How Does Group Therapy for Substance Abuse Treatment Work?
The natural tendency of humans to come together and congregate makes group therapy a particularly powerful tool for substance abuse treatment. Group therapy can have many benefits as a valuable resource for individuals struggling with substance abuse, as it can help reduce isolation, provide support for co-occurring disorders, and nurture a culture of recovery by promoting relapse prevention as an aftercare component.1
The Purpose of Group Therapy
The purpose of group therapy in substance abuse treatment is to:1
- Help group members reduce the feeling of isolation by bonding with others and feeling supported by their peers.
- Provide an opportunity for people to get inspired by other group members and their success stories.
What Do You Talk About in Group Therapy?
The choice of topics and methods depends on factors such as the type of addiction or age of group members. However, there are some common topics and activities for group therapy sessions:2
- The initial stage of group therapy is usually an orientation session. During this stage, the purpose of the group is articulated, working conditions of the group are established, the role of the leader is explained, members are introduced, and a positive tone is set for the group.1
- Some of the key group topics for substance abuse treatment may be triggers for substance abuse. Group members reflect on which situations trigger them to resort to substance abuse and which coping strategies they could use when triggered to steer clear from using substances. There are a number of group ideas for substance abuse treatment as well as resources that can be helpful in structuring this group discussion. Some questions that the members can discuss are:3
How do you deal with loneliness/anger/depression/anxiety? Are there ways to overcome difficult emotions other than substance abuse?
- Past traumas are often at the root of people’s addiction and they need to be addressed in group therapy. Tackling some past issues and analyzing them in a group may play the key role in recovery.4
- Group discussions about relationships and family dynamics help the participants analyze how the quality of their family and social relations has affected substance abuse.5
- In addition to the causes of addiction, an equally important topic is the nature of addiction. Group therapy is an opportunity for people to learn some facts about addiction (e.g. what goes on in their body when they abuse substances) to be more knowledgeable about the problem and confront it more effectively.1
- It is important that group members also discuss the effects of addiction on their life. Would they have made different choices or acted differently if they had not been intoxicated? How are other people affected by their addiction?
- An important educational aspect of group work is the development of healthy habits that should replace the harmful ones. People who are struggling with addiction often neglect their physical and mental health.6 Groups can serve as a source of inspiration for members to improve their habits: eat healthier food, have regular and sufficient sleep, do physical exercise, and pay more attention to personal hygiene.
- There are a number of activities that promote a sense of self-worth and increase the level of self-esteem. For example, group members can discuss their personal qualities, give and accept compliments, and write affirmations. Members should also be encouraged to celebrate their accomplishments on the road to recovery.
- Gratitude is another important topic that is frequently addressed in group treatment.7 Many people resort to substance abuse because they do not see a value or purpose in their life. Group therapy can help direct their attention to what is good in their life and what they should be grateful for (e.g. a second chance, relationships, recovery, and so on).
Frequently Asked Questions
- In order to create a warm and welcoming atmosphere and a sense of community during group therapy, especially at the beginning, it is recommended to include some less formal ice-breaking activities and cooperative team-building games.2Group activities can also include role-plays, in which members can simulate certain situations related to substance abuse. For example, they can simulate situations in which there is peer pressure and think of strategies on how to resist it. They can also play the role of their family members and put themselves into the position of people who are affected by their addiction.2Meditation and visualization are also quite common activities in group therapy sessions, especially in faith-based programs.2
- The role of the facilitator is to maintain a collaborative therapeutic setting. The facilitator needs to ensure that boundaries are clearly defined and respected, so that everyone would feel safe, both physically and emotionally.2The facilitator should work on encouraging communication among members, rather than only between members and the facilitator. This helps build relationships and a sense of community in the group. The facilitator in group therapy sessions generally tells less and listens more.2Furthermore, facilitators need to be mindful of some specific cultural or gender issues that may have an impact on group dynamics. For example, women are less willing to disclose their victimization in mixed-gender groups.2An often unstated and underrecognized challenge in group treatment is that dealing with the same topics in successive sessions may lead to boredom. To retain group energy and effectiveness, facilitators should switch topics and vary techniques in order to make sessions more dynamic and interesting for participants.2
1. Center for Substance Abuse Treatment (2005). Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series, No. 41. 1 Groups and Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
2. Center for Substance Abuse Treatment (2005). Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series, No. 41. 2 Types of Groups Commonly Used in Substance Abuse Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
3. Therapist Aid.Triggers.
4. Khoury, L., Tang, Y. L., Bradley, B., Cubells, J. F., & Ressler, K. J. (2010). Substance Use, Childhood Traumatic Experience, and Posttraumatic Stress Disorder in an Urban Civilian Population. Depression and Anxiety, 27(12), 1077–1086.
5. Center for Substance Abuse Treatment (2004). Substance Abuse Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series, No. 39. Chapter 1 Substance Abuse Treatment and Family Therapy. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
6. National Institute on Drug Abuse. (2004). Handout: Physical and Psychological Effects of Substance Use.
7. Ghalesefidi, M. J., Maghsoudi, J., Pouragha, B. (2018). Effectiveness of Gratitude on Psychological Well-Being and Quality of Life Among Hospitalized Substance Abuse Patients. Electronic Journal of General Medicine, 16, 10.