The Role of Group Therapy in Primary Addiction Rehabilitation

Group therapy is complementary to, but distinct from participation in Twelve Step groups. Through the group process, growth is facilitated, isolation is reduced, and the concept of sobriety as an interpersonal experience is fostered. Indeed, group therapy is frequently considered the treatment of choice for addiction, allowing for positive peer interactions, improvement in communication skills, mutual support, confrontation of ego defenses and an overall substitution of the euphoric state of intoxication with the elation of the group.

Change is facilitated through interaction group dynamics. People are influenced by their interpersonal relationships and group therapy can therefore provide a corrective emotional experience by acting as a social microcosm of their interpersonal world in the here and now. As such, personal issues, conflicts, doubts or fears will emerge within the group. Through process illumination in which the leader and group members comment on specific behaviors and interpersonal communications, augmented by self-reflection, individuals are able to learn to understand the impact of their behavior on others and how they are perceived. Cyclical growth and change are the result of, and emanating from, self-exploration within the microcosm of the group.

The leader's role includes giving feedback, gently confronting, keeping the group in the here and now, and establishing a genuine, therapeutic relationship with the members. Clarification and confrontation are utilized as means of pointing out and explaining the contradictions in behavior between what people say and do. Through the modeling of confrontation, yet empathetic responses, the leader helps the member connect cause-and-effect behavior and increase their self-nurturing. Behavioral approaches such as communication and problem solving skills and assertiveness training can also be incorporated.

Conceptualizing addiction as a relationship hunger, treatment within a group setting allows for a shift in attachment or dependency from a drug to others. Group therapy offers the addicted individual the opportunity to recreate their individual concept of self in terms of their human emotions. Negative feelings of sadness, loss and separation can be dealt with in small doses through therapeutic encounters of groups of individuals.

Group therapy has become the mainstay of addiction treatment in most treatment centers. While the therapeutic process and resultant outcomes are evident, the role of individual counseling must not be overlooked. While group processing provides a context for gaining insight and effecting change, individual counseling establishes a trust and therapeutic rapport between client and counselor that is deeply personal and focused. Issues are often identified and surfaced in individual sessions that can then be processed further to effect change in the group dynamic. Group therapy and individual counseling are synergistic and provide optimal benefit when utilized in tandem during the primary recovery process.
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