Using Group Therapy to Help with Addiction
Although most people think of group therapy in connection with primarily psychological disorders, the first therapy group was actually created for people suffering from tuberculosis. Using this treatment to help people recover from the chronic disease of addiction is consistent with this history. At Kolmac, I have drawn from several different types of group therapy to create an approach that I think is particularly suited to the needs of our patients.
Recovery from substance use disorders is an active, not passive, process that ideally involves interaction with other addicted people. The interventions of the Kolmac group leaders are therefore intended to stimulate interactions between patients rather than between patients and the leaders. In keeping with this approach, one of our measures of the quality of the group session is based on the extent of this patient-to-patient interaction. More specifically, the sharing of one’s own, personal experience is encouraged rather than the giving of advice, no matter how good. Staff members strive to assure an even distribution of patient participation by discouraging domination or withdrawal by individual patients. Educational interventions by the staff are brief and kept to a minimum.
The other primary measure of group functioning is the degree to which the focus of the group is on recovery-related issues. Discussions about topics such as sports events or legalization of cannabis are redirected to ways in which these issues might relate to one’s personal recovery.
Group Therapy Poster
Applying the parameters of patient-patient interaction and recovery-related content yields four possibilities. From this we create a diagram highlighted by colors based on traffic lights. We call the quadrant characterized by high levels of interaction and focus on recovery-related issues the “Green” zone. At the other extreme is the “Red” zone, while the two intermediate possibilities are called the “Yellow” zones. The goal is for the group to spend as much time as possible in the Green zone. One of the tasks of the group leaders is to help the group members recognize when they have moved into one of the other zones, and help them to move toward the Green zone, and stay there for as long as possible.
We recently decided to create a Group Therapy Color poster and put it on the wall of the group rooms as a reference (as well as at the beginning of this article). Our patients are reporting that this guidance has helped them use their group therapy time more productively.
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