Author: Gary Jackson

7 Topics Covered in Group Therapy for Substance Abuse

Group members can learn by observing others, being coached by others, and practicing skills in a safe and supportive environment. Groups help members learn to cope with their substance abuse and other problems by allowing them to see how others deal with similar problems. Groups can accentuate this process and extend it to include changes in how group members relate to bosses, parents, spouses, siblings, children, and people in general.

Programs may even design a support group by combining theories or philosophies. Not all support groups, however, are intended just for clients new to recovery. Support groups can be found for all stages of treatment in all sorts of settings (inpatient, outpatient, continuing care, etc.).

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Clients with cognitive disabilities, for example, may need special considerations. Psychoeducational groups also have been shown to be effective with clients with co-occurring mental disorders, including clients with schizophrenia (Addington and el-Guebaly 1998; Levy 1997; Pollack and Stuebben 1998). For more information on making accommodations for clients with disabilities, see TIP 29, Substance Use Disorder Treatment for People With Physical and Cognitive Disabilities (CSAT 1998b). Helping clients learn about other resources that can be helpful in recovery, such as meditation, relaxation training, anger management, spiritual development, and nutrition. Helping clients in early recovery learn more about their disorders, recognize roadblocks to recovery, and deepen understanding of the path they will follow toward recovery. Despite such discrepancies between neat theory and untidy practice, little difficulty will arise if the group leader exercises sound clinical judgment regarding models and interventions to be used.

Depending on the skill being taught, there may be certain educational or certification requirements. For example, a nurse might be needed to teach specific health maintenance skills, or a trained facilitator may be needed to run certain meditation or relaxation groups. Because of the degree of individual variation in client needs, the particular skills taught to a client should depend on an assessment that takes into account individual characteristics, abilities, and background.

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Two studies demonstrated the superiority of CM groups for reducing cocaine use as compared to CBT [62] or TAU groups [61, 62] at 12 weeks [54], 17 weeks [53], 26 weeks [53] and 52 weeks follow up [51]. Therefore, CBT group therapy and contingency management groups appear to be more effective at reducing cocaine use than TAU groups. More promising findings were reported in Fisher and Bentley’s [18] evaluation of a group CBT and group therapy based in the disease and recovery model (DRM) among 38 individuals with dual diagnosis of SUD and a personality disorder.

• Finally, the group leader should have a firm grasp of material being communicated in the psychoeducational group.
• Any treatment modality—group therapy, individual therapy, family therapy, and medication—can yield poor results if applied indiscriminately or administered by an unskilled or improperly trained therapist.
• Training in cognitive—behavioral theory is available in many workshops on counseling skills and in many alcohol and drug training programs for counselors.
• Different cultures have specific activities that can be used in a treatment setting.
• Treating adult clients in groups has many advantages, as well as some risks.
• More than 20 years ago, John Wallace (1978) wrote about this important issue in an informative essay on the defensive style of the individual who is addicted to alcohol.