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)