The group is advertised in the community and is open to all comers. The group leader reserves the right to insist that members seek additional treatment as a condition of attendance if they appear to be unable to benefit from the group. People with accompanying substance abuse are not excluded, but there is strong group pressure to monitor medication and control substance use. Depression is a disease, but like heart disease or diabetes, self-care is essential to recovery. Depression is not an emotion.
Emotions are self-limiting.
The group borrows from Alcoholics Anonymous in adopting a set of principles, discussion and application of which become the guidelines for recovery. He is open, within certain limits, about his progress in recovery. This allows him an authority in offering hope and understanding to depressed patients that does not come with the traditional therapeutic role. Other group members also learn the importance of lending hope and empathy, and benefit from their caregiving behavior in the group. In our experience, many clinicians are in treatment or have been in treatment for depression, either major depression or dysthymia, but hold back from sharing their experience with clients because of beliefs about the necessity of anonymity or objectivity.