Overview of Addiction Treatment Groups
Besides individual and family sessions, group therapy is a valuable additional tool in addiction treatment. It is neither better nor worse than the other methods. It is an effective additional type of therapy that improves the security of long term sobriety when added to other forms of treatment.
An addiction group meeting consists of a therapist and a number of patients who suffer from various, yet similar types of addictions. During group meetings, patients discuss experiences and solutions through interaction with their peers. Among the many insights they gain, is observing, firsthand, that they are not the only ones affected by certain issues (the principle of universality). It is known that group therapy reduces stress, anxiety and guilt in patients.
Observing other people motivates patients who may still be hesitant about quitting. Getting to know each other also makes it more comfortable for patients to mingle and support each other outside the formal setting.
Unlike family sessions, patient group members do not have the same deeply emotional relationships, yet they share an interest and empathy that adds a different, but essential, element to the healing process. It enables them to approach the situation more objectively, in an environment where they can observe, share and learn from other sufferers.
Knowing that they are not burdening disinterested outsiders, but rather participating in a shared interest, is a unique opportunity for addicts to productively benefit themselves and others at the same time.
However, sometimes resistance to participation is a problem. Therefore, a proficient therapist will apply proven methods to create a conducive atmosphere. Shy or reluctant patients often find themselves taking part in, and even enjoying, the addiction group discussions, despite their initial forebodings. Talk therapy and group exercises are used to improve the quality of addiction group sessions.
Group leaders must, preferably, be proficient addiction therapists, as recovering group members are often in a vulnerable state of mind and must be handled with exceptional skill, especially when exposed to group scrutiny.
Group leaders have to get everybody into a congenial, relaxed, yet engaging mood. They need skills to stimulate participation and keep the momentum going, whilst making the experience productive, meaningful and interesting. They must also recognise individual patient sensitivities and be able to defuse potential conflicts. All at the same time.
Professional therapists who work with members in individual sessions, have the benefit of knowing the patient and, also, of engaging them later about routines they noted during group sessions.
There are different types of groups and methods applicable to addiction group therapy, and they are best determined by a trained therapist, but all of them share some basic requirements.
Managing group therapy sessions
- Paving the way: Some people feel uncomfortable in an emotional group setting, so sessions should start in a way that eases the tension. Leaders may ask new members to talk about their likes, dislikes, interests, and so on, to dismantle barriers and build a trusting “team spirit”. Icebreakers may be used at the start of all sessions. The activity does not have to be about drugs. It could be anything, aimed solely at defusing tension.
- Probing: Leaders may check on members’ moods. If nobody knows how a person feels that day, they may not understand their actions. Also, if someone received bad news, the group can encourage the member and strengthen the group unity.
- Modules: There are many different group therapy modules available, but some can be combined with others. It is up to the group leader to design the module recipe for a group.
- Subjects: Group leaders have to choose a subject for each session. The overriding aim should be to have productive, stimulating sessions and to limit uninteresting rhetoric.
- Discipline: Participation is encouraged, but leaders have to step in, without causing an upset, when a member derails a session. Rules and timelines have to be spelled out and observed in the interest of all members.
- Leadership: The group leader must guide members whilst respecting their dignity. It is very important that patients should not perceive their treatment as a form of punishment.
Group therapy subjects
There is a variety of group therapy modules, but, generally, meetings are either educational, where a subject is presented by an expert and then explored by the group, or it can take the form of gameplay, outings or simply a plain discussion where everybody submits their own input about the subject of the day.
Some subjects can be incorporated into activities like outings or games, or a poster can be used for listing ideas. These encourage lively participation and they also leave a more lasting impression.
The list of items from which to choose the subject for a session, are numerous and it would be impractical to try and list them all, but here are a few examples:
- Vacuum fillers: Most people abuse substances to overcome poor coping skills and also spend much effort on abusive behaviour. After treatment, they must fill both these vacuums. It is vital for a group to suggest and explore a large variety of potential interests and hobbies that can be pursued after completion of treatment.
- Negative talk: Ask members for examples of negative thoughts, words or phrases that make them very angry or sad. Illustrate ways to defuse the responses they create.
- Lifestyle tours: Arrange outings to local venues where members can observe handicraft, hobbies or events of special interest. Discuss the observations at the next meeting. Getting used to going out and ideas about new lifestyles are both important for sustained sobriety.
- Games: Illustrate interesting optical illusions to demonstrate how something is not always what we think it is. Play charades to show how body language works. Or members can write down the thing they fear most and put it in a bowl for others to pick and comment on.
- Debates: Choose an appropriate subject, then divide the group and commence a debate with two opposing sides. Awareness and critical thinking are important considerations when choosing a subject here, as both are at the root of many relapses.
Other subjects close to a recovering person’s heart:
- Relationships in recovery
- Trust after recovery
- Coping with sadness, loss, disappointment
- Resurrection, reconstruction after recovery
- Embarrassing and awkward situations
- Coping with life without drugs
- Emotional triggers
- Relapse prevention
- Identifying and responding to warning signs
Tips for group therapy patients
- Dive in: Engaging with the group benefits you and everybody else. Ask direct questions and give honest answers. It is what the group is meant for. You do not have to feel ashamed or guilty.
- Respond: When someone shares something, tell them how you feel about it. Be honest and specific without being rude. Just being nice as a formality, or being a silent witness, helps nobody.
- Stay relevant: Avoid long, boring stories and do not attempt to glorify or justify yourself. Staying focused, honest and on topic will serve you and everybody else a lot better.
- Be considerate: If somebody disagrees with or critises you, don’t blame them. It’s their opinion and they may even be correct. Respect it and, without arguing, try to find the truth.
- Be gentle: Nobody is perfect. Do not brutally squash obviously flawed opinions. Calmly state your own point of view and leave it at that.
- Be decent: Maintain respect and ethics free from discrimination, sexual inappropriateness, or any behaviour that could make others feel uncomfortable or threatened.
- Maintain trust: Group members expose things they feel vulnerable about. Do not betray their trust by sharing it with others outside your group. It may lead to civil prosecution.
- Complain: If you feel the group does not serve it’s purpose, tell the group leader. There is no sense in being an unhappy or disengaged member. Be specific about the issues that bother you.
The benefits of addiction group therapy
- Observing that you are not alone, not useless, not hopeless.
- A safe harbour from prejudice and uninformed judgement.
- Sharing of non-critical advice about your problems.
- A chance to unburden without the isolation felt elsewhere.
- Reduction in stress, anxiety and guilt feelings in recovery.
- Getting to know, mingle with peers outside formal sessions.
- Peer support and team pressure to overcome hesitation.
- Observing and being motivated by the commitment of peers.
- Benefitting from the combined wisdom of a group of peers.
- Getting more advice from different sources.
- Getting feedback on and correcting flawed ideas.
- Learning practical survival skills from peers.
- Restoring trust, bonding with fellow beings.
- Learning and practicing skills to cope with life’s stresses.
- Getting advice for handling awkward situations after treatment.
- The satisfaction of knowing others are being inspired by you.
- Forming friendships to root you on this new side of the fence.
- Sense of belonging eases re-entry into the larger community.
- Old perceptions are challenged, confronted and cleared.
- Knowing that you can overcome temporary loneliness.
- Restoring discipline and energy to a life that stumbled.