards,
Lynn