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

Lynn Somerstein
Lynn Somerstein, PhD, NCPsyA, C-IAYT is a Manhattan-based, licensed psychotherapist with more than 30 years in private practice. She is also a yoga teacher and student of Ayuveda—the Indian science of wellness. Her main interest is in helping people find healthy ways of living, loving, and working in the particular combination that works best for them, connecting to their deepest energic source so their full range of abilities can be expressed. Lynn's specialty is understanding and alleviating anxiety and depression.
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  • Julie

    Julie

    April 18th, 2014 at 2:43 PM

    Personally I don’t knowt hat the two groups should be together because even if you are dealing with the same issues the way that adults live with something could be very different from how it is playing out with teens.

    Also I would be a little uncomfortable if I was older to be in a group with teens, I just would. I don’t want to be the person who is the bad influence on them and they might not need to have to deal with some very real adult issues that could come up. I know that it could work at times but I would think that the rule of thumb would be to lead the groups separately.

  • Selena

    Selena

    April 19th, 2014 at 10:43 AM

    You may do better in an individual therapy session and not meeting with a group. If you don’t feel like this is the group for you then I would just go find another one or maybe seek out a therapist who is willing to work with you one on one instead of in a group setting.

  • rylee b

    rylee b

    April 21st, 2014 at 4:55 PM

    The only good thing that I could think of that could come from this is that we learn from others who are at different places in our lives. Lots of young people if they are willing to take a chance and listen could really stand to learn something from the older members of the group. I do however think that there is probably some material that could be inappropriate for the younger members of the groups so parents would have to consent to let them participate fully. It could help a whole lot, but I can definitely see where there could be some concerns as well.

  • Dana

    Dana

    April 22nd, 2014 at 3:55 PM

    This would not be right. I don’t see how everyone could ever find that level of comfort that you need to mae]ke group therapy successful.

  • scarlet

    scarlet

    April 27th, 2014 at 7:55 AM

    Just like with anything else, any other group therapy setting, I think that there will be those who will get something from it and then those who don’t. It’s gonna be a toss up.

  • Evan R

    Evan R

    April 28th, 2014 at 3:39 AM

    If you aren’t happy with the group dynamic, then is there a possibility that you could find another group to work with close to your area? You might have to drive a little further or meet with another group leader but I sense some real hesitation on your part about being invested in this group that you aren’t sure about so I am sure that if you talked with the leader or your therapist they could help you find another setting where you might be more comfortable.

  • Mcioffi

    Mcioffi

    May 9th, 2016 at 2:36 PM

    I don’t think mixing ages like this is a good thing. However, if there are extenuating circumstances, everyone agrees that it’s ok & there are guidelines established that topics inappropriate for teens will not be discussed, sticking primarily with issues of anxiety it might work. Take a read in 3-4 weeks and see how it’s going. If members are making progress with their issues, great. If not, regroup and separate the ages.

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