Treatment Solutions: Substance Abuse Treatment Group Activities

Substance Abuse Treatment Through Group Therapy Activities

Substance abuse treatment often includes participation in group therapy. Treatment professionals use a multitude of group exercises as part of group therapy to engage clients and help them stay sober.

These techniques may serve various specific purposes within group therapy. For instance, they can help put clients at ease, express themselves, bring them closer, or provide educational information. However, what they all have in common is their ultimate goal of guiding clients toward recovery.

The Types of Group Therapy Exercises in Substance Abuse Treatment

There are many different types of therapeutic group therapy exercises. The kinds of group activities depend on the theoretic approach that the treatment professional uses as well as the group members’ needs, background, age, and other factors.

These are some common types of activities in group therapy:1

  1. Written exercises: Techniques such as list-making, sentence completion, or answering questions sharpen the members’ focus.
  2. Movement exercises: Group members can engage in a number of physical activities, which gives them an opportunity to learn and grow through movement.
  3. Dyads and triads: Members of the group do these activities by interacting in pairs or groups of three.
  4. Rounds: Rounds are stimulating exercises where each member is asked to react to a question or statement from the therapist.
  5. Creative props: In these therapeutic group exercises, members may use common everyday objects to symbolize or explain some aspect of their lives.
  6. Arts and crafts exercises: Members need to create a DIY project. They get the satisfaction of making something while also expressing their feelings and thoughts.
  7. Fantasy exercises: Fantasy activities require members to imagine themselves in unrealistic situations, which helps them discover more about themselves.
  8. Common reading exercises: Members read a passage, short story, or a poem, which sparks further discussion.
  9. Feedback exercises: Members get a chance to share their opinions on the other members of the group or the leader.
  10. Trust exercises: The purpose of these group exercises is to inspire greater trust among members and lead to better group cohesion.
  11. Experiential exercises: Group members learn through practical experience of various kinds.
  12. Moral dilemma exercises: The leader presents the members with a challenging moral problem to which they need to find a solution.
  13. Group-decision exercises: Group members cooperate to settle on the best solution in a given situation.
  14. Touching exercises: Tactile sensations can be comforting and put group members at ease, which can be especially beneficial at the beginning of substance abuse treatment.

When to Use Therapeutic Group Activities in Group Therapy?

People who are in substance abuse treatment can particularly benefit from group exercises and games in group therapy when the leader uses them in the following situations:2

  • When the group is meeting for the first time. This may help participants loosen up around other group members.
  • In the first few minutes of every session. This way, the leader will introduce a topic of discussion in an engaging way and grab the attention of the group.

The Effects of Group Exercises on Substance Abuse Treatment

There are several reasons to use group exercises in substance abuse treatment:3

  • They make clients more comfortable: Group members get to know each other better through activities. They often reduce anxiety and improve the members’ willingness to share.
  • They let the leader know more about the clients: They may help clients open up and divulge information about themselves that is important for the therapeutic process.
  • They start conversations: Group games and exercises are usually utilized as the basis for later discussions by the group.
  • They change the focus: When it’s time to shift to a new topic of discussion, the treatment professional may introduce it with group exercises.
  • They improve the focus: Members become more alert and their focus is sharper.
  • They help the clients learn from experience: Games and other therapeutic activities offer a change to the usual discussion format of group substance abuse treatment.
  • They are interesting and motivating: These techniques can provide some light-hearted fun to the group and ease the tension after emotionally charged discussions.

Frequently Asked Questions

  • Group leaders are aware of the fact the members of a therapy group commonly feel anxious and fearful of saying something wrong or revealing too much.4 Therapists adopt a variety of techniques to soothe the clients’ anxiety and encourage them to actively and openly participate. The treatment professional may:
    • Make reassuring statements, encouraging all members to be accepting and non-judgemental.
    • Have a warm, approachable demeanor, such as speaking in a pleasant tone of voice and having a friendly facial expression.
    • Adjust the topics discussed in group therapy to the clients’ current level of comfort and stage of recovery from substance abuse.
    • Use ice-breaker therapeutic group exercises, like categories (asking members to group based on something they have in common, such as their favorite color).

  • Group therapy contributes to substance abuse treatment by using carefully selected group exercises. Here are several examples of effective activities that can be used in a group setting:5
    • Strength bombardment: Members describe one of their peers by pointing out their best traits.
    • Picture being something else: Group members imagine themselves as an object and try to explain how they feel and what they experience in this role.
    • Ethical dilemmas: The group has to make a difficult moral decision, such as which person in a group of imaginary people they would save from a shipwreck.
    • I have to/I choose to: A member of the group lists what the things they believe are their duties. Next, they go over the list saying “I choose to” instead of “I have to”.
    • Values continuum: The leader reads out a statement and group members show their opinion of it by standing in a previously designated area of the room.

  • As part of substance abuse treatment group therapy, there are several kinds of activities that encourage imagination and artistic expression. Creative exercises are therapeutic activities that allow clients to express feelings and thoughts—conscious or unconscious—that they might have difficulty communicating with spoken words alone.6 Apart from helping people to share their experiences and feelings, they may also reduce stress and anxiety.

    Firstly, there are art and craft activities, where people channel their creative energy and represent their inner states through drawing, painting, cutting, or building something from different materials.

    Also, music can be the basis for effective creative therapy. For example, the group leader may play some music and ask the members to visualize pleasant images and evoke happy memories.

    Another way for group leaders to stimulate the creativity of people in substance abuse treatment is to introduce unusual props. For example, the treatment professional could hand out rubber bands to the group and ask members to stretch them to show how much stress they are currently experiencing in their lives.

  • Grounding exercises can be used in substance abuse treatment to aid recovery. Grounding is a method that makes people deeply aware of everything that they are experiencing in the present time.7 It contributes to overcoming traumatic memories, stopping flashbacks, and dealing with negative feelings. It also helps with relaxation and reduces anxiety. It is closely related to the practice of mindfulness.

    The Buddhists have used mindfulness as part of their meditation practice for a long time. The purpose of mindfulness techniques is to achieve present-moment awareness.8 Instead of letting one’s mind wander to disturbing or triggering thoughts and feelings, mindfulness helps people stay in the here and now. However, it isn’t about never getting distracted by your thoughts but about bringing your attention back once distractions occur.9

    Acceptance is another integral part of being mindful. Practicing mindfulness means paying attention and accepting what you perceive without judging.

  • Some mindfulness activities that can be used in a substance abuse treatment group are:
    • Body-scan meditation: With eyes closed, group members pay attention to each of their body parts one by one.
    • Studying an object: Group members quietly observe an everyday object in the room. They notice its texture, shape, and other features. Later, they inspect it by running their hands over it and touching it attentively.
    • Mindful listening: The group carefully listens to and counts every sound they hear while keeping their eyes closed.
    • Breathing together: Sitting opposite each other with eyes closed, group members focus on their partners’ breathing and try to adjust their own accordingly.
    • Meditation through movement: The group leader gives instructions on the movements that the group should make slowly while paying attention to their breathing.

1. DeLucia-Waack, Janice L., editor of compilation. Kalodner, Cynthia R., editor of compilation. Riva, Maria T., editor of compilation. (2014). Handbook of Group Counseling and Psychotherapy. Thousand Oaks, CA: SAGE Publications.

2. Ed E. Jacobs. Robert L. Masson. Riley L. Harvill. Christine J. Schimmel. (2012).Group Counselling: Strategies and Skills. Belmont, CA: Brooks/Cole, Cengage Learning.

3. Center for Substance Abuse Treatment. (2005). Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series, No. 41.HHS Publication No. (SMA) 15-3991. Rockville, MD: Substance Abuse and Mental Health Services Administration.

4. American Psychological Association. (2019). Mindfulness meditation: A research-proven way to reduce stress.

5. Williams, Rebecca E. Kraft, Julie S. (2012). The Mindfulness Workbook for Addiction. Oakland, CA: New Harbinger Publications.