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Group Therapy, Group Therapy, Who, What, Who, What,
Where, and HowWhere, and How
Cheryl Gentile, MS, LPCS, Cheryl Gentile, MS, LPCS, LCAS, CRC-MAC, ACS, CCSLCAS, CRC-MAC, ACS, CCS
The Advantages of GroupThe Advantages of Group
Help members learn to cope with Help members learn to cope with problems related to substance abuse problems related to substance abuse by allowing them to see how others by allowing them to see how others deal with similar problemsdeal with similar problems
Reduces the sense of isolationReduces the sense of isolation Witness the recovery of othersWitness the recovery of others Provides information about recoveryProvides information about recovery Provides feedback to othersProvides feedback to others
Allow a single treatment professional Allow a single treatment professional to help a number of clients at the to help a number of clients at the same timesame time
Help clients overcome past harmful Help clients overcome past harmful experiences. experiences.
Encourage, coach, support, and Encourage, coach, support, and reinforce members as they reinforce members as they undertake difficult or anxiety-undertake difficult or anxiety-provoking tasks. provoking tasks.
Add needed structure and discipline Add needed structure and discipline to the lives of people with substance to the lives of people with substance use disorders, who often enter use disorders, who often enter treatment with their lives in chaos. treatment with their lives in chaos.
11 Curative Factors 11 Curative Factors
Instillation of hopeInstillation of hope UniversalityUniversality Imparting Imparting
informationinformation AltruismAltruism Corrective Corrective
Recapitualtion of Recapitualtion of Primary FamilyPrimary Family
Improved social Improved social skillsskills
Imitative behaviorImitative behavior Interpersonal Interpersonal
learninglearning CohesivenessCohesiveness CatharsisCatharsis Existential factorsExistential factors
Negative Attributes of GroupNegative Attributes of Group
Not for everyoneNot for everyone ConfidentialityConfidentiality Difficult to build trustDifficult to build trust Untrained facilitatorsUntrained facilitators Not enough time to meet everyone’s Not enough time to meet everyone’s
needsneeds Conformity vs. peer pressureConformity vs. peer pressure
Types of GroupsTypes of Groups
PsychoeducationalPsychoeducational
Skills developmentSkills development Cognitive–behavioral Cognitive–behavioral
Support Support
Interpersonal processInterpersonal process
Psychoeducation GroupsPsychoeducation Groups
Role of the facilitator is to educateRole of the facilitator is to educate
Targeted for the pre-contemplative Targeted for the pre-contemplative and contemplative stages of changeand contemplative stages of change
Provides information about recoveryProvides information about recovery
Structured with specific contentStructured with specific content
Skills Development GroupsSkills Development Groups
Facilitator is a role model and Facilitator is a role model and educatoreducator
Anger managementAnger management Resiliency Resiliency Identifying and avoiding triggersIdentifying and avoiding triggers Enhance coping Enhance coping Relaxation techniquesRelaxation techniques StructuredStructured
Cognitive–Behavioral GroupsCognitive–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
Interpersonal process GroupsInterpersonal 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
Self Help Vs. InterpersonalSelf Help Vs. Interpersonal
Peer leaderPeer leader VoluntaryVoluntary No screeningNo screening No theoretical No theoretical
approachapproach Unlimited numberUnlimited number No contractNo contract
ProfessionalProfessional INV or VoluntaryINV or Voluntary ScreeningScreening Multiple Multiple
approachesapproaches 8-15 members8-15 members ContractualContractual
Qualities of a Group FacilitatorQualities of a Group Facilitator
ConfidenceConfidence KnowledgeKnowledge SpontaneitySpontaneity IntegrityIntegrity TrustTrust HumorHumor EmpathyEmpathy
Facilitator SkillsFacilitator Skills
Active ListeningActive Listening ReflectingReflecting ClarifyingClarifying SummarizingSummarizing FacilitatingFacilitating EmpathizingEmpathizing InterpretingInterpreting QuestioningQuestioning LinkingLinking
ConfrontingConfronting SupportingSupporting BlockingBlocking AssessingAssessing ModelingModeling SuggestingSuggesting InitiatingInitiating EvaluatingEvaluating TerminatingTerminating
Stages of GroupStages of Group
FormingForming StormingStorming NormingNorming PerformingPerforming AdjourningAdjourning
Placement considerationsPlacement considerations
Meet with each candidate for group Meet with each candidate for group placementplacement
Assess the client’s level of:Assess the client’s level of:– interpersonal functioning interpersonal functioning – impulse controlimpulse control– MotivationMotivation– StabilityStability
The How TosThe How Tos
IntroductionsIntroductions Setting the NormSetting the Norm Provide directionProvide direction Facilitator acknowledges each Facilitator acknowledges each
member, and their reactions to one member, and their reactions to one anotheranother
Middle StageMiddle Stage
Content, information, and feelings Content, information, and feelings are expressed, and processedare expressed, and processed
Non verbal cues are addressedNon verbal cues are addressed
Ask members how they are doing in Ask members how they are doing in groupgroup
End StageEnd Stage
“ “Termination is more then the end of Termination is more then the end of therapy it is an important force in the therapy it is an important force in the process of change……a stage in the process of change……a stage in the individuals career of growth.”individuals career of growth.”
Yalom (1995, pp361-362)Yalom (1995, pp361-362)