Author: John Carter

Group Therapy: Substance Misuse Treatment

Unlike group therapy, support groups are not led by a professional counselor or addiction therapist. A peer support specialist or other group members usually lead these groups. Outdoor group therapy sessions are common for meditation and recreational therapies.

While skills development groups often incorporate elements of psychoeducation and support, the primary goal is on building or strengthening behavioral or cognitive resources to cope better in the environment. Psychoeducational groups tend to focus on developing an information base on which decisions can be made and action taken. Support groups, to be discussed later in this chapter, focus on providing the internal and environmental supports to sustain change. While a specific group may incorporate elements of two or more of these models, it is important to maintain focus on the overall goal of the group and link methodology to that goal. Because our need for human contact is biologically determined, we are, from the start, social creatures.

How Does Group Therapy Work?

Group therapy is commonly used for the treatment of substance abuse and other mental health disorders such as depression, eating disorders, and trauma. Group therapy is an evidence-based treatment for substance use disorders. This typically serves as a primary component of a drug or alcohol rehab program.

It is useful to keep in mind that most skills, such as riding a bicycle or swimming, seem relatively simple, straightforward, and easy once incorporated into one’s repertoire of behavior. The process of learning and incorporating new skills, however, may be difficult, especially if the previous approach has been used for a long time. For instance, individuals who have been passive and nonassertive throughout life may have to struggle mightily to learn to stand up for themselves. As a consequence, it is crucial for leaders of skills development groups to be sensitive to the struggles of group participants, hold positive expectations for change, and not demean or shame individuals who seem overwhelmed by the task. Theoretical orientations also have a strong impact on the tasks the group is trying to accomplish, what the group leader observes and responds to in a group, and the types of interventions that the group leader will initiate.

Specialized Groups in Substance Abuse Treatment

Group therapy, such as skills development groups, can help people recognize the stages of relapse. Identifying triggers and developing coping skills can help people reduce their risk of relapse. Substance abuse treatment is challenging, but recovery is possible with the right support and guidance. Group therapy provides a nurturing environment where individuals can share their struggles, learn from each other, and build the skills needed to overcome addiction. If an individual experiences a relapse, it is not a reason to lose hope.

Play and art therapies enable these clients to work through their trauma and substance abuse issues using alternatives to verbal communication (Glover 1999). Relapse prevention groups draw on techniques used in a variety of other types of groups, especially the cognitive—behavioral, psychoeducational, skills development, and process-oriented groups. Relapse prevention groups focus on activities, problemsolving, and skills-building. For instance, Khantzian et al. (1992) assert that, because the same traits in personality and character predispose people to use substances initially and to relapse during recovery, psychodynamic approaches can mitigate psychological vulnerabilities.

1. Furthermore, many behavioral changes that seem straightforward on the surface have powerful effects at deeper levels of psychological functioning.
2. Group therapy can take many forms, and has shown to offer several benefits for people who are overcoming a drug or alcohol addiction.
3. As part of a larger program, psychoeducational groups have been used to help clients reflect on their own behavior, learn new ways to confront problems, and increase their self-esteem (La Salvia 1993).

As long as respect and awareness are evident, the use of such practices will not harm the members of a particular culture. In addition to making the right strategic choice of approach, the interventions should be done at the right time. Treatment as a time-dependent process should be the guiding principle when working with people with addictions in group. Figure 2-5 describes how an interpersonally focused group might respond to the conflict described in Figure 2-3.

Develop Communication Skills

Early on in group development, process group leaders might consciously decide to be more or less active in the group life. They might also choose, based on the needs of the group, to make more or fewer interpretations of individual and group dynamics to the group as a whole. Likewise they might choose to show more warmth and supportiveness toward group members or take a more aloof position. For instance, in contrast to leading a support group, where the leader is likely to be unconditionally affirming, the process leader might make a conscious decision to allow clients to struggle to affirm themselves, rather than essentially doing it for them. Most group leaders who apply a process-oriented approach to group therapy with people who abuse substances recognize the theoretical influence of the Interactional Model (Yalom 1975).

What Is Group Therapy Used For?

For this reason, most effective treatment programs make attendance at AA or another 12-Step program a mandatory part of the treatment process. By the same token, AA and other 12-Step programs are not group therapy. Twelve-Step programs can help keep the individual who abuses substances abstinent while group therapy provides opportunities for these individuals to understand and explore the emotional and interpersonal conflicts that can contribute to substance abuse.

Advantages of Group Treatment

The adjective “support” itself may be a way of destigmatizing the activity. For this reason, a “support” group may be more attractive to someone less committed to recovery than a “therapy” group. In cognitive-behavioral groups for people who abuse substances, the group leader focuses on providing a structured environment within which group members can examine the behaviors, thoughts, and beliefs that lead to their maladaptive behavior. Treatment manuals—providing specific protocols for intervention techniques—may be helpful in some, though not all, cognitive—behavioral groups.

Cognitive—behavioral therapy groups work to change learned behavior by changing thinking patterns, beliefs, and perceptions. The groups also work to develop social networks that support continued abstinence so the person with dependency becomes aware of behaviors that may lead to relapse and develops strategies to continue in recovery (Matano et al. 1997). Other specific techniques for skills development groups depend on the nature of the group, topic, and approach of the group leader.

Often, a psychoeducational group integrates skills development into its program. As part of a larger program, psychoeducational groups have been used to help clients reflect on their own behavior, learn new ways to confront problems, and increase their self-esteem (La Salvia 1993). Figure 2-1 lists some groups commonly used in substance abuse treatment and classifies them into the five-model framework used in this TIP. This list of groups is by no means exhaustive, but it demonstrates the variety of groups found in substance abuse treatment settings. For addiction, group therapy is commonly recommended alongside other evidence-based services, including medication management, individual therapy, and family therapy. During individual therapy, a therapist will provide one-on-one counseling.

Process-oriented group therapy uses the process of the group as the primary change mechanism. Cognitive-behavioral groups are particularly appropriate in early recovery. Clients still use substances, but intend to stop since they have recognized the advantages of quitting and the undesirable consequences of continued use. We are here to provide assistance in locating an Ark Behavioral Health treatment center that may meet your treatment needs.