Group Therapy in Addiction Treatment
Overview of Group Therapy
- Allows people to share experiences with others who are dealing with similar issues.
- Can consist of as little as 3–4 members or more than 12.
- Generally held once or twice weekly for 1–2 hours.
- Appears to be more effective in an inpatient setting.
- Type of group is determined by the therapist and can include support groups, skills development, and psychoeducational.
What Is Group Therapy?
Group therapy is a specific form of counseling that is used to treat psychological disorders including substance abuse and addiction.
It typically involves regular sessions where one or more therapists work with several individuals who are being treated for the same health issue.
Many people benefit from the peer support in group therapy.
This form of therapy may be offered in a:
- Private practice setting.
- Mental health clinic.
- Community center.
Group therapy can help people in several ways:
- Being able to interact with other people who are learning how to cope with and overcome a drug or alcohol addiction can be quite helpful for those who are beginning the process.
- This type of setting also helps members realize that they are not alone and allows them to share information and experiences with one another, which can help boost confidence and self-esteem.3 Overall, sharing experiences and feelings has been shown to reduce stress, guilt, and pain among group therapy members.4
- Group therapy becomes a setting in which members can learn how to avoid engaging in destructive behaviors such as actively seeking out drugs, and instead begin to practice new, healthy behaviors.
The therapist provides a structured platform that controls the discussions and also offers feedback and additional advice that helps each member gain a better understanding of themselves as well as ways to make continuous progress.
Addictions Treated by Group Therapy
- Alcohol addiction
- Tobacco or nicotine
- Prescription pain medication
- Opiate addiction
- Stimulants (e.g., methamphetamine, ecstasy)
- Hallucinogens (e.g., LSD)
- Illegal (e.g., cocaine, heroin) or recreational drugs (e.g., marijuana)
Is Group Therapy Effective?
We asked 379 alumni to rate their satisfaction with a variety of treatment centers based on selected criteria.
We found that those who had a positive group counseling experience were 168% more likely to recommend their treatment facility to others. This suggests that group therapy plays a big role in treatment success and satisfaction.
How Group Therapy Is Used to Treat Addiction
The basis for group therapy is helping members progress through the 6 stages of recovery:
- Pre-contemplation: Clients are not actively considering changing their substance abuse behavior because they do not believe they have a serious problem. Other factors (e.g., family, counselors) led them to attend group therapy.
- Contemplation: The therapist’s guidance and group sessions begin to cause clients to think about decreasing their drug use or quitting altogether.
- Preparation: The client is still using the substance but plans on stopping due to understanding the harmful consequences of substance abuse and recognizing the advantages of quitting.
- Action: This involves choosing a strategy to stop the substance abuse and beginning to make the necessary changes to carry out the plan with the help of the therapist and other group members.
- Maintenance: The client works hard to remain abstinent and avoid relapsing. Some clients achieve complete recovery at this stage.
- Recurrence: A client relapses and returns to one of the previous stages. They can quickly progress back to the maintenance stage and may have gained a better understanding of the problems that led to the relapse.
Typically, a licensed therapist will be able to determine what type of group therapy best suits a client based on how willing they are to change and participate in group therapy.5
5 Types of Groups Used
A 5-group therapy model is a common and effective form of treatment for substance abuse. It is led by a team of licensed therapists and entails the following 5 types of groups:5
- Psychoeducational groups focus on feelings and anger management, conflict resolution, prevention, trauma (e.g., abuse or violence), health and wellness, culture, and family roles.
- Cognitive behavioral groups focus on building new skills, conflict resolution, anger/feelings management, relapse prevention, and early recovery.
- Skills development groups focus on the same factors as the cognitive behavioral group, as well as relaxation training, meditation, and life skills training.
- Support groups focus on relapse prevention, trauma, spirituality, culture, ceremonial healing practices, and gender-specific topics.
- Interpersonal Process Group psychotherapy focuses on trauma and different forms of abuse, psychodynamics and humanistic/existential topics.
Additional forms of group therapy include:5
- Specialized groups in substance abuse treatment typically in the form of 12-step programs, but may also entail ceremonial healing practices, expressive therapy, gender-specific topics, adventure-based activities, marathons, and psychodrama.
- Relapse prevention treatment groups focus on providing continuous support, psychological education about the consequences of addiction, cognitive behavioral therapy, and skills development.
- Communal and culturally specific groups offer community support as well as culturally based topics and activities.
- Expressive groups focus on different forms of therapy including art, dance and drama.
What to Expect in a Therapy Session
- Room setup: The actual sessions may involve meeting in a room where chairs are arranged in a circle for small groups. But the chairs may be in rows facing a platform for larger groups.
- Introduction: Sessions often begin with members introducing themselves and briefly stating why they are attending group therapy.
- Updates: Regular members may share their progress and experiences since the last session.
- Group discussion: The therapist then decides how the meeting will proceed, whether it be through member dialogue or more of an educational session.
- Learning aids: Different types of learning material such as memory improvement techniques, visual aids, written projects, audiotapes, role playing, homework, and review sessions may be used as well.
General Characteristics of a Group
- May consist of as few as 3 to 4 members, or as many as more than 12 members depending on the setting in which the sessions are held.
- Generally meet once or twice weekly for 1–2 hours.5
- May be structured in an open manner, which would allow new members to join at any time. Or they may have a closed structure in which only the main members are allowed to participate to the end of the program.
- May also be group-focused, therapist-focused, or a combination of both.
Length of Treatment
In general, the type and length of group therapy that is recommended to a client depends on the member’s motivation to participate in the treatment and their stage of recovery.
- Substance abuse treatment programs often require members to attend a certain number of minimum sessions (e.g., 6 sessions) over a 3-month period. But one full year of sessions may also be recommended.5 Most of these types of meetings are outpatient forms of treatment where members are responsible for attending.
- There are also 4–6 week daily treatment programs for clients who need this type of intensive therapy due to the severity of their substance abuse. These types of sessions are usually a part of inpatient treatment programs.
Furthermore, when a client reaches a particular stage of the recovery process, they may also be encouraged to join a particular group. The length of treatment may vary depending on how long a client takes to progress from one stage to the next.
Cost of Treatment
The cost for substance abuse treatment varies depending on:
- Whether you receive inpatient or outpatient treatment.
- Whether you have insurance that will cover this form of treatment.
- Your individual case as well as each center’s particular program. Some facilities provide services for a monthly fee, while others may offer daily rates.
If therapeutic drugs are given in combination with group therapy, the cost usually becomes substantially higher.
If you do not have health insurance, contact Substance Abuse and Mental Health Services Administration (SAMHSA) to discuss financial options.
Group Therapy with Other Treatments
Therapeutic drug treatment may be needed in conjunction with group therapy, depending on the form of addiction an individual has.
For example, opiate addiction often requires a detoxification process in which medications such as methadone or buprenorphine are given to clients to taper off of the opiate with less withdrawal symptoms.6 The client may be referred to group therapy during this treatment or when they reach the stabilization or maintenance stage.5 The therapist will usually indicate when the time is right to join group therapy.
Group Therapy Effectiveness in Treating Addiction
According to recent studies, group therapy that is offered in an inpatient setting appears to be more effective at helping clients overcome their addiction by focusing on treating anxiety, painful withdrawal, and symptoms of depression.7,8 Clients who are asked to come into a facility for weekly sessions are less likely to complete the entire program, often due to a lack of motivation to continue.8
Therefore, assessing a client’s motivation to change at the initiation of treatment is an important factor in predicting whether or not the individual will completely recover.
What to Look for in a Therapist
- Degree: Be sure that the professional holds either a master’s or doctoral degree in counseling, psychology, etc., from an accredited institution of higher education.
- Licensure: Licensed professionals usually have to pass a state exam as well and usually have a copy of their degree in their office where clients can see it.
- Group therapy experience: Asking the therapist how long they have led group therapy sessions also helps provide an indication of how much experience a therapist has at facilitating these types of sessions.
Find a Program
- Ling, W., Amass, L., Shoptow, M., et al. (2005) A multi-center randomized trial of buprenorphine-naloxone versus clonidine for opioid detoxification: Findings from the National Institute on Drug Abuse’s Clinical Trial Network. Addiction 100, 1090–1100.
- Bell, J.R., Butler, B., Lawrance, A., et al. (2009) Comparing overdose mortality associated with methadone and buprenorphine treatment. Drug Alcohol Depend, 104, 73–77.
- Yalom, I. D. & Lesczc, M. (2005). The theory and practice of group psychotherapy. New York, NY: Basic Books.
- Kanas, N. (2005). Group therapy for patients with chronic trauma-related stress disorders. International Journal of Group Therapy, 55(1), 161–166.
- Center for Substance Abuse Treatment. Substance Abuse Treatment. (2005). Group Therapy. Treatment Improvement Protocol (TIP) Series, No. 41. Rockville (MD): Substance Abuse and Mental Health Services Administration (US).
- Katz, E.C., et al. (2009). Brief vs. extended buprenorphine detoxification in a community treatment program: engagement and short-term outcomes. The American Journal of Drug and Alcohol Abuse, 35, 63–67.
- Hunter, S.B., Paddock, S.M., Zhou, A., Watkins, K.E., & Hepner, K.A. (2013). Do client attributes moderate the effectiveness of a group cognitive behavioral therapy for depression in addiction treatment? Journal Behavioral Health Services Res, 40(1), 57–70.
- Lunde L.H. & Skjotskift S. (2012).Group therapy for drug addiction. Tidsskr Nor Laegeforen, 132(2), 132–3.