1. By: Christy Hicks, CADC/CSW Regional TEAP Specialist
Group Counseling
By: Christy Hicks, CADC/CSW
Regional TEAP Specialist

2. Why use group therapy? Engages therapeutic forces Affiliation Support
Peer confrontation
Bonding
Lack of isolation
Examples of recovery and positive activities
Social skills training
Encouragement

3. What skills you need to lead any group?
Educator/Facilitator needs to be warm, and show genuineness, and positive regard for others
Good knowledge of materials to present
Have knowledge of group process and how our students interact within a group
Know how group dynamics influence and individual’s behavior in group
Basic teaching skills: organizing, planning, delivery
All groups must be effective, meaningful, and promotes learning
All people learn differently. What does that mean?

4. What skills you need to lead any group?
Active Listening
Clarifying
Supporting
Reflecting
Attending
Confronting
Terminating

5. What do we need to watch for in group situations?
Conflict between group members
Encouraging withdrawn group members to be more active
Make sure all group members have a chance to participate
Unpleasant experiences: mocking others or their ideas, insensitivity, or laughing.
Avoiding leader-centered group
Transference and countertransference
Confidentiality

6. Some Group Basic Models
Psychoeducational groups
Skills development
Cognitive behavioral groups
Support groups
Interpersonal process groups
Relapse prevention groups
Communal- and culturally-specific groups
Expressive groups
Groups focused on specific problems

7. Psychoeducational Groups
Designed to educate clients about substance abuse, and related behaviors and consequences
Specific topics presented by lectures, videos, audio, etc.
Direct application to our clients life to instill self-awareness, suggest options for growth and change, identify community resources that can assist, develop a understanding of the process of recovery
Expansion of awareness about behavioral, medical, psychological consequences of substance abuse to become recovery ready
Must be supervised throughout the process

8. Psychoeducational Groups
Most helpful in:
Learning about their disorder
Recognize road blocks
Help family members understand substance abuse behavior
Help students lean about resources (anger management, relaxation, nutrition, and medical needs)
Highly structured (manual or pre-planned curriculum)
Leader/instructor takes active role

9. Skills Development Group
Cognitive-behavioral orientation, but other forms of treatment can be used. Incorporates psycho-educational groups but should focus on the primary focus skills development.
Develop coping skills training
Avoid triggers to use drugs/alcohol
Cope with urges to use drugs/alcohol
Manage anger
Solve problems
Relaxation

10. Skills Development Group
Group size is important (no more that 15). Why??? Needs to be small enough for the group to practice skills
Demonstrate the skills the students can learn
Model skills
Sometimes a group may need to be lead by someone trained in meditation, or other special skills

11. Cognitive-Behavioral Groups
Cognitive restructuring is the basic method of change. Change learned behaviors by changed thinking patterns, belief, assumptions, and precipitations.
Identify stimuli associated with addictive behaviors
Avoid that stimuli
Development of enhanced contingency management strategies
Response and desensitization
I’m a failure/ I’m different
I’m not strong enough to quit/ I’m loveable
I’m a bad person/ I’m a good friend
Changing such cognitions and beliefs assist students to be more productive.

12. Cognitive-Behavioral Groups
Must be structured
Goal orientated
Deal with issues immediately
Problem-solving skills groups help build skills and resources
Things to think about:
# of sessions
Male/ female groups
Where the student is in the change process
Mandatory vs. non-mandatory groups

13. Cognitive-Behavioral Groups
You must know about CBT to effectively lead this type of group
Can be directive or non directive
Active or non-active groups
Confrontational or non-confrontational
Engagement is the key to access
Teaching group members about self-destructive behavior
Focus on problem solving and short/long-term goal setting
Help student monitor their feelings and behaviors
Fosters open and honest communication
Leader active but not directive

14. Support Groups
Groups show unconditional acceptance, inward reflection, open and honest interpersonal interaction, and commitment to change.
Helps with dependence when though they don’t know the root cause.
Groups can be peer generated or peer leaders
Increases self-esteem
Increase self confidence
Decrease anxiety
Provides positive reinforcement to students
Understand commonality
Less directive

15. Interpersonal Process Group
Focuses on healing by changing basic interpersonal or within self psychological dynamics.
Experiences affects future
Sometimes perceptions distort reality
Psychological and cognitive processes outside awareness and influence behavior
Behaviors are chosen to adapt to situations and protect students from harm
Attention is paid more to the group than to each individual student

16. Relapse Prevention Groups
Maintaining abstinence or recover from relapse. Relapse prevention helps to maintain sobriety by providing students will skills and knowledge to anticipate identify and mange high-risk situations that lead to substance use stabilization.
Focuses on activities, problem solving, and skill building
Supportive relationship building
Targeting high risk students
Relapse needs to be handled in a non judgmental way
Understand the wide range of consequences for relapse: criminal justice, child protection, job, school, family, relationships, etc.

17. Communal and Culturally Specific Groups
Risk factors
Specific cultural healing practices
Cultural prohibitions patterns

18. Expressive Groups
Assists students to express feeling and thoughts that are difficult with spoken work alone.
Art
Music
Drama
Psychodrama
Games
Play
Dance
Free movement
Poetry

19. Groups Focused on Specific Problems
Works specifically on one problem.
Shyness
Loss of a loved one
Substance abuse
Smoking
Eating
Short highly structured groups, effective coping skills until substance abuse treatment is initiated.

20. How to be a great group leader?
Our students are from a broad and diverse population, ages, ethnic groups, co-occurring conditions and histories.
In substance abuse treatment you use the same type of skills, qualities, styles, and approaches needed in any type of therapeutic treatment group.

21. How to be an great group leader?
Personal Qualities:
Communication skills
Responsive and affirming
Safe and supportive
How to manage the group’s anxiety
When you need to intervene
Consistency:
Security
Boundaries

22. How to be a great group leader?
Active Listening:
Verbal
Non-verbal
Firm Identity
Confidence
Spontaneity
Integrity
Trust
Humor

23. How to be a great group leader?
Empathy: Ability to identify someone else feelings, while remaining aware that others’ feelings are not your own.
How do we project empathy?
Communicates respect for and acceptance of students and their feelings
Encourages a non-judgmental, collaborative relationship
Is supportive and knowledgeable
Sincerely complements rather then denigrates or diminishes another person
Tells less and listens more
Gently persuades, while understanding that the decision to change is the students
Provides support throughout the recovery process
As a leader you should be able to model empathic interaction to the students

24. Leaders Improve Motivation by:
Overcoming resistance
Defending limits
Maintaining safe therapeutic settings
Helping cool down affect
Encouraging communication within the group

25. Confidentiality and 42 CFR Part 2 Confidentiality of Alcohol and Drug Abuse Patient Records
Confidentiality is both and ethical and legal issue. Guarantees strict confidentiality of information about all people receiving substance abuse prevention and/or treatment services. Clients should be fully informed regarding issues of confidentiality, and group leaders should do all they can to build respect for confidentiality and anonymity within groups.

26. Confidentiality and 42 CFR Part 2 Confidentiality of Alcohol and Drug Abuse Patient Records
Six limited conditions
Release of information
Threatens imminent harm him or herself
Threatened imminent harm to someone else
Emergency medical emergency care
Suspected of child neglect and/or abuse
Direct court order

27. Management of the Group
Handling conflict in group
Subgroup management
Responding to disruptive behaviors
Students who cannot stop talking
Students who interrupt
Students who flee
Contraindications for continued participation in group
Coming late or missing sessions
Silence

28. Group Management Tuning out
Participating only around the issues of others
Fear of losing control
Fragile clients with psychological emergencies
Anxiety and resistance after self-disclosure

29. Group Rules Here are some typical group rules: Be on Time
Come clean and sober
No cell phones
Only one person talks at a time
What's said in group stays in group
Respect others opinions
Say "Thank You“
Offer feedback to your group members
No disruptive language
Speak the truth

30. Group Rules
Group has to be a safe place for members to come and work on their issues. Certain rules have to be put into place to help establish the space effectively.
Some group leaders have a copy of group rules for each group member to sign and have opportunity to ask questions about the rules prior to group attendance.

31. Questions??????