March, 2023. Group therapy is a well-respected treatment format that is widely used in treatment centers and clinical practice. Though not for everybody, it provides advantages that can be uniquely beneficial either as a sole treatment modality or in combination with individual psychotherapy. Simply stated, participants learn that they are not alone in their suffering. The ubiquitous experience of shame about having a mental illness—the social stigma that sticks to these conditions like Velcro—can be eased, hearing first-hand that others feel just as miserable as you do. Just talking about it together can be therapeutic. But with the help of skilled group therapists, strategies to lighten the burden can be figured out. In my many years working at The Menninger Clinic in Houston, I heard from patients over and over again how much they valued learning from peers about their struggles with similar problems, and then working to help each other.

Group work is, of course, a mainstay of treatment for some conditions such as substance use disorders, either in residential or outpatient settings. It is also a key ingredient in specialized programs such as dialectical behavior therapy, which involves a combination of individual therapy and group skills training. Perhaps less recognized is the inherent value of socially interacting with others for conditions like anxiety disorders or depression. In this issue of the Journal, Bandera and colleagues propose a novel group fitness program designed to help patients with major depressive disorder. Though, of course, exercise and fitness are important for us all as part of healthy lifestyles, it has been well-established that exercise can be an actively therapeutic agent to help ameliorate disabling depression. Many studies along those lines have been published in JPP, several examples of which are listed in the references below.1–5

In developing their proposal for a group fitness program, Bandara et al drew on the recommendations of an earlier publication in this Journal. In that article, Rethorst and Trivedi6 reviewed the evidence (including randomized controlled trials and meta-analyses) supporting the use of exercise in the treatment of major depressive disorder and provided specific evidence-based recommendations for prescribing exercise for depressed patients. In their proposal, Bandara et al used those specific evidence-based recommendations to design a group-based intervention for depressed patients. They noted that providing exercise intervention in a group setting is likely to increase patients’ feelings of social connectedness, support, and safety as well as being more cost-effective.

1. Escobar-Roldan ID, Babyak MA, Blumenthal JA. Exercise prescription practices to improve mental health. J Psychiatr Pract. 2021;27:273–282. 2. Giles A, Nasstasia Y, Baker A, et al. Exercise as treatment for youth with major depression: The Healthy Body Healthy Mind Feasibility Study. J Psychiatr Pract. 2020;26:444–460. 3. Scott TM, Gerbarg PL, Silveri MM, et al. Psychological function, Iyengar yoga, and coherent breathing: a randomized controlled dosing study. J Psychiatr Pract. 2019;25:437–450. 4. Uebelacker LA, Epstein-Lubow G, Gaudiano BA, et al. Hatha yoga for depression: critical review of the evidence for efficacy, plausible mechanisms of action, and directions for future research. J Psychiatr Pract. 2010;16:22–33. 5. Trivedi MH, Greer TL, Grannemann BD, et al. Exercise as an augmentation strategy for treatment of major depression. J Psychiatr Pract. 2006;12:205–213. 6. Rethorst CD, Trivedi MH. Evidence-based recommendations for the prescription of exercise for major depressive disorder. J Psychiatr Pract. 2013;19:204–212.