Foundations of Addictions Counseling, 3/E David Capuzzi & Mark D. Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Chapter 10 Group Therapy for Treatment of Addictions Updated by Melinda Haley, Walden University

Group Therapy for Multiple Addictions Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Introduction Group counseling Most common treatment 94% of treatment facilities use group therapy Low cost Common functions of group: education, therapy, support

Theory Behind Group Work Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Sense of universality (I’m not alone) Empathy and support Interpersonal learning Group cohesiveness Preventative and remedial

Benefits of Group Treatment of Addiction Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Breaks down denial Opportunity to interact with others Promote social skills Promote self-disclosure Assist one another Confronting defenses, blind spots Peer influence enhances commitment to recovery

Purpose of Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Remedial or preventative Increase knowledge of self and others Help clarify changes desired Provide Tools Experiment with new behaviors in safe setting Receive feedback

Psychoeducational Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Educating members Foster self-understanding Provides experiential learning Provides discussion of the learned material Information about addiction Communication skills Assertiveness Social skills

Psychotherapeutic Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Helps with insight for dually diagnosed patients Explore pertinent life issues Family-of-origin issues Painful emotions Shame-based issues Grief

Effectiveness of Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Structured psychoeducational groups show better outcomes Little empirical evidence that preventative psychoeducational groups (i.e. DARE) are effective Limited evidence group psychotherapy effective with addiction Treatment success more likely with greater proportion group to individual counseling Addiction clients in group counseling improve depression, trauma symptoms, suicide risk

Self-Help Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Great variety of programs No charge Most prominent are based on 12-step model AA, NA, CA, GA, ACOA, Al-Anon SMART Recovery is cognitive-behavioral Share experiences Social support Give and receive help

Ethical and Legal Issues With Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Thoroughly understand the code of ethics and standards of practice as well as: State and Federal Laws Competence of counselor Screening of Participants Informed Consent Confidentiality Voluntary vs. involuntary participation Group conflict

Managing Diversity in Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Consider three dimensions Age, culture, ethnicity, gender, sexual orientation, and social class Education, geographic region, spiritual beliefs Historical era and current social context

Managing Diversity in Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Ethnicity All group counseling is cross cultural Group leaders facilitate balance of power and status among group members. Develop awareness of personal values and the worldview of the group members. Provide culturally appropriate interventions

Managing Diversity in Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Gender Residential treatment groups are usually composed of all one gender. This limits members’ ability to work through family of origin or cross gender relationship issues. Not all men appreciate groups, because they have not be socialized to talk about their problems with others.

Managing Diversity in Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Sexuality Sexual identity stereotypes Requires sensitivity and planning Group leader can teach and model repsect

Type of Addiction in Groups Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Alcoholics may prefer being with other alcoholics Clients who abuse drugs more open to groups that address multiple substances Difficult for facilitators to navigate

Group Counseling for Family Members Of Addicts Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Changing family system will likely assist addicts in sustaining change Learn new ways of coping Acceptance of the addiction Knowledge that individual is ill and needs treatment Become educated about addiction Share experiences Al-Anon, Alateen, Nar-Anon, ACOA

Strategies for Effective Group Treatment Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Maintain safety – address outbursts directly and quickly Encourage normal tones of voice Contract with members to practice new skills in group Make resentments overt to address anger Ask members to repeat what another said if tension arises

Strategies for Effective Group Treatment, (continued) Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved Ask those in conflict to identify their similarities Dismantle subgroups Directly deal with members who monopolize group time Allow for shifts between emotions and thoughts

Useful Web Sites Foundations of Addictions Counseling, 3e Capuzzi & Stauffer Copyright © 2016, 2012, 2008 by Pearson Education, Inc. All Rights Reserved The Addiction Recovery Guide Association for Specialists in Group Work SMART Recovery ® Sober Recovery