1. HLSC 2120 Preparing the Chemically Dependant Person for Group Psychotherapy

2. …they cannot manage the initial anxiety that group psychotherapy always triggers.

3. Their level of cognitive impairment and chemical-induced emotionality make it difficult, and in many cases impossible, for them to respond appropriately to psychological levels of intervention

4. most alcoholics will look and sound better than they are

5. Rutan and Stone (1984): 1. Establish a preliminary alliance between patient and clinician; 2. Gain a clear consensus about the patient’s therapeutic hopes; 3. Offer information and instruction about group psychotherapy; 4. Deal with the initial anxiety about joining a group; 5. Present and gain acceptance of a contract.

6. Establish a Preliminary Alliance

7. They must adapt to the unknown demands of the group and learn which behaviors will lead to acceptance and which behaviors will lead to rejection.

8. Alcoholics and addicts handle stress poorly

9. It has been reasoned by MacLeod (1968) that the awkwardness of the management of the early hours of treatment was the most significant factor contributing to premature dropouts and treatment failures.

10. To discover ourselves and others as feeling persons, and To identify the defenses that prevents this discovery.

11. Offer Information and Instruction about Group Psychotherapy

12. A. Give the new group members reading material. B. Didactically explain to them what they can expect. C. View a group session behind a one-way mirror (Wogan et al., 1977). D. Audio-tapes of a “good patient’s” participation in group.

13. Deal With the Initial Anxiety About Joining the Group

14. Agazarian and Peters (1981) list four common fears that may be stimulated by entry into a therapy group: 1. Confidentiality of personal information. 2. Rejection by the group. 3. Embarrassment over revealing intimate information to other group members. 4. Pathology of others.

15. Uncovering Shame Harper, J. & Hoopes, M. (1990) Uncovering Shame. New York. W.W. Norton & Company.

16. Pitfalls For Therapists 1. Assuming that the joining techniques sued for non-shamed clients in the first sessions of therapy are appropriate for shame-prone clients. 2. Being careless and miscalculating what the trust issues are. 3. Ignoring or misinterpreting shame-prone clients’ responses to typical information- seeking interventions.

17. Guidelines For Therapists 1. Expect that clients have no reason to trust therapists and that very likely they have trusty issues with everyone. 2. Acknowledge to clients that they have no reason to trust you, but that you are willing to earn their trust. 3. Be patient and give information to clients about your behaviour.

18. Guidelines For Therapists 4. Encourage clients to ask about anything that you do or say. 5. Give normalcy and credibility to anything that clients do in the sessions. 6. Acknowledge that clients have reasons to believe that they are bad. 7. Match humorous comments with your client’s style of humour.