Many of us in the clinical community have shared ideas about the critical elements that are basic in the treatment of patients in group therapy for substance use disorders. Here are three that I (Moe Briggs) would suggest.
Change: Beginning with abstinence, treatment is first an opportunity to make change for the better, change one might not make in a self-directed manner. The primary task of the treatment provider is to create and maintain an environment in which patients can make change if they choose to do so. The milieu serves as a “change agent.”
A significant part of the treatment environment is structure. The establishment of boundaries is crucial to changing behavior. Often repeated is the phrase, “Patients must act their way into a new way of thinking because if they could think their way into a new way of acting, it’s doubtful that treatment would be necessary.” Change is determined by what one is willing to give up, such as the obstacles to one’s progress; not by what one might get. Learning to be on time, for example, initiates behavioral change. Being required to be on time is a new boundary for many and a positive recovery value.
Choice: One of the greatest of human freedoms is the power of choice. If one cannot see all sides, there is no choice. Treatment, including group therapy for substance use disorders, can support the ability to explore, which can lead to the discovery of options and help with the development of insight. Weighing options, making decisions and moving into action is an important part of the recovery process.
Community: The third element of effective treatment is a focus on the patients’ approach to relationships. The group therapy process that is central to addiction treatment supports the social re-engagement process. Issues of safety, commonality and hope are fundamental to treatment. Recovery in isolation is doubtful; social isolation protects the addiction. Social engagement with positive peer culture insulates recovery. This can be experienced, learned and practiced in the group setting.
Techniques, strategies and interventions are important, but without the intrinsic elements mentioned, they more than likely will fall short. This is important to consider for group therapy for substance use disorders.
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