What is Group Therapy?

Group Facilitation

Groups for substance use disorders are available within the community and online, but treatment groups should be facilitated and maintained by an addictions professional who is a trained leader and who is capable of promoting recovery from substance use.  The emphasis in these groups is on the interpersonal process, which helps people resolve their problems through relating to each other.  

 Treatment groups (meaning any group which is facilitated by a professional) can be a source of stabilization, support and persuasion to remain in recovery.   Therapeutic goals are identified within the groups, and offer insight and guidance.  Members who are struggling with a crisis, feelings of isolation or loss, sadness, grief or anger may find comfort and understanding from members who have or are experiencing similar issues.  

Group facilitation is a skill, and the leader who is skilled can direct and foster healthy attachments, provide positive reinforcements, and generate new social skills, coping mechanisms and provide a foundation for peer reinforcement.  

“Group therapy and addiction treatment are natural allies. One reason is that people who abuse substances often are more likely to remain abstinent and committed to recovery when treatment is provided in groups, apparently because of rewarding and therapeutic forces such as affiliation, confrontation, support, gratification, and identification. This capacity of group therapy to bond patients to treatment is an important asset because the greater the amount, quality, and duration of treatment, the better the client’s prognosis”.   (Leshner 1997; Project MATCH Research Group 1997).

What are the Benefits of Group Therapy?

Therapeutic groups should be based on the goals and intentions of the groups that have trained leaders and  intend to produce some type of healing or recovery from substance abuse. 

  • Groups provide positive peer support and pressure to abstain from substances of abuse. Unlike AA, and, to some degree, substance abuse treatment program participation, group therapy, from the very beginning, elicits a commitment by all the group members to attend and to recognize that failure to attend, to be on time, and to treat group time as special disappoints the group and reduces its effectiveness. Therefore, both peer support and pressure for abstinence are strong.
  • Groups reduce the sense of isolation that most people who have substance abuse disorders experience. At the same time, groups can enable participants to identify with others who are struggling with the same issues. Although AA and treatment groups of all types provide these opportunities for sharing, for some people the more formal and deliberate nature of participation in process group therapy increases their feelings of security and enhances their ability to share openly.
  • Groups enable people who abuse substances to witness the recovery of others. From this inspiration, people who are addicted to substances gain hope that they, too, can maintain abstinence. Furthermore, an interpersonal process group, which is of long duration, allows a magnified witnessing of both the changes related to recovery as well as group members’ intra ‐ and –  interpersonal changes.
  • 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.
  • Groups can provide useful information to clients who are new to recovery. For example, clients can learn how to avoid certain triggers for use, the importance of abstinence as a priority, and how to self‐identify as a person recovering from substance abuse. Group experiences can help deepen these insights. For example, self‐identifying as a person recovering from substance abuse can be a complex process that changes significantly during different stages of treatment and recovery and often reveals the set of traits that makes the system of a person’s self as altogether unique.
  • Groups provide feedback concerning the values and abilities of other group members. This information helps members improve their conceptions of self or modify faulty, distorted conceptions. In terms of process groups in particular, as specific themes emerge in a client’s group experience, repetitive feedback from multiple group members and the therapist can chip away at those faulty or distorted conceptions in slightly different ways until they not only are correctable, but also the very process of correction and change is revealed through the examination of the group processes.
  • Groups offer family‐like experiences. Groups can provide the support and nurturance that may have been lacking in group members’ families of origin. The group also gives members the opportunity to practice healthy ways of interacting with their families.
  • Groups encourage, coach, support, and reinforce as members undertake difficult or anxiety‐provoking tasks.
  • Groups offer members the opportunity to learn or relearn the social skills they need to cope with everyday life instead of resorting to substance abuse. Group members can learn by observing others, being coached by others, and practicing skills in a safe and supportive environment.
  • Groups can effectively confront individual members about substance abuse and other harmful behaviors. Such encounters are possible because groups speak with the combined authority of people who have shared common experiences and common problems. Confrontation often plays a part in substance abuse treatment groups because group members tend to deny their problems. Participating in the confrontation of one group member can help others recognize and defeat their own denial.
  • Groups allow a single treatment professional to help a number of clients at the same time. In addition, as a group develops, each group member eventually becomes acculturated to group norms and can act as a quasi‐therapist himself, thereby ratifying and extending the treatment influence of the group leader.
  • Groups can add needed structure and discipline to the lives of people with substance use disorders, who often enter treatment with their lives in chaos. Therapy groups can establish limitations and consequences, which can help members learn to clarify what is their responsibility and what is not.
  • Groups instill hope, a sense that “If he can make it, so can I.” Process groups can expand this hope to dealing with the full range of what people encounter in life, overcome, or cope with.
  • Groups often support and provide encouragement to one another outside the group setting. For interpersonal process groups, though, outside contacts may or may not be disallowed, depending on the particular group contract or agreements.

Optimal group therapy requires specially qualified leaders. Therapy groups cannot just take care of themselves. Group therapy, properly conducted, is difficult. One reason that it is challenging has to do with the nature of the clients; an addicted population poses unique problems for the group therapy leader. A second reason is the complexity of group therapy; the leader requires a vast amount of specialized knowledge and skills, including a clear understanding of group process and the stages of development of group dynamics. Such mastery only comes with extended training and experience leading groups.

Many groups led by untrained or poorly trained leaders have not fulfilled their potential and may even have had negative effects on a client’s recovery. It matters little whether the inadequately trained group therapist is a person who once abused substances or someone who developed knowledge in a traditional course of academically based training.

When deciding upon a treatment program for outpatient services, ask about their group therapy structure and models.  The primary goal for group therapy is to prevent relapse for its members; this is achieved through a variety of group methods.  All treatment groups are Relapse Prevention.  The treatment facility should be able to discuss with you in depth at least four of the five models, including a schedule for when these groups are offered.  

Psycho-educational Groups

Psycho-educational Groups  are interactive groups teaching about substance abuse.  These topics vary, and are formatted to provide information relating to aspects of substance use disorders.  

Skills Development Groups

Skills Groups concentrate on developing and strengthening skills to break free from addictions and remain in recovery.  These might be coping skills, trigger awareness skills, and more.

Cognitive–Behavioral Groups

Cognitive Behaviorial groups focus on how to rearrange patterns of thinking and action that lead to addiction.  CBT focuses on challenging and changing cognitive distortions and behaviors, improving emotional regulation, and the development of personal coping strategies that target solving current problems.

Support Groups

Support groups comprise a forum where members can debunk each other’s excuses and support constructive change.  Often called a Process Group.

Interpersonal Process Group Psychotherapy

Interpersonal process group psychotherapy (referred to as “interpersonal process groups” or “therapy groups”), which enable people to recreate their pasts in the here‐and‐now of group and rethink the relational and other life problems that they have previously fled by means of addictive substances.

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