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Wednesday, 6 October 2010

Request For Help: What’s the Ideal Size for a Therapy Group?

Hello everybody

I am writing to ask for your help on a question that keeps cropping up in group work but which never really gets a sound answer – namely what is the “ideal” size for a therapy group?
Whether it is activity based, CBT, psycho-educational, exploratory or discussion based – we all know intuitively that group size has an enormous bearing on outcome and many of us have strong opinions on it. So what research is there on the subject? The surprising answer is – remarkably little. There is lots of opinion expressed, there are traditions and norms for group size, but actually there is very little controlled research available to answer this question.
We will explore the available research evidence in our upcoming seminar "The Essential Toolkit for Running Groups" ( ). However, prior to it I would like to approach the issue in a slightly different way and to ask for your help on the matter.
If you have experience in running groups or ever being involved with it in any way – I would very much like to hear from you regarding:
  • what size your groups usually are (e.g. 6-16),
  • who your client group is (e.g. young people with depression, or elderly clients, or clients with eating disorders etc)
  • how many people are running the group (e.g. only you or 2 co-leaders etc.)
  • do you think that types of clients’ problems you are working with might dictate different group sizes
What we aim to do is to create a database of current group practice which we will post on the SDS website ( ) as well as feed into our subsequent group training . That is why the more examples of different types of groups we receive from you, the broader the range of group topics or aims we can cover – the better. This should at least begin to provide us with a reference point regarding current practice.
Again... please help us to create this guide that will be used by many of your colleagues by forwarding the details of your groupwork experience.

Looking forward to hearing from you.
Take care, Paul



  1. Dear SDS

    I have run 2 womens therapy groups both had no more then 8-10 people initially in them. Both groups were for adult female rape and sexual abuse survivors. The clients were more inclined to be open in the smller group of the two which had 5 clients in it. I was the only facilitator of the groups in both cases. I do think working with survivors means disclosure and trust can be more so than working with some other issues. Therefore I think it is essential when working with this client group to keep numbers small.

    I hope this helps

    Kind regards

    Services Manager

  2. Hi Paul

    Have been on a couple of your courses and have found them invaluable.

    Anyway I am from a counselling background and have co-facilitated several groups. Group size for adolescent I have found most successful with between 4 and 8 young people with two facilitators. We usually ran an open group for the fist 2/3 of an acaedmic year with the last 1/3 closed. We checked out young people aims and planned activities accordingly for sessions that were as unlike school work as we could manage . Often we abandoned plans and went with what the young people bought into the room. Key componenets were 1. two way respect ( unconditional positive regard) 2. young people helping decide boundaries and consequences with facilitators.and sticking to these. 3. congruence. 4. Empathy. 5. Talking increasingly about process rather than content. Issues that seeme to be helped by group work ( through evaluation) were confidence, self esteem, anxiety, low mood and broadly identity.

    Groups for younger children aged between 8-12 tended to be a little more structured, 2 facilitators and a six week programme followed by review with parents. Often the reveiw with parents had as big an impact on changes as the group work. Systemic tools extremely useful with the whole family to raise consciousness and challenge beliefs in a non threatening manner.

    Psycho educationl group generally quite structuered. 8-16 with 12 being as near to perfect as I have found depending on mix of individuals. 2 facilitators. Subject- parenting for emotional well being.

    Adult therapy groups 8-12 I have found the best. Two few in early days too threatening. ( For clients) Too many can be overwhelming. ( For me too!) Mix between men and women also can be important.

    As for the type of problem dictating group size I've never really given it that much thought. I guess that a smaller group might be needed for some practical reasons . I'll give that one more thought.

    Hope this useful .


  3. Hello,
    In response to your request for input on the ideal group size I have a few

    1. I have facilitated therapeutic support groups for those bereaved by
    suicide. After seeking guidance from other (many!) colleagues and
    professionals I decided on a group sixe maximum of 8 with 2 counsellors
    present. The groups I ran had 5 and 7. Both sizes worked equally well as
    each member had enough space to be individual but enough around them to be
    2. As a tutor of counselling skills the class size permitted is 9-15. I
    consider this to be a therapeutic environment as counselling skills classes
    need personal development and self exploration. With only 1 tutor 15 is
    simply too many. Individuals feel they don't get enough tutor time in
    smaller groups, individuals can 'hide' easily in an unhealthy way as well as
    a way of simply needing to withdraw and process. I find it harder to keep an
    eye on the whole group process when it takes all my time to get around the
    smaller groups (2's and triads). Individuals whose issues are around feeling
    inferior or intimidated can feel overwhelmed by such a size group.
    Individuals who are naturally louder and more extravert have more of an
    audience. The ideal size for me as a tutor as well as the students is 9-12
    in one cohort.
    3. On a personal level, the various training and development scenarios I
    have experienced have included being 1 of 15 and 1 of 6 (often the latter)
    and my preference is a smaller group of 6-9.

    I have done a fair bit of 'watching' on this as I believe it is vitally
    important and essential that it is observed in order to offer the potential
    experience, whatever that is. If you want any more input I am happy to add
    to this.

    I applaud you for looking at this seriously.


    Counsellor, Counselling Supervisor and Tutor

  4. Hello,
    In response to your request for input on the ideal group size I have a few

    1. I have facilitated therapeutic support groups for those bereaved by
    suicide. After seeking guidance from other (many!) colleagues and
    professionals I decided on a group sixe maximum of 8 with 2 counsellors
    present. The groups I ran had 5 and 7. Both sizes worked equally well as
    each member had enough space to be individual but enough around them to be
    2. As a tutor of counselling skills the class size permitted is 9-15. I
    consider this to be a therapeutic environment as counselling skills classes
    need personal development and self exploration. With only 1 tutor 15 is
    simply too many. Individuals feel they don't get enough tutor time in
    smaller groups, individuals can 'hide' easily in an unhealthy way as well as
    a way of simply needing to withdraw and process. I find it harder to keep an
    eye on the whole group process when it takes all my time to get around the
    smaller groups (2's and triads). Individuals whose issues are around feeling
    inferior or intimidated can feel overwhelmed by such a size group.
    Individuals who are naturally louder and more extravert have more of an
    audience. The ideal size for me as a tutor as well as the students is 9-12
    in one cohort.
    3. On a personal level, the various training and development scenarios I
    have experienced have included being 1 of 15 and 1 of 6 (often the latter)
    and my preference is a smaller group of 6-9.

    I have done a fair bit of 'watching' on this as I believe it is vitally
    important and essential that it is observed in order to offer the potential
    experience, whatever that is. If you want any more input I am happy to add
    to this.

    I applaud you for looking at this seriously.


    Counsellor, Counselling Supervisor and Tutor

  5. The only group I run is a peer support group. We have 14 members but not
    everyone comes every time - numbers usually around 8-10. I facilitate it to
    ensure that everyone has a fair chance to speak, etc.

    I think more than 10 would be inhibiting for some, whether therapists or

    Hope this is helpful.


  6. Paul Grantham

    I am at present facilitating groups in Hammersmith & Fulham with a colleague in regard to Relapse Prevention and Substance Misuse Education. The groups I facilitate are between 3 and 8, I believe the 'ideal size' is around 8/10..... Dependent on the subject matter

    We are working with over 18's, age group presently 21 - 47 all of which are on Community Orders sentenced by the Court.
    Depression is something our client's suffer with as a consequence of drug use.

    Hope this helps


    Throughcare Manager

  7. Hi,
    This is a very interesting question. I run a programme specifically for
    stimulant users. The ideal number for me is to start with 10 and then
    generally a couple drop out.
    The programme is ran by 2 co-facilitators. I think that the types of clients
    problems should dictate how many you have in a group.

    I hope this helps

    Drug and Alcohol Development Officer

  8. Dear colleague,
    3 of us run a 5 wk 10 session pain management group - I guess it's more of a psycho educational than therapy group but in our experience (clin psych, physio and nurse specialist), anything from 8-16 works ok and 13-15 is probably optimum.

    Dr C.S., clinical psychologist

  9. Dear Paul,

    I work in a secure hospital (low and medium security). All patients are male and detained under the mental health act. We run groups that vary in size and I think this reflects the group aims and patient problems being addressed. I have given some examples:

    We run a psycho educational group for patients with a diagnosis of schizophrenia/ bipolar disorder/ Schizo-affective disorder. This is primarily an educational group, with a focus on normailsing. From experience there is often limited patient engagement (e.g., limited interaction during group discussions, fewer questions) than other groups. More discussion was noted when we introduced larger groups (7-10), as oppose to the original (5-7). I think this is because a larger group allows for a number of smaller contributions from a larger number of patients. So far, I feel that the larger numbers means that someone can have the opportunity to talk, but if they had been initially reluctant to attend because of group anxiety, they can 'hide' in the group, whilst talking the information on board; thereby reducing pressure to have to talk. This can give the individual the time to feel more comfortable in the group setting, whereas smaller groups can quickly be more focused and challenging. On the other hand a patient could feel overwhelmed by the large numbers; hopefully the smaller group discussions can help with this and help to build confidence to engage in group work. 2 co-facilitators usually run this group, increased numbers help with assistance during smaller group exercises.

    The coping with voices (CBT) group (often the next group patients attend after the psycho-educational group) works better with smaller group numbers (average 3-5). Patients interact more in this group, and the smaller group numbers allow for this, giving them the opportunity to ask questions and discuss issues. Patients are usually familiar with the group environment. Smaller numbers also appears to help with issues around confidentially, which is a concern of this patient group; smaller group numbers appear to help patients get to know other members more quickly and build trust. Larger groups means that someone can get "lost" more easily, particularly if less vocal and they can struggle to make contributions and ask questions; thereby benefiting less from the group. 1-2 co-facilitators usually run this group.

    A psycho educational programme is also run for patients with a diagnosis of personality disorder. Again this group has much smaller numbers than the programme for patients with a diagnosis of schizophrenia (average 5-7). This patient group often makes significantly more verbal contributions and the smaller group numbers and increased sessions/ discussion time allows for this. Feelings of frustration are evident in group members if the group is too large and material not sufficiently discussed. 1-2 co-facilitators usually run this group.

    To date we rarely have had someone drop out of any of the groups and no negative feedback has been given about current group numbers (via post-group feedback forms).

    I would tend not to be rigid with group numbers. For example if we planned to run a psycho-educational group for patients with a diagnosis of schizophrenia, and during the screening interviews many of the patients appeared to be very talkative/ interactive, the final group numbers would reflect this (i.e., smaller).

    Hope this helps

  10. Hi

    I typically have experience delivering group work for adults with obesity, helping them with lifestyle change issues. However, I also deliver group work for vulnerable ladies with low level anxiety and depression teaching confidence and communication skills.

    For adults obesity services I usually facilitate alone, but on the occasions when two staff delivered the session, these run smoother, group dynamics are better managed and there is opportunity to explore issues from several perspectives.
    For confidence building courses I have always delivered these as a pair, and would find it near impossible to do alone due to the vulnerability of the client group, and potential to find it difficult engaging some of these clients.

    For both of the above I have worked with a group as small as 3 and as large as 30. I personally think 10-12 usually works best for me for less 'intimate' group issues, but probably 6-8 for more personal issues.

    Hope that helps, would like to know the outcomes!

    HPS - Workplace Health and Alcohol (adults)

  11. Hi Paul

    My client group would be young people between the age of 8-18, issues
    they must fit the criteria of being directly or indirectly affected
    through drugs and alcohol.

    Young people would be assessed to check out there need and alocation of
    a group, ie one group would be aged 8-10 years, another could be age
    14-16 years depending on the young person.

    There would be 2 facilitators/counsellors, The size of the group would
    normally be 8-10 people.

    In a case for example if we were working with a hidden harm group of
    high risk young people perhaps involved with court, youth justice
    agency etc 5 young people may be enough in this particular group again
    meeting the criteria above.

    Hope this is the information you are looking for.


  12. Hi Paul.

    I believe an ideal group size is 8-10 clients. I run a group with a co facilitator. The clients all have substance misuse issues and anxiety issues.


    ETE Tutor

  13. That's easy
    There are a few answers
    One, Less than 6 for those clients at a stage open enough to be more
    intimate (to share) so to speak
    Two, a larger group where people can belong but safe not to interact.
    Good Luck

  14. Paul,

    In response to your email:

    I work in a low secure women's unit (adult women age between 18 & 60 with severe and enduring mental health problems, personality disorders, etc).

    OT group size here is often dependent on type of group. For example, groups that are offsite are usually facilitated by 2 members of staff (usually a mix of qualified and unqualified) and we take a max of 4 patients out at a time.

    Internal groups such as arts and crafts are again facilitated by 2 staff but we can take a maximum of 6 patients to these. This is down to size of room / number of people that can fit around the table and risks involved in use of tools within the group. Very often, in OT if patients are particularly demanding we have still tried to offer the maximum available spaces to patients to ensure maximum engagement, e.g. we wouldn't only take 4 if 2 were quite demanding, however we would carefully select which patients would be coming to the group the week beforehand to ensure that the group will be feasible to run with the mix of patients we have selected.

    Groups are accessible to patients who have a particular tool level, for example advanced crafts and conservation groups are only open to patients who are on tool level 4 (the highest level) due to the nature of tools used in the group - sewing machines, spades, rakes, hammers etc.

    Cooking groups are facilitated by 2 staff and the number of patients in these is 2, due to size of the kitchen and risks involved in tool use at the time.

    Larger groups we have are onsite, such as the social group and the music group where we can take 8 patients under two staff and more if there is a third member of staff (rare that we get additional staff though).

    Average size of psycho-educational groups also varies depending on type of patients that are attending, for example on average 7-8 patients to two staff facilitating, however if the nature of the information to present is complex, the ideal size of the group also drops to around 6. If attendees have learning disabilities then this drops to 4 as it takes longer to put the information across.

    Hope this helps,

    Occupational Therapist

  15. Hi Paul,
    I run a group for drug and alcohol users twice a week and the range of attendance is normally between 10 -17. The group is ran by myself and 2 co-workers.
    It is worth pointing out that when the group gets to the higher end of the range mentioned above it is certainly more difficult to facilitate. I do imagine that the needs of the group may dictate the ideal size including the requirement for everyone to have their say etc.
    Hope this helps.

  16. Hi Paul

    In answer to your question:

    I co-facilitate groups of staff in Stress & Anxiety Management. The groups are usually 18 people and two of us facilitating

    Both Lyn and I find that having the two of us works well, because:
    We both have different styles of facilitating and they seem to compliment each other's style and meet the needs of individuals in the group

    Whilst one of us is facilitating the other can observe what is going on such as Group dynamics, body lannguage and the non verbally communicated language. This then helps that person pick up on things in a non-direct & non-threatening way. It also really helps in deciding what we will cover/deliver next during the course of the two days we are working with a group

    Learning & Development Team

  17. Hi Paul

    general advice I,ve heard for running a psychotherapy group would be to have 5-9
    people- a minimum being important to allow for absenteeism-two people become a couple and not a group.

    Also, if your style is to make use of interpersonal interactions then the above would apply.

    See you on the 26th; looking forward to it


  18. I think it is the wrong question. It assumes there is such a thing as an "ideal.
    Isn't it better to ask "what is this group in place to achieve" and "how might the number of participants support or limit it reaching this goal".

  19. Dear Paul,

    Thanks for your interesting email. I occasionally run Anxiety Management
    and Confidence Building courses for a charity for people with panic and
    anxiety disorders, therefore the people who attend my courses are quite a
    mixed group of ages and disorders. In recent years I have also run courses
    at a local authority day centre for people with physical disabilities.

    In answer to your questions:

    1. Size: Because of the fragility of some group members I like my groups
    to be no more than 8. However, through experience I found when running the
    courses for people with physical disabilities it was more effective to have
    even smaller groups (in fact the original training courses 9 years ago
    evolved into individual Life Skills sessions, (one to one) still running!.

    2. Client group: My group members from the charity may suffer from
    phobias, general anxiety, depression or may be fairly recovered but want to
    gain further skills.
    Disabled clients may suffer from any of the
    above but may have acquired a disability through stroke, or may have life
    long conditions.

    3. How may run the group: I run the groups alone.

    4. Different client groups = different size groups: yes, as mentioned
    above I feel to give the best attention to the individuals it is important
    to assess the individual needs, and where possible tailor training to suit.
    This can only be done in smaller groups.

    I hope this is useful to you and look forward seeing your website.



  20. Hi

    I have worked in substance misuse for two years, and have run many groups. Some voluntary and some by order of the court. When the group has been part of the client's sentence, there has often been far too many people in group, (smoetimes it has been over 20) so I have always felt that a maximum of twelve seems more manageable. Obviously, less is better.
    I think it depends on the facilitator and their experience. For me personally, I prefer between eight and ten. Substance misuse groups can be hard if its by order, but voluntary groups for people who want help, is much more fluid and they do not spend half of their time being objective. I have run groups alone and with a co-facilitator. Providing you have a good relationship with your facilitator, then it can work well, but if not you can sometimes find yourself carrying them, and often in conflict if they have different training ethics (or they have had no trainig at all).

    I hope that this is of some help.

    Kind regards


  21. Dear Paul,

    I have put my response to your questions straight after each question in
    CAPS. (By the way, I haven't run a group for a few years but hope to get one
    going again in the next few months).

    - what size your groups usually are (e.g. 6-16), ANSWER:10-14
    - who your client group is (e.g. young people with depression, or elderly
    clients, or clients with eating disorders etc), ANSWER: VARIOUS THEMES - I
    - how many people are running the group (e.g. only you or 2 co-leaders
    - do you think that types of clients' problems you are working with might
    dictate different group sizes, ANSWER: I BELIEVE A MAXIMUM OF 12

    Hope that helps.

    Psychotherapeutic Counsellor & Supervisor

  22. Thank for you e-mail.

    I have in the past run a number of group sessions. One was for adult male victims of childhood abuse and the other was for male self-harmers.
    Each group consisted of no more that 12 (twelve) attendees. We found that this number was big enough to be productive and not too large to be intimidating.
    We had 2 co-deliverers, again we found this to be the ideal as it was less intimidating for the attendees and also easier to work together in two's rather than three or more. It can be quite off-putting when a deliverer is sat doing nothing for long periods and can often confuse the participants
    I hope this has been of some help


  23. Hi Paul,

    I've run psycho-educational groups and the optimum size I've found has
    been 6-9 members.

    Hope this is helpful.

    Best regards,

    Specialist Clinical OT

  24. Hi
    At Birmingham Drugline we feel that under ten is ideal 6-7 people would be able to have more indivdual attention from the facilitator.

  25. Dear Paul

    My colleague has forwarded the email you sent out regarding therapy group sizes.

    I manage the Bereavement Service at the hospice, being a trainer, counsellor and supervisor. I have a team of 20 volunteers who are trained by me to do Bereavement support – note, not counselling. I have also trained 6 of these volunteers to facilitate the groups.

    · Our target population is bereaved people – only from the hospice and not the community.

    · We usually run groups for bereaved partners/spouses, though if we have sufficient numbers we may run groups for bereaved adult children.

    · We run closed groups over eight consecutive weeks.

    · We have two co-leaders who mainly alternate in leading on a weekly basis.

    · Our ideal group is 6-8.

    · At times we have run with as few as 4/5 and we find this is OK as long as there is commitment to attend all the sessions. It is not ideal at this low number though.

    · From experience it seems that people who have attended our groups need a small enough number to be able to share intimately and have enough air space, but large enough to be able to sit quietly if they so wish. Because our groups are specifically aimed at grieving people there is not an emphasis on therapy so much as mutual support - guided and facilitated and “safe-guarded” by the facilitators.

    I would be really interested in your feedback as research is very thin on the ground as I have found out myself. If you need any further information, I would be glad to assist if I can.

    Yours truly,

    Bereavement Service Co-ordinator

  26. Group size = 4-12
    Client group = Adults with mental health issues aged 16+
    2 people normally facilitate the group
    Size of group will differ depending on subject matter. Eg people who have issues socializing will be in smaller groups.

  27. Dear Paul

    Over the years I have been involved in group work with a variety of different patient groups. The seize depended both on the client group and the aim of the group. As an OT I would run 'doing groups' as well as 'talking groups' and although the seize mattered in all groups it was more important to get it right in the 'talking groups'.

    Here in forensics where the majority of patients have a diagnosis of schizophrenia, 6 seems to be the ideal seize. Much smaller, and the participants begin to feel threatened and are unable to 'hide' and much bigger and they tend to get lost, disengage and leave. Because of the risk element we always have 2 facilitators.

    In previous jobs, working with adults suffering from a neurotic illness, we would try to keep the numbers to 8 which seemed a good workable seize for the problems that were discussed. We were often under pressure to increase the numbers but inevitably the bigger the group the more superficial the work. This might of course have been as much due to fluctuating numbers an inconsistent facilitation (1 or 2) as group seize.

    As a bereavement counsellor I ran loss groups (adults) with no more than 6 group members at a time for a fixed number of weeks and found this number just right.

    OT Workforce Development Manager

  28. Dear Paul
    -The groups that I have run are usually 6 participants with myself and occasionally with a co-therapist
    -Client group would be over 18 yrs and the types of groups have been eating disorders (each category separate), anxiety management groups, self-esteem groups etc.
    -I have had monthly support groups for those recovering from Bulimia and there were 10 places in those groups but I find therapy groups it is better with 6 places.
    Hope this is helpful.
    Best Wishes

  29. I have been involved in training students on diploma and cert courses
    since 2000. For the past ten years, It has been my experience that too
    large a group, 20+, will reduce in size over the period of a course
    year to 15/16.
    Start with 12-15 and keep all students. This is based on time
    available within the group for participation and 1:1 time with tutor.
    Groups divisible by three have always been our aim so that practise
    skills work can be consistent in triads (co/cl/obs).
    Both cert and dip classes benefit from having a second tutor during
    skills practise for observation and feedback.

    In dip courses the second tutor is then available to divide group in
    half for supervision. This ensures all students benefit from time
    available to present caseload.

    I know the question was more related to client groups, and I think if
    I was presenting to clients I would maintain that a minimum of 8-12
    would be ideal.

    I had to pilot a L5 course with only 6 students and found this
    extremely difficult because it was like everyone was under a
    microscope (including me). No-one could hide, which put the whole
    group under pressure.
    I would imagine this might be a similar experience if it was a therapy

    Having been a student, I think 12-15 is a good number. But of course,
    depends on the training. I have participated in process with a group
    of 10. Any more and you could get 'lost', and avoid participating.

    Hope this helps,


  30. Hello Paul; I have run groups before I find its more enjoyable plus more intermit to have about 8, in our groups and there is usually two of us that runs the groups. We work with 16 year olds to how ever old they are, as we work with women and children fleeing domestic abuse. looking forward to this course as I have booked for Manchester.

  31. Hi Paul, i am involved in running groups on Substance misuse in a mens low and medium secure setting in a large independent hospital. Our patient group is male, aged 18 - 60, most are detained on forensic sections, 37/41 with some section 3`s also.I predominantly work in the mental health pathway, but have facilitated mixed groups with mental health, learning disability and ASD patients.I have found the ideal size of these groups are 6-8 patients depending on the mix and of course each group is different. I usually aim for a maximum of 8. Against my better judgement i have allowed some groups to rise to 10-11 and they have become unwieldy, unruly and difficult to manage with this particular client group. I have also worked in an acute mixed addictions unit and again we always considered the ideal group size to be 8, but did find larger groups up to 12 could also work quite well.
    We usually have at least two facilitators and often three. This is because we have patients visiting from different wards, we have to manage smoke breaks and keep up an appropriate level of supervision available if an individual wishes to leave or becomes disruptive. Many also have significant literacy problems and require asistance if there are any written exercises to complete. I do think that the types of clients problems you are working with dictate different group sizes. But feel that 6-8 probably works for most different groups. Regards, F.B.

  32. Dear Paul

    I hope you are well, it is a while since I came to one of your seminars.

    My years of experience in running groups may be out of date or not the
    clinical range you are looking for.

    My clinical group experience was in private practice. I ran either mixed
    gender, single gender or gay men's groups. I found the 'ideal' size of
    group to be 8 - 10 with an average of 9 people at any one time as people
    holiday, have work commitments and life events at different times.

    The reason for keeping the groups small was to enable each member of the
    group to have time to both check in and work on their own issue each week if
    that is what they chose to do.

    Please note that these people were self funding and mostly highly
    functioning individuals for most of the time.

    I hope this is helpful.

    Best wishes.


  33. Hello,
    My first experience of running groups is when I worked in prison. I ran groups with another therapist. We had a maximum of 12 people on the group and we worked on issues around drug addiction. Despite the clients being in prison, we never had full attendance and often had only 6-8 clients attending.
    My second experience of running groups is for clients who were suffering with depression, in a primary care setting. Again myself and another therapist ran the group and we had 16 clients. We ran the group over 4 full days, two hours in the morning anf two hours in the afternoon.

    I hope this is helpful.
    Kind regards,

  34. Dear Paul,
    Thank you for your mail, my response is:-
    Size of group is between 6 - 8 people
    Currently women only substance misuse (Drug and Alcohol) age range 22 - 52
    2 co- leaders - myself ( female age 53 ) & staff member (male at 29)
    We have previously run mixed sex groups but single sex group seems stronger
    and more committed.
    We were careful to choose who attends the group and if they are ready, it's
    about "pacing" and training! as well as size!
    kind regards L.

  35. I work with clients who have challenging behaviour following a brain injury aged 18-60.
    Our group sizes can vary from as little as 2 to as much as 6. The types of clients’ problems we are working with definitely dictate different group sizes as clients may require support from additional staff in some groups (this could be functional, cognitive or behvioural support). Hence why smaller groups work better.
    We do try and have 2 co-facilitators for each group, but depending on the size, participants skill base and behaviour we may have times when just 1 facilitator is required.

    I hope this is helpful.

  36. Hi Paul

    I work with clients who are referred to us through the criminal justice system for Alcohol related offenses. My team have had pre-conceived notions that group sizes had to be between 8 and 12. However we have had on occasion 28 in a group and they had to re-evaluate this. Our group sizes have since evened out as I split them and run more now average 12. Both the clients and staff team feedback to me that this is better therapeutically.

    Hope this helps

  37. Dear Paul,

    As far as I'm concerned, Irvin Yalom has said the last word on groups and, if you're not familiar with him, I would urge you to read him.

    My own experience has been that, whatever the composition of the group, a male and a female facilitator are useful (if not essential) to field the many transferences. For a group where all members are to have input, I would consider six the optimum number - certainly no more than eight.

    I admire your energy!


  38. Dear Paul
    I am not running groups any more but in the past I have done groups with primary and secondary aged children and also with parent groups and, a very long time ago , with adult patients.

    The absolute maximum number I would ever consider is 12. I'm sure I read some research supporting that as a max but I cant tell you the ref, sorry.

    In my experience 8-10 is a successful number, but I once did a secondary group with 4 deaf children, myself (SLT) and a TOD which was great. It was a social skills group. We had discussion and role play.

    Hope that's useful to you.
    Best wishes


  39. This really depends on the type of group, I believe. Group Supervision, would ideally be 6 - 8, from say - with breaks for lunch and coffee. Seminars and and training groups work well with about 20, if the participants are expected to pair up to work together, if not then, however many fit comfortably into a lecture hall.

    Hope this helps,


  40. Hi Paul

    I organize 8 week facilitated Bereavement Group sessions for groups of people on our current waiting list.

    The size varies between 8-12 people, depending on how many clients I can persuade to attend. The optimum for this work at Doncaster seems to be 10 individuals. The only criterion for attendance is that the clients are on our adult (i.e. 18+ years old) waiting list and are therefore in need of help with bereavement issues. I usually work with one co-facilitator, and possibly a second individual who is in training. As regards your fourth question about the types of clients’ problems affecting the group size – it would be possible to split our groups into specific types e.g. those bereaved by suicide, but we have never had enough clients under such a category who are willing to attend a group. I believe, however, that if it were possible I would still prefer 10 attendees for the sake of the group dynamics.

    I hope this is of some use to you.

    Cruse Bereavement Care

  41. For me, and so for in all group settings, my ideal number is between 12 and
    20. Anything less than 12 I feel there is a danger of the group becoming
    too cosy and this reduces the 'edginess' of the encounter. Anything larger
    than 20 can prevent an adequate level of trust building up within the group.
    However, this is all my stuff a ballpark figure. I do not think a precise
    number can be put on it.

    Warm Regards

  42. Dear Paul

    Some thoughts on running groups in response to your e-mail. I am a palliative care counsellor employed by the NHS and have run a number of different groups, the majority have been bereavement groups, but also carers' groups and some parents groups. If I am on my own as facilitator then my ideal number is 6, groups which I co-facilitate the ideal is between 6 and 10. These are for more therapeutic groups where the main aim is sharing emotional material, normalising and making connections. I feel groups this size can begin to trust each other relatively quickly and there is space for everyone to tell their story and be heard. More educational type groups which I also run can be much larger.

    Hope that's helpful
    Palliative Care Counsellor

  43. Dear Paul Grantham,

    I run weight management groups for adults above their ideal weight for height.

    I find less than 6 people in a group doesn’t really work as it limits group discussion as not enough ideas result. It often results in the facilitator becoming a teacher instead and therefore hinders the group bonding together.
    10-15 is ideal – enough people to split into smaller groups to work on tasks, enough range of people to get lots of ideas on a subject and not so many that it’s hard to control the group or that people feel too shy to express their opinions and ideas.

    Hope that’s helpful,

    Health Promotion Dietitian

  44. Dear Paul,

    Apologies for not responding sooner to your e-mail but seem to have been really busy.
    I have been involved in running groups with bulimic patients and groups with anorexic patient.

    1. The bulimic groups were fairly structured groups based on working with their eating disordered behaviour and the emotions underlying the behaviours. We had two therapists working together for the twelve week programme with eight patients.
    These groups tend to work well and the patients are interactive and rewarding to work with.
    2. We run a day-care service for anorexic patients and this treatment includes groups.
    I have been running a group, again based on the emotions underlying the anorexia and have used concepts such as self-esteem and values and principles which they live their lives by.
    The anorexics are a very difficult client group to try and treat in group, they tend to be withholding and competative with each other making the running of it really hard work.
    Hope this is the information you were looking for?


  45. Hi Paul,

    As I work in a physiotherapy department in Mental Health the groups I have most experience in at the moment are Tai Chi style groups. I say style as I sometimes have to adapt the way I run them with the clients I have at the time. I find that a maximum of 8 people is the optimum amount.

    The patients like other people around them when they exercise, but not too many as they can find that intimidating at times.

    I run 2 groups - one with adult in patients and the other with elderly out patients who really enjoy the social side of these groups.

    I usually run these sessions on my own but on occasions, if possible, one of my colleagues will join in the session.

    I would also say that the adults (age 18-65)would rather have a slightly smaller group than eight people.

    I hope you find this information useful.

    E.B., Physiotherapy Technician

  46. Dear Paul

    I have only just got back from maternity leave and since my departure the whole service has changed dramatically so what I left is no longer what is here. To cut a long story short when I left we ran a couple of groups most notably a self esteem group (mainly psycho-educational although a therapeutic element evolved) on a Monday evening. The group size varied but we found no more than 10 was best. They varied in age, background etc and there was always 2 facilitators which I think was ideal.

    I definitely think the presenting problem would influence group size, therefore self esteem for instance could exist in a larger group, maybe low grade depression etc.

    Kind regards

    Psychological Wellbeing Practitioner

  47. I a involved in running two different sorts of groups in two different setting. Both are more educational than therapeutically focused and I am therefore unsure how useful the following is to you.

    1) a closed educational group of 4 sessions for people learning practical skills in self management of inflammatory arthritis. The group size is ideally 6. This is small enough for us all to fit into a OT kitchen for some of the practical sessions and large enough to facilitate discussion and interaction between clients.

    2) an open educational group of 4 sessions looking at self management and work related issues following long term illness and unemployment. Size ranges from 4 - 12. My experience leads me to consider 8 an optimal number although engagement with the issues is more relevant to outcomes than size within this range.

  48. Dear Paul

    Here is some feedback from MIND........

    I have read the email from Paul regarding group size, I have given my opinion with regards to this below;

    . Group size is very important when working with this client group, we have been working with a maximum of 15 clients per group and always used 2 trainers.
    . The only time that we have had difficulty with the groups is when there has been a vast difference in diagnosis of the clients, I would therefore recommend that separate groups be run for clients with specific diagnosis. We have been working with clients with phobia's, anxiety, depression, etc. I would therefore agree that it is important to tailor the group sizes to the client age and problems.
    . We have only worked with clients that are over the age of 18 so I am unable to comment on the group dynamics of younger clients - however, from experience, I feel that there is a need for more groups and services to be offered for young people in the area.

    I hope that this helps, if you need anything further from me please let me know.
    Kind regards

    Wellbeing Worker

  49. If you have experience in running groups or ever being involved with it in
    any way – I would very much like to hear from you regarding:

    - what size your groups usually are (e.g. 6-16), I run 3 groups, between 6 and 9 adults in each group.
    - who your client group is (e.g. young people with depression, or elderly
    clients, or clients with eating disorders etc) Family support groups, typically mothers between 18 and 30 years of age, variety of problems e.g post natal depression, lack of confidence, lack of confidence in parenting abilities, social isolation.
    - how many people are running the group (e.g. only you or 2 co-leaders
    etc.) Only me
    - do you think that types of clients’ problems you are working with might
    dictate different group sizes Not in my case


  50. I normally run relaxation groups and my OTA runs craft and hobby groups. We tend to have 2-3 people in our groups as we often only have 1 member of staff and feel we do not do the clients justice if we have too many of them attending and insufficient staff support. On a ward of 10 people we often find for each activity we are unlikely to interest everyone. We work with elderly functional mental health clients but at present we also have several dementia clients.

    We try to make groups client led and ask them what would interest them at the same time as making them therapeutically beneficial.

    I hope this helps.

    Many thanks, I.A.

  51. I have recently been running three groups to assist people on health related benefits to remove barriers to work.
    1. work healthy group four sessions averaged nine people.
    Followed on with
    2. confidence building three sessions averaged 7
    3. CBT 3 sessions expecting four.

    All groups are based on a biopsychosocial spiritual approach and involve a variety of psychoanalasys, transactional analasys, humanistic approach amongst others.

    Hope that helps.
    Rebecca Turbitt
    Occupational Therapist/Employment Therapist
    Condition Management programme
    Pathways to work
    Reed in Partnership


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