Online Therapy in Groups: Platform & Ideas for Your Session

Online Group Therapy

Online therapy has huge advantages over in-person therapy, but it also has some challenges. The lack of face-to-face interaction may make it difficult to form a trusting, effective working relationship between the therapist and client. Further, privacy concerns and technology issues can also disrupt and complicate the therapeutic process.

In group therapy, these challenges not only remain to be addressed—they can multiply! The more people are involved in the therapy session, the more places where connection issues may arise.

But online group therapy also has its benefits; by holding sessions online, you can bring people together from a much wider area. This means you can build groups that are focused on more specific issues, struggles, or goals than in-person groups, since in-person groups are bound by physical distance.

If you have multiple clients that are dealing with similar challenges, it’s a good idea to consider online therapy groups. This piece provides guidelines, tips, and ideas for your group sessions.

5 Benefits of Online Group Therapy Sessions

Before we dive into the tips and techniques, let’s take a look at the research and explore the benefits of online group therapy.

Researchers have been looking into the efficacy of online group sessions for over two decades—basically as long as publicly available internet has been around. The results have shown that online group therapy:

  • Reduces feelings of loneliness in group members[1]
  • Can contribute to better coping with the symptoms of depression[2]
  • May be used to decrease symptoms of depression and anxiety in young people[3]
  • Can improve self-esteem in group members struggling with mental health disorders[4]
  • Can reduce food cravings, depressive symptoms, and weight in group members[5]

There’s some ground left to cover, but so far studies have shown that online group therapy can be just as effective as in-person therapy to treat a wide range of issues.

So we know online group therapy may be a good option for you and your clients. But how do you get started?

How To Conduct Online Therapy in Groups

The process for setting up group sessions is similar to setting up individual sessions, but there are a few extra things you’ll need to think about beyond the additional complexity in scheduling.

If you want to start group sessions with existing clients, consider these initial steps:

  1. Determine whether there is interest in a group therapy session. Ask your clients if they would be willing and eager to attend.
  2. Think about how your sessions will be formatted. Would they start with a group share? Perhaps a quick lesson or resource sharing and then discussion? Do you have certain exercises or techniques you’d like to focus on each session?
  3. Find a time that works for your clients. Ask around to figure out what days and time slots fit best.
  4. Define your group’s rules and norms. Determine what rules and norms will guide your group (e.g., no interrupting another member, respect and kindness as grounding values, everyone speaks at least once a session).
  5. Choose and test your platform. Make sure the platform can handle multiple people and that the interface is straightforward and easy for your clients to use. You may need to find a different platform than the one you use for individual sessions.
  6. Share information and set expectations beforehand. Once you’re all set to begin offering group sessions, make sure to share any relevant information about the sessions, the agenda, the resources that will be shared, and any group rules, norms, and expectations beforehand. You want your clients to come prepared for growth!

What Is the Best Online Group Therapy Platform?

As always, the best platform for your online group therapy sessions depends on your unique needs and what features you want. There are tons of options available that offer a wide variety of tools and resources, so it’s a matter of determining what your needs are and what options fit those specific needs. The 3 below are a few good options to get you started in your search.

TheraNest is a comprehensive platform for therapists that offers a one-stop shop with tons of tools and features for practice management, including HIPAA compliant video conferencing, scheduling, billing, note-taking, and documentation.

Therapists who want to conduct group therapy sessions online will enjoy these features:

  • Ability to add up to six participants to any group telehealth session (additional participants can be clients and/or providers)
  • Each participant has their own secure, unique session link
  • All the same functionality as individual telehealth (including screen-sharing)
  • Participants can join from any browser-enabled device
  • Seamless integration with the rest of TheraNest’s features
Price$39/month and up
Good ForPractice Management, Online Therapy, Group Therapy, Therapists, Psychologists, e-Counseling, Online Psychotherapy
Kareo is a complete technology platform for mental health care providers. It offers a wide range of features, including electronic health record (EHR) management, coding and billing, scheduling and appointment reminders, payment processing and billing analytics, reputation management, and HIPAA compliant video conferencing.

Kareo’s Telehealth extension helps you:

  • Seamlessly schedule telehealth appointments within your practice management system
  • Communicate with your clients throughout the scheduling process as well as during and after sessions
  • Provide a smooth experience for your clients in requesting and joining video visits
Price$110/month and up
Good ForPractice Management, Online Therapy, Group Therapy, Therapists, Psychologists, e-Counseling, Online Psychotherapy
ICANotes Secure Telehealth PlatformICANotes is a behavioral health-focused electronic health record (EHR) platform that helps mental health care providers manage their practice with a broad range of features, including documentation, scheduling, e-prescribing, billing, reporting, and videoconferencing.

Here are the details on running group therapy sessions in ICANotes:

  • Easy-to-use, HIPAA-compliant video conferencing platform
  • Add multiple individuals to your video session
  • Video sessions launch directly from your EHR interface
  • Ability to take notes for multiple individuals
Price$46/month and up
Good ForPractice Management, Online Therapy, Group Therapy, Therapists, Psychologists, e-Counseling, Online Psychotherapy

Is Zoom an Effective Online Group Therapy Platform?

You might be wondering, is the old standby Zoom a good tool for online group therapy?

The answer is yes, Zoom can be used to facilitate online group therapy sessions; however, it is more of a single-use tool, as opposed to the feature-rich platform options listed above. You will be able to conduct group sessions with your clients using Zoom, but it can’t provide other features you would get out of a practice management solution, like help with scheduling, billing, client communication, and documentation.

If you already have all of that covered and only need a tool for group videoconferencing, Zoom may be a good choice for you! It may also integrate with another platform you have, like 10 to 8.

Ideas in Quenza: 3 Activities and Games for Online Groups

Quenza is a helpful tool for putting together care pathways, exercises, and education for your clients. It offers tons of customization options, making it easy to design content that works for individuals, groups, or both.

You can use Quenza’s pre-made content or create your own to put together a carefully curated path through resources, assessments, activities, and more.

Here’s a small sample of the activities and games you might use in creating custom group content:

  1. Applying the Yin and Yang of Self-Compassion: an exercise that helps clients learn how to build and practice self-compassion to help them get through tough times. Group members can discuss their experience and share techniques with each other during group sessions.
  2. Strength Interview: you can adapt the strength interview activity to be completed in pairs by your group members, having them help each other identify their own strengths. Group members can point out what strengths they see in each other and discuss in the group session.
  3. Pushing the Ball Under the Water Metaphor: this enlightening and easy-to-understand metaphor can be shared with the group as a lesson on how to accept rather than suppress or deny negative experiences. To make it extra interactive, you could have each group member grab a ball and a bowl or bucket to feel the difference! Then the group can discuss their experiences with suppressing negative experiences.

Final Thoughts

Although there are some unique challenges to online group therapy, there are also a lot of benefits. Group members can learn from one another and support each other, which can be an effective way to further therapeutic goals.

Use this piece as a guide to get the ball rolling on designing and facilitating your own group therapy sessions.


  1. ^ Hopps, S. L., Pépin, M., & Boisvert, J. M. (2003). The effectiveness of cognitive-behavioral group therapy for loneliness via inter relay chat among people with physical disabilities. Psychotherapy: Theory, Research, Practice, Training, 40(1-2), 136–147.
  2. ^ Griffiths, K. M., Mackinnon, A. J., Crisp, D. A., Christensen, H., Bennett, K., & Farrer, L. (2012). The effectiveness of an online support group for members of the community with depression: A randomized controlled trial. PLoS ONE 7, e53244.
  3. ^ van der Zanden, R., Kramer, J., Gerrits, R., & Cuijpers, P. (2012). Effectiveness of an online group course for depression in adolescents and young adults: A randomized trial. Journal of Medical Internet Research14(3), e86.
  4. ^ Kunikata, H., Yoshinaga, N., Yoshimura, K., & Furushima, D. (2020). Clinical and cost-effectiveness of nurse-led cognitive behavioral group therapy for recovery of self-esteem among individuals with mental disorders: A single-group pre-post study. Japan Journal of Nursing Science 18, e12371.
  5. ^ Stapleton, P., & Stewart, M. (2020). Comparison of the effectiveness of two modalities of group delivery of Emotional Freedom Technique (EFT) intervention for food cravings: Online versus in-person. Open Journal of Social Sciences 8(2), 158-181.

About the author

Courtney is currently working as a healthcare workforce researcher for the state of California and is a regular contributor to the Quenza blog. She has a passion for taking research findings and translating them into concise, actionable packages of information that anyone can understand and implement.


  1. J Jakob

    Practitioners also need to do their due diligence when it comes to making sure their decision to contract with an online therapy company doesn’t run afoul of complying with the Health Insurance Portability and Accountibility Act (HIPAA), state licensing laws and other legal and ethical practices, Baker says. In addition, platforms that allow patients to connect anonymously with therapists may create legal and ethical issues for psychologists.

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