Group counseling for substance use disorder is a challenging and yet effective way to help individuals with this problem through a system of activities and techniques. The group sessions prove to have a positive effect on the behavioral outcomes among substance abusers. For people who have a history of alcohol and drug addiction, a choice of group counseling is a chance to engage in meaningful psychological interventions capable of restructuring the behavioral patterns and improving the cognitive processes that facilitate the recovery. The introduced group is aimed at utilizing cognitive behavioral therapy to help group members achieve treatment goals through individual and interactive interventions. The proposal provides a rationale for the group type, its basic characteristics, applicable theories and techniques, engagement strategies, ethical considerations, and evaluation of the outcomes. The implementation of the group is anticipated to achieve a substantial level of symptoms improvement among the participants with substance use disorder.
Group Components
The group for substance abuse includes individuals with drug and alcohol addiction. The behavioral patterns and the level of willingness of such individuals to change their lives differ. Therefore, the counselor’s task is to find relevant means of influence, effective techniques of group interaction, and flexible approaches to each group participant to ensure beneficial outcomes for everyone. The screening process and the choice of setting should align with the group’s purpose.
Participants
The individuals participating in the group will be the inpatients at a residential treatment center. The target population includes people recently diagnosed with a substance use disorder and those seeking help. The participants will be allocated on a voluntary basis. Both males and females aged 18 and older will be included in the therapy. No ethnic or nationality constraints should be applied when submitting individuals to group sessions. Since the participants are expected to be the residents of a treatment center, the counseling interventions will be designed for those who failed to struggle with the addiction independently and have admitted the need for professional help.
Setting and Structure
The group session will take place at a residential treatment center and will be an integrative part of the participants’ recovery process. The sessions will be organized within a 10-week program of intensive therapeutic interventions. The meetings will be held twice a week and will last for two hours each. Overall, the participants will be exposed to a 40-hour treatment group, during which the issues leading to substance dependency, the particularities of behavior and cognition associated with substance use, and the coping methods will be discussed. The size of the group is anticipated to engage from ten to twenty participants, which will allow for comfortable work of the counselor and effective outcomes for the members.
It will be an open group, which will allow for the participants’ free joining and leaving therapy at any stage (Corey, Corey, & Corey, 2018). Thus, the sessions will be designed in a manner that will allow for achieving short-term goals within one session; however, will be integrative parts of a general process of recovery. In such a manner, each participant will be able to observe a certain level of improvement upon each session and will be motivated to engage in the consecutive meetings. Each group session will start with a check-in procedure, discussions of the previous assignments, and new topics. The discussions of main topics, such as substance use, dependence, coping skills, relapse prevention, and others, will occur in a small and large group, enabling each member’s active participation. At the end of each meeting, the members will be able to ask questions and receive responses to them. Also, the tasks for work on the discussed issues at home will be given after each session. Consequently, the systematic and continuous inclusion of the participants to the group process will be achieved.
Goals
As mentioned above, group therapy will be designed for patients diagnosed with a substance use disorder, including both drug and alcohol addiction. Therefore, the purpose of the sessions is to develop participants’ stress coping skills, self-control, relapse prevention, and contingency management, as well as the ability to identify and address behavioral issues related to substance use (Lo Coco et al., 2019, p. 105). The ultimate goal of the group is to encourage members to face substance-related problems and eliminate abusing behavioral patterns by enjoying the benefits of a sober life. These goals are achievable through cognitive behavioral therapy.
Theory and Techniques of Substance Use Disorder Group
Cognitive Behavioral Theory
Cognitive behavioral therapy is based on the action-centered approach that prioritizes the change in behavior and attitudes toward the problematic area. According to Corey, Corey, and Corey,2018), the behavioral aspect of the therapy method entails the development of specific skills that will help change the ultimate behavior. In the case of a substance use disorder, the patients will cultivate communication skills and coping skills that facilitate the resistance and enhance relapse prevention. The core of the behavioral approach is its restructuring of the patterns in the current patients’ behavior by recognizing their harm and ineffectiveness in coping with addiction. Through a series of interventions, the members of the group are expected to acquire a new set of skills and behavioral patterns that will enable contingency of recovery.
As for the cognitive aspect of the proposed therapy, it mainly concentrates on the restructuring of the patients’ beliefs and perception of the problem. This approach justifies that the way people think about an issue determines the methods of coping with them. Therefore, the chosen therapy allows for altering the participants’ faulty thinking and inadequate decision-making in relation to substance use and other harmful choices in life (Corey, Corey, & Corey, 2018). The core belief of the supporters of the cognitive approach is that people can easily acquire faulty thinking but that they can substitute them with new, correct ones. When placed in the setting of substance abuse, this approach acquires significant relevance, since addicts have erroneous attitudes toward alcohol or drug intake, thus causing harm to themselves. When obtaining a tool of coping with unreasonable decision-making, group members will be able to withstand the problem on their own upon the completion of the sessions.
Ultimately, the combination of the two elements, the behavioral and the cognitive, into one approach allows for obtaining a systematic change in the attitudes and behaviors, which are crucial for substance use disorder patients. A group counselor is a leader, and a teacher who educates the participants about the causes of their problems and explains the rationale ways of coping with those problems through informed methods (Corey, Corey, & Corey, 2018). Overall, cognitive behavioral theory concentrates on the engagement of the participants into the learning process through meeting interventions and home assignments both inside the sessions and outside of them. In the field of psychotherapy and social work, the techniques used within cognitive behavioral therapy prove to bring the most effective results (Lo Coco et al., 2019). This method allows for obtaining long-term effects and continuous positive change in the behavior of those suffering from substance use disorder through self-control skills and positive mind-set.
Techniques
The techniques that are believed to be effective for a substance use disorder treatment group might contain a combination of cognitive and behavioral interventions. They include Socratic dialogue, guided discovery, “self-monitoring to recognize cravings early and identify situations that might put one at risk for use, and developing strategies for coping with cravings and avoiding those high-risk situations” (“Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine),” 2018). These techniques allow for substantial work with each individual in a group, provide peer support and integration of each member in the group. Also, they facilitate the respect to participants’ values by addressing the issues that they all have in common, as well as those individuals, might have in particular.
Firstly, the Socratic dialogue technique provides an opportunity to engage al the group or divide the participants into several smaller groups for a discussion of philosophical and moral issues. Through the interaction with the group, each individual expresses his or her way of thinking concerning issues and learns from others. Similarly, the technique of guided discovery allows the members of the group to identify alternative ways of thinking, recognize the faultiness of their own approach to their decision-making, and acquire new cognitive patterns (Corey, Corey, & Corey, 2018). The role of the group facilitator is crucial here since it is necessary to guide the participants through the intervention and ultimately ensure their achievement of the anticipated goals.
Secondly, the techniques of self-monitoring might be utilized through journal writing and reflection on the behaviors with the application of objective reasoning. This technique might be used as a basis for home assignments where the group members will be exposed to continuous self-exploration and analysis of their behavior (“Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine),” 2018). Similarly, the technique of the development of skills helping to cope with cravings enables to align the observed behaviors with the possible ways of eliminating the erroneous ones.
Effective Engagement Strategies
Due to the fact that the proposed group is an open one, the issue of participants’ engagement is pertinent. The members will be allowed to join and leave at any moment; therefore, it is of the counselor’s priority to ensure positive outcomes for everyone. It is possible to increase the level of engagement through the application of specific engagement strategies. It is strongly believed that the cooperation based on mutual respect, orientation on the result, continuous support, and favorable climate during the sessions will promote participants’ attendance and engagement.
Firstly, by allowing the participants to express their opinions freely and openly, the counselor will ensure the achievement of cognitive behavioral therapy goals. Also, people will feel comfortable in the presence of others and will be willing to participate. Secondly, by encouraging the members to engage themselves in the interventions at a comfortable pace, the group leader will express respect and understanding toward the needs and preferences of each individual. In such a manner, the members will have an opportunity to proceed through the program by engaging in the activities to a degree they deem sufficient. At the same time, they will be supported in their respective progress.
Thirdly, the leader is expected to lead the discussions in a respectful manner without extreme opinion expression and with regard to the values and beliefs of the group participants. In accord with the previous strategy, the awareness of the diversity of the group will amplify the level of trust of the group toward the counselor and will enhance their engagement in the sessions’ activities. Fourthly, to maintain participants’ attendance, one should continuously demonstrate the group goals and current achievements by appealing to the individuals’ reflection on their experience (Corey, Corey, & Corey, 2018). Well-structured therapy will bring positive results, which need to be demonstrated for motivational purposes. Finally, the fifth strategy consists in encouraging engagement in all activities as an effective way to recover from the perspective of the importance of professional help. Indeed, it is vital to show the validity of professional counseling in comparison to self-helping therapeutic interventions. The effectiveness and the evidence-based therapy utilized within the sessions might become a reasonable motivation for the clients to maintain their recovery in a group.
Ethical Considerations for Group Discussions
Facilitating a group consisting of ten to twenty individuals is a challenging process. Moreover, it might be complicated to achieve anticipated results through ethically informed decision-making. However, it is vital to ensure that the needs and interests of each member of the group are met. Since the group incorporates individuals of different ages, genders, ethnicities, and social statuses, it is important to encourage the participants to employ a respectful manner of discussion. Also, the issues related to substance abuse are of personal character; the treatment process entails sharing, feelings, exposure, and public demonstration of personal issues. The counselor should address these aspects when encouraging different individuals to participate (Corey, Corey, & Corey, 2018). The principles of voluntary participation in the interventions will be utilized to ensure ethical treatment process. Also, the counselor will consider the stages of group development to pursue the mediation of individual and group interests.
Group’s Success Measurement
To measure the group outcomes, it will be necessary to compare the perception of the problem by the participants before and after the sessions and also apply an objective evaluation of the counselor. For that purpose, one will apply a questionnaire for self-reflection for the participants. As it is shown in Figure 1, it contains questions related to behavior patterns and cognitive perception of addiction (Dobson & Dobson, 2018, p. 25).
Figure 1:
Secondly, an interview will be conducted with the participants, the results of which will be combined with the observation of the performance of the group members during the sessions. This approach will allow the facilitator to ensure an objective evaluation of the changes in participants’ behavior and estimate their progress in the recovery process. Thus, the measurement of the outcomes will be an indicator of the effectiveness of the group and will allow for improving the approach for future usage.
References
Cognitive-behavioral therapy (alcohol, marijuana, cocaine, methamphetamine, nicotine). (2018). Web.
Corey, M.S., Corey, G., & Corey, C. (2018). Groups: Process and practice (10th ed.). Boston, MA: Cengage Learning.
Dobson, D., & Dobson, K. S. (2018). Evidence-based practice of cognitive-behavioral therapy. New York, NY: The Guilford Press.
Lo Coco, G., Melchiori, F., Oieni, V., Infurna, M. R., Strauss, B., Schwartze, D., … Gullo, S. (2019). Group treatment for substance use disorder in adults: A systematic review and meta-analysis of randomized-controlled trials. Journal of Substance Abuse Treatment, 99, 104-116.