1Group Therapy 1. how common is it 2. how favorable is it?
Most common form of treatment fo substance abuse
Considered treatment of choice
2Group vs Individual Treatment
Individual therapy provides more individualized pace
Individual has more advantages with certain problems
3Rationale for Group treatment from a clinician's perspective
Cost effective
Decreases the impact of individual session no-shows
Client's benefit from each other's experiences and certain types of training such as social skills
Fosters a sense of community, hope and optimism along with a sense of commonality and belonging
4Research on effectiveness of group therapy
Least effective vs most effective group therapy?
Effectiveness is equal or better than individual therapy in some findings
Least effective group approach = psychoeducational
Most effective group approach = cognitive behavioral coping skills and motivational interviewing groups
5Benefits of group therapy from a client's perspective
Group therapy is less costaly than individual treatment
Group therapy provides more effective medium for confrontation by peers
Provides useful info and knowledge
Allows role play
Clients can observe and model skills
Groups can provide useful information to new clients in recovery
6Curative Factors (Yalom) (will be on midterm) UIA-CSS-GI
Universality
Instilling hope
altruism
confrontation of denial
Socialization development
Safe space for feedback and skill practicing
Group cohesion
Imparting of information
7Types of Group therapy - 5
Psychoeducation
Skill Development
-Roleplay, communication skills, anger management, etc
Cognitive Behavioral groups
-Very effective
Support groups
-AA, CAFAA, NA, SA, etc
Interpersonal Process groups
-Unstructured (who wants to voice a concern)
-Free flow group for feeling processing of trauma, addiction, etc
8Practical Considerations - 10 considerations
Duration and Timing
Accessibility
Group Size (8-12)
Leaders (1-2)
Treatment Goals
Physical Contact - no touching is typically recommended; ask before anything
Contact outside group - generally discouraged until after group completes (can influence group dynamic)
Time limited vs ongoing - Open vs closed, time limited vs ongoing
Therapist self-disclosure - Treatment is about the individuals in treatment, not you
Talking Rules
9Therapist Style
Group-oriented style is best
Leader should be knowledgeable about substance abuse
Client centered approach is best
Therapist variables were best predictors of whether clients stay in treatment
Direct confrontation is not advised in early stages of group treatment
10Successful Group Facilitator
Empathetic and client-centered
Must build multiple alliances
Must build cohesion in the group
Requires more re-direction
11Recommendations for the first group session
Start with collaboration instead of leading with group rules
Leader presents an overview of group process
Leaders identify themselves and their mission to help clients improve
12OPEN - Approach to initiate every group session
Open with an overview of group purpose - learn about member thoughts, concerns, and choices
Personal choice is emphasized
Environment is one of respect
Nonconfrontational nature of the group