Group Therapy, Who, What, Where, and How

1. Group Therapy, Who, What, Where, and How Cheryl Gentile, MS, LPCS, LCAS, CRC-MAC, ACS, CCS

2. The Advantages of Group Help members learn to cope with problems related to substance abuse by allowing them to see how others deal with similar problems Reduces the sense of isolation Witness the recovery of others Provides information about recovery Provides feedback to others

3. Allow a single treatment professional to help a number of clients at the same time Help clients overcome past harmful experiences. Encourage, coach, support, and reinforce members as they undertake difficult or anxiety-provoking tasks.

4. Add needed structure and discipline to the lives of people with substance use disorders, who often enter treatment with their lives in chaos.

7. 11 Curative Factors Instillation of hope Universality Imparting information Altruism Corrective Recapitualtion of Primary Family Improved social skills Imitative behavior Interpersonal learning Cohesiveness Catharsis Existential factors

8. Negative Attributes of Group Not for everyone Confidentiality Difficult to build trust Untrained facilitators Not enough time to meet everyone’s needs Conformity vs. peer pressure

11. Types of Groups Psychoeducational Skills development Cognitive–behavioral Support Interpersonal process

12. Psychoeducation Groups • Role of the facilitator is to educate • Targeted for the pre-contemplative and contemplative stages of change • Provides information about recovery • Structured with specific content

13. Skills Development Groups • Facilitator is a role model and educator • Anger management • Resiliency • Identifying and avoiding triggers • Enhance coping • Relaxation techniques • Structured

14. Cognitive–Behavioral Groups • Facilitator role is one of active engagement • Focuses on immediate problems • Promotes self-control skills to manage overwhelming emotions • Is early-recovery–oriented • Emphasizes structure • Goal oriented

15. Interpersonal process Groups • Role of the facilitator is to monitor individual needs • Early experience affects later experience. • Focuses on the Now • Interactions in a group setting • Explores attachments

16. Self Help Vs. Interpersonal Peer leader Voluntary No screening No theoretical approach Unlimited number No contract Professional INV or Voluntary Screening Multiple approaches 8-15 members Contractual

17. Qualities of a Group Facilitator Confidence Knowledge Spontaneity Integrity Trust Humor Empathy

18. Facilitator Skills Active Listening Reflecting Clarifying Summarizing Facilitating Empathizing Interpreting Questioning Linking Confronting Supporting Blocking Assessing Modeling Suggesting Initiating Evaluating Terminating

19. Stages of Group Forming Storming Norming Performing Adjourning

20. Placement considerations • Meet with each candidate for group placement • Assess the client’s level of: • interpersonal functioning • impulse control • Motivation • Stability

21. The How Tos Introductions Setting the Norm Provide direction Facilitator acknowledges each member, and their reactions to one another

22. Middle Stage Content, information, and feelings are expressed, and processed Non verbal cues are addressed Ask members how they are doing in group

23. End Stage “Termination is more then the end of therapy it is an important force in the process of change……a stage in the individuals career of growth.” Yalom (1995, pp361-362)