Group Therapy Resource Guide

A resource guide for clinicians who facilitate counseling groups

By Cassie Jewell, M.Ed., LPC, LSATP

Throughout my counseling career, group therapy has been a focal part of what I do. I’ve worked mainly in residential settings where groups take place several times a day.

Initially, group counseling terrified me. (What if I can’t “control” the group? What if a member challenges me? What if I can’t think of anything to say? What if everyone gets up and leaves? – that actually happened, once – and on and on. What made group therapy especially intimidating was that if I “messed up,” an entire group of people [as opposed to one person] would witness my failure.)

I got over it, of course. Group facilitation wasn’t always comfortable and I made many (many!) mistakes, but I grew. I realized it’s okay to be both counselor and human; at times, humans say dumb stuff, hurt each other’s feelings, and don’t know the answer. By letting go of the need to be perfect, I became more effective. Group facilitation is now one of my favorite parts of the job.

This resource guide provides practical information and tools for group therapy for mental health practitioners.

Group Therapy Guidelines

Group therapy is an evidence-based treatment for substance use and mental disorders. An effective group calls for a skilled clinician to meet treatment standards. Professional associations, such as the American Group Psychotherapy Association, develop best practice guidelines based on scientific data and clinical research.


SAMHSA promotes research-based protocols and has published several group therapy guides for best practice, including TIP 41: Substance Abuse Treatment: Group Therapy, Substance Abuse Treatment: Group Therapy – Quick Guide for Clinicians, and Substance Abuse Treatment: Group Therapy Inservice Training (a training manual), in addition to group workbooks/facilitator guides for anger management, stimulant use disorder, and serious mental illness.

Book Recommendations

Group Exercises for Addiction Counseling (2012) by Dr. Geri Miller

The book itself is small in size but packed with helpful information and creative ideas. As a new counselor lacking in clinical skills, I supplemented with activities to engage the clients. Group Exercises for Addiction Counseling never failed me.

250 Brief, Creative & Practical Art Therapy Techniques: A Guide for Clinicians and Clients (2019) by Susan I. Buchalter

A more recent discovery of mine. This guide provides detailed instructions accompanied by thought-provoking discussion questions for each intervention. I was impressed with both the quality and originality; an instant upgrade to “house-tree-person.”

For clinical group practice

  • Corey, M. S., Corey, G., & Corey, C. (2018). Groups: Process and practice.
  • Yalom, I. D., & Leszcz, M. (2015). The theory and practice of group psychotherapy.

Icebreakers & Teambuilding

You need only Google “icebreakers” and you’ll have a million to choose from. I’m not listing many, but they’re ones clients seem to enjoy the most.


Activity 1: My most highly recommended icebreaker activity involves passing out blank slips of paper to each group member and instructing them to write a “fun fact” about themselves, something no one else in the group would know. I provide them with examples (i.e. “I once had a pet lamb named Bluebell” or “I won a hotdog eating contest when I was 11 and then threw up all over the judges’ shoes”). Depending on the crowd, you may want to tell clients not to write anything they wouldn’t want their peers to know. (I adopted this guideline after a client wrote about “sharting” himself.) Once everyone has written something, have them fold their papers and place in a container of some sort (a gift box, paper bag, plastic bowl, etc.) Group members take turns passing around the container (one-at-a-time) and picking a slip to read aloud. They must then guess who wrote it. (I give three guesses; after that, I turn it over to the group.)

Activity 2: A similar but more structured activity is to write out questions ahead of time and have clients take turns drawing and answering the questions. Questions can be silly, thought-provoking, or intending to illicit a strong emotional response (depending on the audience and goals for the group).

Activity 3: “People Search” involves a list of traits, feats, talents, or experiences. Each client receives the list and is given x amount of time to find someone in the group who is a match; that individual will then sign off. The first person to have their list completely signed sits down; they win. I typically let clients continue to collect signatures until two additional people sit down. (Prizes optional, but always appreciated.) During the debriefing, it’s fun to learn more (and thereby increase understanding and compassion).

Activity 4: “First Impressions” works best with group members who don’t know each other well. It’s important for group members to know each other’s names (or wear name tags). Each group member has a sheet of paper with various “impressions” (i.e. judgments/stereotypes). For example, items on the list might be “Looks like an addict” and “Looks intelligent.” Clients write other group members’ names for each impression. In addition to enhancing a sense of community, this activity provides an avenue for discussing harmful stereotypes and stigma.

Activity 5: Affirmations groups can be powerful, generating unity and kindness. The effect seems to be more pronounced in gender-specific groups. There are a variety of ways to facilitate an affirmations group, ranging from each person providing an affirmation to the client on their right to individuals sharing a self-affirmation with the group to creating a self-affirmation painting. Another idea is to give each client a sheet of paper. (Consider using quality, brightly-colored paper/posterboard and providing markers, gel pens, etc.) Clients write their name on it and then all the papers are passed around so each group member has the opportunity to write on everyone else’s sheet. Once their original paper is returned to them, they can read and share with the group. This can lead to a powerful discussion about image, reputation, feeling fake, etc. (Plus, clients get to keep the papers!)

Activity 6: “Most Likely to Relapse/Least Likely to Relapse” works best with a well-formed group and may require extra staff support. It’s good for larger groups and can be highly effective in a therapeutic community. Clients receive blank pieces of paper and are tasked to write the names of who they think is most likely and least likely to relapse. After writing their own name on the sheet, they turn it in to staff (effectively allowing staff to maintain a safe and productive environment). Staff then read each sheet aloud (without naming who wrote it). If they choose, clients can share what they wrote and provide additional feedback. (Most do.) Clients selected as “most likely” (in either category) have the opportunity to process with other group members and staff.


Access group therapy worksheets and handouts here.

Links to Additional Group Activities

Psychoeducation & Process Groups

In need of fresh material? It can be easy to fall into a rut, especially if you’re burnout or working with a particularly challenging group. The following three PDF downloads are lists of ideas for group topics. I also included two links to sites with helpful suggestions.


As a group facilitator, consider incorporating some sort of experiential activity, quiz, handout, game, etc. into every session. For example, start with a check-in, review a handout, facilitate a discussion, take a 5-minute bathroom break, facilitate a role-play, and then close the group by summarizing and providing clients with the opportunity to share what they learned. If that’s not feasible, provide coffee or snacks; sitting for 45 minutes is difficult for some, and 90 minutes can be unbearable.

Another idea is to have a “fun” or “free” group in the curriculum. Ideas include going bowling, having a potluck, Starbucks run, game group (i.e. Catchphrase, Pictionary, etc.), escape room, nature walk, etc.


Dealing With Challenges

Clients are not always willing therapy participants; some are court-ordered to attend or there to have privileges restored. Some attendees may be there “voluntarily,” but only to save their marriage or keep a job, not believing they need help. In residential treatment, clients attend mandatory groups as part of the daily schedule — participate or you’re out.

Even when attendance is truly voluntary, a group member may be in a bad space. Maybe they’re stressed about the rent or just got into a fight with their significant other. Or what if the AC is broken and the group room is 80 degrees? What if a client has unpleasant body odor or bad breath or an annoying cough?

Multiple factors combine and it’s suddenly a sh**show. (I’ll never forget the client who climbed onto a chair to “rally the troops” against my tyranny.) Anticipating challenges is the first step to effectively preventing and managing them.


Click here for an excellent article from Counseling Today that addresses the concept of client resistance.

Tips for dealing with challenges

  1. If possible, co-facilitate. One clinician leads while the other observes. The observer remains attuned to the general “tone” of the group, i.e. facial expressions, body language, etc.
  2. Review the expectations at the beginning of every group. Ask clients to share the guidelines with each other (instead of you telling them). This promotes a collaborative spirit.
  3. After guidelines are reviewed, explain that while interrupting is discouraged, there may be times when you interject to maintain overall wellness and safety. (Knowing this, a client is less likely to get angry or feel disrespected when/if it happens.)
  4. If you must interrupt, apologize, and explain the rationale.
  5. Avoid power struggles at all costs, especially when a client challenges the benefits of treatment. (The unhealthier group members will quickly side with a challenger, leading to a complaint session.) Challenging the efficacy of treatment (or you as a clinician) is often a defense mechanism. Sometimes, the best response is simply “okay,” or none at all… and keep moving. You can also acknowledge the client’s perspective and ask to meet with them after group (and then get back on topic). If the group is relatively healthy, you may want to illicit feedback from other group members.
  6. If a client becomes angry or tearful, give them time to vent for a moment or two (don’t “Band-Aid”); they may be able to self-regulate. (If they do self-regulate, share your observations and offer praise.)
  7. If a client’s anger escalates to a disruptive level, ask them to take a break. At this point, their behavior is potentially triggering to other group members. Don’t raise your voice or ask them to calm down. Direct them step out and return when they’re ready. You may have to repeat yourself several times, but remain firm and calm, and they will eventually listen.
  8. If a client is disrespectful (cursing at you or another client, name-calling, insulting, etc.) while escalated, let them know it’s not okay, but don’t attempt to provide feedback. (A simple, “Hey, that’s not okay,” will suffice.) Bring it up with the client later when they’re able to process.
  9. Once the client who has been disrespectful leaves the room, acknowledge what happened and let the group know you will follow up with the client. If another client wants to talk about it, ask them to share only how it made them feel, but stress that it’s not okay to talk about an absent group member. (“How would you feel if we talked about you when you weren’t here?”) Strongly suggest that they wait until the person returns (and is open) to have a group discussion.
  10. After a major blow-up (and once everyone is calm), it can be beneficial for the group to process it with the person who escalated. Group members can empathize/relate, share their observations and/or how it made them feel, and offer feedback.
  11. If other disruptive behaviors occur in group (side conversations, snoring, etc.) address them in the moment (without shaming, of course). Point out the behavior and explain how it’s disruptive to the group. Refer back to the group guidelines. Ask group members to comment as well. If you let a behavior persist, hoping it will eventually stop, you’re sending the message that it’s okay, not only to the person who is disruptive, but to the entire group. This impacts the integrity of the group and opens things up for additional disruptive behaviors.
  12. For clients who monopolize, who are constantly joking, or who attempt to intentionally distract by changing the topic, point out your observations and encourage group members to give feedback.
  13. If, on the other hand, clients seem disengaged or unmotivated, seek out their feedback, privately or in the group, whichever is clinically appropriate.
  14. If there’s a general level of disengagement, bring it up in the group. Remain objective and state your observations.
  15. Anticipate that at times, people may not have much to say. (And while yes, there’s always something to talk about, that doesn’t mean someone is ready to or has the emotional energy to.) Maybe they’re distracted or tired or feeling “talked out.” It’s good to have backup plans: watch a psychoeducational film, take a walk in the park, listen to meditations or music, provide worksheets, education reading material, or coloring sheets.

Always keep in mind a client’s stage of change, their internal experiences (i.e. hearing voices, social anxiety, paranoia, physical pain, etc.), external circumstances (i.e. recent medication change, loss of housing, conflict with roommates, etc.), and history of trauma. What looks like resistance may be something else entirely.

Professional Group Therapy Associations

Academic Articles

Online Articles

Additional Links

Free Printable PDF Workbooks, Manuals, & Toolkits for Providers Who Work with Children, Adolescents, & Families

(Updated 2/10/20) A resource list for providers who work with youth and families. Free PDF manuals for clinicians and handouts/guides for families.

Compiled by Cassie Jewell, M.Ed., LPC, LSATP

The original source for this list is my post, Free Printable PDF Workbooks, Manuals, & Self-Help Guides. However, the “Children, Youth, & Families” section was becoming too lengthy. The purpose of this post is to organize the youth and family resources so you can quickly find what you’re looking for. This post is divided into two sections: one for providers and one for families.

For Providers

Treatment Manuals/CURRICULUMs & Workbooks

Mood & Anxiety Disorders

Adolescent Coping with Depression Course: Leader’s Manual for Adolescent Groups (321 pages) | Student Workbook (199 pages) | Leader’s Manual for Parent Groups (139 pages) | Parent Workbook (73 pages) (Source: Kaiser Permanete for Health Research) (Find more information here)

The Adolescent Coping with Stress Course: An Eight-Session Curriculum Developed for the Prevention of Unipolar Depression in Adolescents with an Increased Future Risk: Leader Manual (118 pages) | Adolescent Workbook (79 pages) (Source: Kaiser Permanete for Health Research) (Find more information here)

The Adolescent Coping with Stress Course: A Fifteen-Session Class Curriculum Developed for the Prevention of Unipolar Depression in Adolescents with an Increased Future Risk: Leader Manual (112 pages) | Adolescent Workbook (82 pages) (Source: Kaiser Permanete for Health Research) (Find more information here)

Break Free from Depression: A 4-Session Curriculum Addressing Adolescent Depression (Source: Suicide Prevention Resource Center)

Managing Depression: A Facilitator’s Guide for Working with Groups of Women Living with Depression During Pregnancy, After Delivery and Beyond (Source: Best Start, 42 pages)

STEADY: Intervention Manual (107 pages) | Adolescent Workbook (87 pages) (Source: Kaiser Permanete for Health Research) (Find more information here)

Substance Use Disorders

Matrix Series (Intensive Outpatient Treatment for People with Stimulant Use Disorders): Counselor’s Family Education Manual (Source: SAMHSA, 176 pages)

A Modified DBT Group Therapy Manual

Partners In Parenting: A DATAR/FIRST CHOICE Treatment Manual (Source: Texas Institute of Behavioral Research at TCU, 294 pages) 2002

Trauma & Related Disorders

Dealing With Trauma: A TF-CBT Workbook for Teens (Source: The National Child Traumatic Stress Network, Medical University of South Carolina, 35 pages) (Link to facilitator training here)

The T.O.P. Workbook for Sexual Health: Facilitator’s Manual (Source: Resources for Resolving Violence, Inc., 87 pages) 2010 (Purchase additional workbooks/manuals here)

Triad Girls’ Group Treatment Manual (Source: The Louis de la Parte Florida Mental Health Institute, University of South Florida, 201 pages) (More information on the Triad Project here)

Anger

Getting Along and Keeping It Cool: How Anger Works (Therapist Group Manual) (Source: Centre for Clinical Interventions with YouthLink, 79 pages)

Self-Esteem

On My Own Two Feet Series: Identity and Self-Esteem (76 pages) | Understanding Influences (103 pages) | Assertive Communication (121 pages) | Feelings (83 pages) | Decision Making (113 pages) | Consequences (81 pages) | Work Cards (129 pages) (Source: Department of Education and Skills and Professional Development Services for Teachers) (Find more information here)

LGBTQ Youth

Growing Up Lesbian, Gay, Bisexual, or Transgender (Source: Department of Education and Skills and the Health Service Executive through the Social, Personal and Health Education Support Service, in conjunction with GLEN [Gay and Lesbian Equality Network] and BeLonG To Youth Services; and Professional Development Services for Teachers, 82 pages) (Find more information here)

It Gets Better: A Group Experience for LGBTQ Youth (Group Curriculum Outline) (Source: Catherine Griffith, Ph.D., 13 pages)

Latinix Youth

Latino Multifamily Group Program Manual, (Source: Valley Nonprofit Resources, 64 pages)

Health & Wellness

Be Real. Be Ready. (A comprehensive relationship and sexuality curriculum for high school students) (Source: Adolescent Health Working Group)

Healthy Living, Healthy Minds: A Toolkit for Health Professionals (Promoting Healthy Living in Children and Youth with Mental Health Challenges) (149 pages) | Healthy Living… It’s in Everyone (A Companion Workbook, 82 pages) (Source: BC Mental Health and Substance Use Services)

TRUST (Talking. Relationships. Understanding Sexuality. Teaching Resource.) Workbook (Source: National Council for Curriculum and Assessment; Department of Education and Science, the Health Service Executive, and Crisis Pregnancy Agency; and Department of Education and Skills and Professional Development Services for Teachers, 126 pages) (Find more information here)

Group Counseling Resources

A Collection of Icebreakers and Connection Activities (33 pages)

Favorite Therapeutic Activities for Children, Adolescents, and Families: Practitioners Share Their Most Effective Interventions (Source: Edited by Liana Lowenstein, MSW, 119 pages)

Group Counseling Guide (Group activities for children) (Source: Rita Zniber Foundation, 45 pages)

Toolkits & Guides

Alcohol Problems in Intimate Relationships: Identification and Intervention (A Guide for Marriage and Family Therapists) (Source: National Institute on Alcohol Abuse and Alcoholism, 83 pages)

Behavioral Health: Adolescent Provider Toolkit (Source: Adolescent Health Working Group)

Body Basics: Adolescent Provider Toolkit (Source: Adolescent Health Working Group)

Child Trauma Toolkit for Educators (Source: The National Child Traumatic Stress Network, 21 pages)

Community Reinforcement and Family Training Support and Prevention (Source: U.S. Department of Veterans Affairs, 103 pages)

A Practitioner’s Resource Guide: Helping Families to Support Their LBGT Children (Source: SAMHSA, 18 pages)

Promoting Emotional Resilience: Helping children to find ways to function in a world where bad things happen – A Resource Pack (Source: West Sussex CAMHS and School Attendance Project, 141 pages) 2008

Sexual Health: Adolescent Provider Toolkit (Source: Adolescent Health Working Group

Stress Lessons Toolkit (Source: Psychology Foundation of Canada in partnership with Pfizer Canada, 52 pages) 2012

Trauma & Resilience: Adolescent Provider Toolkit (Source: Adolescent Health Working Group)

The Use of a Full Family Assessment to Identify the Needs of Families with Multiple Problems (Source: UK Department for Education, 105 pages)

For Families

Workbooks For Children & Adolescents

Anxiety Toolbox: Student Workbook (42 pages)

COPE (CAPS COPING SKILLS SEMINAR): Student Workbook (Source: West Carolina University Counseling and Psychological Services, 28 pages)

Dealing With Depression: Antidepressant Skills for Teens (Source: Vancouver Psych Safety Consulting Incorporated, 68 pages)

Just as I Am Workbook: A Guided Journal to Free Yourself from Self-Criticism and Feelings of Low Self-Worth (Source: Queen’s University, 56 pages)

Lemons or Lemonade? An Anger Workbook for Teens (Source: Jane F. Gilgun, PhD, LICSW, Education4Health, 38 pages)

Mighty Moe: An Anxiety Workbook for Children (Source: Lacey Woloshyn, 79 pages)

Safe Spot Stress Management Series

Safe Spot: Stress Management Workbook 1 – What Is Stress? (45 pages)

Safe Spot: Stress Management Workbook 2 – Behaviour and Stress (27 pages)

Safe Spot: Stress Management Workbook 3 – Thought Patterns and Stress (29 pages)

Safe Spot: Stress Management Workbook 4 – Problem-Solving and Well-Being (27 pages)

Your Best You: Improving Your Mood (Source: Queen’s University, 103 pages)

Your Best You: Managing Your Anxiety (Source: Queen’s University, 169 pages)

Youth Transition Workbook (Source: Pennsylvania Youth Leadership Network/The Rhode Island Transition Council/The Rhode Island Department of Health Youth Advisory Council, 68 pages) 2017

Toolkits & Guides

For Parents & Caregivers

ADHD: Attention Deficit Hyperactivity Disorder (Information for Families) (Source: BC Mental Health and Substance Use Services, 12 pages)

After an Attempt A Guide for Taking Care of Your Family Member after Treatment in the Emergency Department (12 pages) | Spanish Version (14 pages) (Source: SAMHSA)

After a Loved One Dies – How Children Grieve and How Parents and Other Adults Can Support Them (Source: New York Life, 24 pages)

Bipolar Disorder in Children and Teens: A Parent’s Guide (Information Booklet) (Source: National Institute of Mental Health, Hosford Clinic, 27 pages)

Bipolar Disorder: Parents’ Medication Guide for Bipolar Disorder in Children & Adolescents (Source: American Academy of Child and Adolescent Psychiatry, 63 pages)

Borderline Personality Disorder: An Information Guide for Families (Source: CAMH, 72 pages)

Coping with Anxiety During Pregnancy and Following the Birth: A Cognitive Therapy-Based Self-Management Guide for Women and Health Care Providers (Source: BC Mental Health and Substance Use Services, 178 pages)

Coping with Depression During Pregnancy and Following the Birth: A Cognitive Therapy-Based Self-Management Guide for Women (Source: BC Mental Health and Substance Use Services, 118 pages)

Coping with Separation Anxiety Handbook (Source: BC Legal Services Society, 24 pages)

Emotional Intelligence Activities for Teens Ages 13-18 (Source: The Ohio National Guard, 34 pages)

Families in Transition: A Resource Guide for Families of Transgender Youth (Source: Central Toronto Youth Services, 56 pages)

A Family Guide to Concurrent Disorders (Source: CAMH, 222 pages)

Gaining Control of Your Life After Having a Baby: A Self-Help Workbook for Post-natal Depression (Source: Maternal Mental Health Alliance, 38 pages)

Managing Depression: A Self-Help Skills Resource for Women Living with Depression During Pregnancy, After Delivery and Beyond (Source: Best Start, 57 pages)

The Mind Body Connection and Somatization: A Family Handbook (Source: BC Mental Health and Substance Use Services, 46 pages)

Oppositional Defiant Disorder: A Guide for Families by the American Academy of Child and Adolescent Psychiatry (18 pages)

Patient & Family Guide to Second-Generation Antipsychotics (Source: BC Mental Health and Substance Use Services, 44 pages)

Postnatal Depression and Perinatal Mental Health (Source: Mind UK, 31 pages)

Recognizing Resilience: A Workbook for Parents and Caregivers of Teens Involved with Substances (Source: BC Mental Health and Substance Use Services, 104 pages)

A Resource Guide for Families Dealing with Mental Illness (Source: Michigan National Alliance on Mental Health, 40 pages)

Suicide Prevention for Consumers and Family Members (Source: Montgomery County Emergency Service, Inc., 26 pages)

Tools & Resources (Toolkit for Families) (Source: Kelty Mental Health, 25 pages)

What Community Members Can Do: Helping Children and Adolescents Cope with Violence and Disasters (For Teachers, Clergy, and Other Adults in the Community) (Information Booklet) (Source: National Institute of Mental Health, Hosford Clinic, 20 pages)

For Youth & Adolescents

Healthy Living for Teens (Source: BC Mental Health and Substance Use Services, 23 pages)

A Sibling’s Guide to Psychosis: Information, Ideas, and Resources (Source: Canada Mental Health Association, 34 pages)

Student Life (Source: Mind UK, 22 pages)

Worksheets, Activities, & Guides for Group or Individual Therapy

(Updated 5/30/20) A list of free PDF printable worksheets and activities to use with clients in group and individual sessions

By Cassie Jewell, M.Ed., LPC, LSATP

This is a list of forms, handouts, and worksheets I created to use with clients. Feel free to print/reproduce/share. Please check back frequently as I update regularly!

(Click here for a list of additional sites with free therapy resources.)



Good for newly formed groups. Each group member writes down their “first impression” of other group members. The facilitator then reviews each “impression,” and group members have the opportunity to share their answers.

Print/cut the cards, fold, and place in a container. Group members take turns drawing the cards and answering the questions.

Give group members 15-20 minutes to collect signatures. The first person to collect all signatures wins.

Print/cut the cards, fold, and place in a container to pass around. This activity works best with a working group.





Daily Self-Inventory for Mental Health Professionals