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Groups, groups, groups. In clubs, clubhouses, 12-step groups and clinics, we participate in support groups, therapy groups, rap groups and psychoeducational groups. Groups can be one of the best places to find support and healing. But how do they work? And how can we help them work better?

It might seem odd that I'm writing an article for consumers about how groups work. After all, shouldn't the facilitator or group leader be the one who's worried about that? But wait a second. Who does most of the talking, most of the listening, and most of the work in the group? Right--you, the group members. Just as in every part of the work I do, I think consumers are the experts, and I want you to be as informed and empowered as possible.

This article will take a look at some of the things that make groups work, and how we can all help them work better. A lot of my thinking about groups comes from the work of Irvin Yalom, who wrote extensively about groups in books like The Theory and Practice of Group Psychotherapy (1975). Yalom broke down his ideas about groups into 11 "therapeutic factors." In 2000, Kurt A. DeBord and Ruperto M. Perez reviewed Yalom's ideas and examined them with an eye to their importance for lesbian, gay, bisexual and transgender (LGBT) consumers. I'll be including some of their ideas as well.

Why? Well, for one thing, because I'm gay, and so are lots of the people in your clinic, clubhouse or day treatment program whether you know it or not. But more importantly, I want to include these ideas because many of us who participate in groups are marginalized, or different from the people around us, in some way. Maybe we're female, or Black, or Latino, or Jewish, or Muslim. In many ways, just about all of us are both similar to, and different from, the other people in the group. So ideas that help LGBT people in groups would probably help many other people too. That's why I want to point them out and share them with you.

Let's get started. The first of Yalom's therapeutic factors is the INSTILLATION OF HOPE. Groups often give us hope, but paradoxically, if we didn't have at least a little hope to start with, we probably wouldn't see much point in attending the group in the first place!

So ask yourself: do you believe that participating in a group can help you and other people? Do you believe that you can change? If you don't quite believe that, try taking a "what if" attitude like, "well, what if I did believe that being in this group could really help me? What might I be doing differently?" Let yourself play with this idea. And when you notice yourself or someone else in the group changing, doing something differently, or getting better, even just a little bit, take the risk of saying so. It might really make a difference.

Thinking about ways that groups have helped you or made a difference in your life can also help. Share those stories. They may help the person sitting next to you to feel hope and confidence as well.

The second therapeutic factor is UNIVERSALITY. It's the "we're all in the same boat" phenomenon. Universality is one of the most important therapeutic factors in any kind of group. It can be a huge relief for any of us to realize that we're not the only person who shares our difficulties or concerns. This point is of great importance to LGBT consumers (and other marginalized people) because they often have a very hard time finding people who accept and support them. As a result, many marginalized consumers are isolated, and many of them go through their lives trying to hide parts of themselves. This is a very painful way to live, and it certainly exacerbates psychiatric symptoms.

So how can we help ourselves and other group members to "come together?" It's not so hard. People in groups are often surprised to find how similar other people's stories and experiences are to their own, especially if the person talking seems very different from themselves in some way. Let them know! "I've felt just the same way," or "I've been through something just like that," or even, "I bet I would feel exactly the same way if that happened to me" are simple things to say, but they really help people feel that precious sense of closeness; that universality. In spite of our differences, our feelings and how we respond to them are often very similar. When we can show each other that similarity, it's a precious gift, and one of the most wonderful things group therapy can do. Give it a try.

Universality is great, but we shouldn't forget that everybody's different, too. Every group has differences of race, class, gender, age, sexuality and more. We can balance respect for differences with the search for common ground. Real understanding across differences takes hard work, but it's worth it. When someone who's different from you shows that they are willing to work to understand you, it's something you never forget.

Over the next few weeks, keep an eye out for the importance of hope and universality in the groups that you attend. See if you can't help these important therapeutic factors to flourish and grow.