Group Psychotherapy With
Addicted Populations
HLSC 2120
A well conducted group
 Flores
states: A well-conducted group in
conjunction with AA has a substantial
impact on the treatment effectiveness
with this population.
Group Psychotherapy
 Modern
group therapy is aimed at
resolving impediments of its members
by saying new things and establishing
new relationships.
1) Bridging

Melt barriers of isolation.

It is believed that clients are more apt to
respond to peer influence rather than to
authoritative influence.

Similarity bridging

Reactive bridging
2) Focus on Immediacy
A
group in which resistances to
immediacy are resolved is a group that
brims with life.

Flores
3) Establishing
the Observing Ego
The insightful one’s
4) Developing the Insulation
Barrier
 The
therapist has learned how to
strengthen and thicken these insulation
barriers so that these people can more
successfully wall off what is noxious to
their function and sense of self.
5) Accentuating Emotional
Communication
 One
of the most important technical
operations is to keep the group on an
emotional level.
The Influence of the Disease
Model
 Rather,
it is seen as a primary condition
that must first be arrested if any
progress in treatment is to be achieved
and abstinence from all chemicals must
by the first goal of recovery.
Disease concept
 However,
the disease concept stands
that view completely on its head.
Depression, anxiety, and character
pathology are now viewed as a
symptoms-the result, not the cause-of
addiction.
Specific Implications of Group
Therapy with Chemical Dependency
 …the
nature of the addiction process
itself, which either produces or
exacerbates depression, anxiety,
isolation, denial, shame, transient
cognitive impairment, and character
pathology.
A disease of denial
 Addiction
is, in fact, frequently cited as a
disease of denial.
Altering a defensive style
 …the
advantages group psychotherapy
provides by confronting and altering the
addict’s and alcoholic's defensive style
is a major theme.
The power of peer influence
 “By
the crowd, they have been broken,
by the crowd they shall be healed.”

Ettin (1998)
Group Therapy

Washton (1992) summarizes advantages of
group therapy
1) Mutual identification with and acceptance from
others going through similar problems.
2) Positive role modeling for abstinence and reality
testing about chemical use is enhanced because the
addicted person has the opportunity to better
understand their own attitudes about addictions and
their defenses against giving up chemicals by
confronting similar attitudes and defenses in others.
Group Therapy
3) Confrontation, immediate feedback and positive
peer pressure for abstinence.
4) Affiliation, cohesiveness, social support while
learning to identify and communicate feelings
more directly.
5) Structures, discipline and limit setting while
permitting experiential learning and exchange of
factual information about recovery and drug use.
6) Instillation of hope, inspiration for the future and
the pursuit of shared goals and ideas.
Addiction viewed as a disease
 Accepting
addiction as a disease means
viewing this condition as a physiological
illness with emotional, behavioral, and
conditioned response components, not
as a secondary sign or symptom of
some underlying mental or emotional
disorder.
Disease concept
 Finally,
the disease concept establishes
addiction as the primary illness and not
some underlying symptom that will be
alleviated once the real problem is
solved.
Physiological effects
 …flexible
thinking, fluid intelligence, and
new learning, alcoholics and addicts
consistently score in the brain-impaired
range. Yet their verbal intelligence and
old learning remains pretty much intact.
Consequently, they will often appear
unimpaired to the unsuspecting
observer.