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Unit 6 Assignment
Scenario 2: Sam
Maricay O’Shea
Department of Psychology, Purdue University Global
PS521: Group Counseling
Dr. Jacquelin Darby
March 16, 2020
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Abstract
This paper addresses the case study of an individual who has been court-ordered to a
psychoeducational group due to the conviction of driving under the influence of drugs and/or
alcohol. There is a complete biopsychosocial based on the information provided by the client at
the time of the initial interview. Addressed are strengths and challenges a group leader will face
in running this particular type of group and how that group leader can use their strengths to
overcome the challenges. Problems at each stage of group therapy, including the initial,
transition, working, and final stage, are mentioned that the client will face, as well as how these
problems can be addressed effectively. The process in which assessment of the client are
described, including examples of the client’s long- and short-term goals.
Keywords: biopsychosocial, group leader, stages of group therapy, assessment
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Sam is a 26-year-old Caucasian male, who was born and raised in Pompano Beach, FL.
He lives with his parents, who are still married, and his younger brother, Jake, who is 21 years
old. He implies that he is in a serious relationship, however, expresses that it is “toxic” due to
his inability to stay sober for longer than thirty-day periods of time, to which is when he is in
treatment for substance abuse or living in halfway houses. He notes that the toxicity and
instability often times makes him feel inadequate, insecure, and lowers his self-esteem quite
tremendously. Sam states that him and his girlfriend have been trying to have a baby, but he is
afraid that all the drugs he has done in his lifetime will prevent that from becoming a reality, and
this often feeds into his depressive state of mind; noting that he feels like he has no purpose in
life anymore. He is a high school graduate, but he has no college level education and has no
future plans to go to college. He claims to bounce from job-to-job as an electrician, in which he
claims to be “really, really good at it.”
Sam reports to having smoked what he thought was marijuana when he was younger (16
years-old) and states that he has never been the same since, that something in the drug changed
his personality completely. There are times, he reports, that he is paranoid and often isolates to
cope with the constant craving to use substances of any kind. He reports to using any type of
substance he can get his hands on, whether it be drugs or alcohol, but he does not enjoy smoking
marijuana because he doesn’t enjoy the effects. He expresses that he hears voices in his head
that urge him to use drugs most of the day, more days than none. He reports to having used
mainly crack, amongst other drugs and alcohol, for six years straight now. He has been
homeless a number of times and has been in and out of treatment facilities (6 total), but he
currently resides with his parents and younger brother because he claims that treatment does not
work for him. His medical reports indicate that he is positive for Hepatitis-C, in which he states
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that he contracted from needle use. When asked to describe his moods, Sam confesses that he
gets extremely angry and often times aggressive when he gets the urge to use and people want to
stop him. He articulates that those fits of anger happen about three to four times per week. He
discloses that he has attempted to physically attack his girlfriend by forcing her out of his car
during a night when they were drinking heavily, because he wanted to go get high. Although he
says his girlfriend is extremely supportive, as evident by the fact that she hasn’t left him in over
two years, he admits that he feels scared that she will eventually leave him if he doesn’t change
his ways and stop using. Sam alleges that his feelings of abandonment cause him to push her
and others close to him away, and he says that these irrational feelings cause him to want to use
more days than none. He reports having no close social network of friends, but knows he is
loved by his mother, father, and brother.
Sam has come into the office for consideration to be a member of a court ordered
psychoeducation group after being convicted of driving under the influence of drugs and alcohol.
He was arrested after he crashed into the back of another person’s vehicle with a blood alcohol
level more than double the legal limit and in his possession was a dime-sized baggy of crackcocaine. He displays signs of anxiety, as it was hard for him to sit still for longer than three to
five-minute periods of time. He shows signs of substance abuse by his own admittance of using
a variety of drugs and alcohol from the age of 16 years old to present (26 years old) and while
driving the day of the accident/arrest. Sam was alone in his vehicle, claiming that him and his
girlfriend had gotten into an argument and he left her house to go use. His paranoia and voices
urging him to use could be symptoms of an underlying mental health disorder. With his claim of
depression, substance abuse, anxiety, paranoia, and constantly feeling inadequate to the people
around him, a psychological test has also been recommended.
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Group therapy with individuals who have past and present accounts of substance abuse or
dependency involve a leader to be active and responsive (Substance Abuse and Mental Health
Services Administration, 2005). Group leaders should be able to keep the group dynamic up and
members on task, while making sure that they are engaged throughout the process in a
meaningful way with one another and by being honest with themselves (Substance Abuse and
Mental Health Services Administration, 2005). According to Substance Abuse and Mental
Health Services Administration (2005), the center of attention should never be on the leader; the
leader should be able to acknowledge the differing personalities of group members, while always
searching for commonalities in the group therapy process.
Every group leader will experience strengths and challenges within the groups they are in
charge of running. Three strengths of mine in regard to Sam’s group scenario include a belief in
the group process and enthusiasm, empathy, and a firm identity. My ultimate goal is to inspire
the members of my group and show them that change is possible, and the interventions of the
group can work for them in the same respect they have worked for many, which is especially
important to involuntary groups like Sam’s. Being empathic means communicating respect for
and being accepting of my members and their feelings, encouraging a nonjudgmental,
collaborative relationship, and gently persuading, while understanding that the decision to
change is the theirs alone. According to Corey (2016), to do this effectively a group leader needs
to care for each of its members. In order for me to help my group members discover who they
are, it is important that I model being aware of my own competences and tendencies. In other
words, I am able to ask myself questions like, “Am I cutting off discussions that could lead to
verbal expression of anger because I am uncomfortable with anger?” or “Have I blamed clients
for the group’s failure to make progress?” (Substance Abuse and Mental Health Services
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Administration, 2005). The Substance Abuse and Mental Health Services Administration (2005)
claims that leaders who are not in control of their own emotional responses can do a substantial
amount of harm, espcially if they are unable to admit a mistake and apologize for it, and I feel
confident in my own skin.
As confident as I am with my own identity, there are some foreseeable challenges I am
likely to face as a group leader, especially in an involuntarily ran psychoeducational group for
individuals with a driving under the influence (DUI) charge hanging above their head. As a
beginning leader, I am faced with the initial anxiety of getting the group started and keeping the
momentum up and moving effectively. Being in recovery for addiction and having had two
DUI’s myself, I am facing the challenge of self-disclosure and/or how much of my story I am
willing to divulge to the members of my group, like Sam, who I may feel a strong connection
with because of our similar cases. In my opinion, these challenges are valid and came be
addressed by using my strengths.
According to Corey (2016), it is beneficial to have a moderate level of anxiety because it
can lead to honest self-reflection. I can use my awareness of personal strengths, limitations,
needs, fears, motivations, and goals as a way to steer my initial anxiety in a more positive
direction, rather than making it counterproductive. Corey (2016) suggests voicing questions and
concerns and exploring them with more experienced leaders, perhaps a supervisor. As far as
self-disclosure, I believe that my ability to be empathetic will be the key to addressing this
concern. Instead of disclosing the personal details of my own journey, I would rather convey
empathy by modeling it through the group process. I feel that I can model empathic interaction
for group members, in regard to individual’s like Sam with substance use disorders who often
cannot recognize and convey their feelings, let alone value the emotional world of others. My
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goal would involve teaching group members to appreciate one another’s independent world and
empowering clients to develop empathy for each other through their own personal stories.
Often times individuals enter into the the initial stage of a psychoeducational group with
conflicting emotions; some excitement mixed with apprehension and resistance (Alle-Corliss &
Alle-Corliss, 2009). Due to the fact that Sam has stated that treatment doesn’t work for him, he
will be anxiously observing other members and assessing his own level of comfort about sharing
in the group because he doesn’t yet trust the process. Consciously or unconsciously, at this
stage, Sam will be exploring his fears and expectations concerning his particular role in the
group. According to Corey (2016), it is a misconception to believe that individuals like Sam will
“naturally” trust one another and the process of the group at this point. In order to optimize
Sam’s treatment in the initial stage of group and address his trust issues, it is important to allow
him to express his expectations, concerns, and anxieties openly (Alle-Corliss & Alle-Corliss,
2009). Alle-Corliss & Alle-Corliss (2009), suggests that during this stage of the group, the
leader should clarify any misconceptions about the group process in general. This can be done
by recapping information previously stated in pre-group interviews and going over the general
purpose, objectives, and expectations of the group to show a level of preparation and planning
(Alle-Corliss & Alle-Corliss, 2009). Alle-Corliss & Alle-Corliss (2009) notes that this type of
structure, along with introducing confidentiality and informing the group of guidelines,
responsibilities, and expectations early on will create a climate of trust for someone like Sam.
It is common for members to start to truly work on their different issues at a more
complex level as they move into the transition stage and for Sam this can bring up a tremendous
amount of anxiety causing resistance (Alle-Corliss & Alle-Corliss, 2009). At this stage of the
game, Sam may begin to become reluctant and hesitant about making changes that will cause
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him some level of discomfort. He has many personal issues and has painful feelings about the
way his life has been going, for example, the physical conflict he had with his girlfriend,
therefore his resistance may start to deter him from exploring and dealing with emotions
effectively. In order to optimize Sam’s treatment in the transition stage of group and address his
resistance, it is important to expect and accept his level of resistance and understand that it may
just be a defense mechanism because he is fearful. Allie-Corliss & Allie-Corliss (2009) suggests
being open to addressing the resistance directly and empathetically, modeling acceptance and
striving to develop a respect for his resistance, as it may serve a valuable purpose, and/or be
willing to relax and listen to the Sam while placing responsibility on him. These strategies will
allow for a better understanding of new insights and awareness of Sam as an individual.
The working stage is known to be the center of the group process and it is the time in
which members benefit the most from (Alle-Corliss & Alle-Corliss, 2009). At this time in the
group process, Sam will be ready to work through many of his issues and he has developed a
sense of belongingness, and this is where productivity within the group commonly arises (AlleCorliss & Alle-Corliss, 2009). According to Alle-Corliss & Alle-Corliss (2009) this is when
members are also more likely to talk straight to one another rather than to the group leader, and
they appear more safe in their own skin, therefore, they are less anxious about the other
members’ and the leader’s hopes for them. In Sam’s case, this level of cohesiveness may make
him feel so comfortable and secure that he resorts back to resisting to challenging himself any
further. In order to optimize Sam’s treatment in the working stage of group and address his
cohesiveness, Allie-Corliss & Alle-Corliss (2009) suggests that the leader takes the initiative to
continue encouraging members to note their commonalities and focus on the mutual bond that
links them. To prevent cohesion from causing inactivity or disinterest, leaders must encourage
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members to actively work on goals and challenges by calling each other out (Allie-Corliss &
Alle-Corliss, 2009). This is extremely important in Sam’s cause, as evidenced by the fact that he
has a family and girlfriend that tend to enable, and he is extremely manipulative in getting his
way.
During the final stage of group therapy, members prepare to say their good-bye’s and
process the group’s ending challenges. Sam has never had a close network of supportive
“friends” like he is likely to make in group therapy before, and this may bring about some
feelings and emotions of sadness that he has yet to encounter. Alle-Corliss & Alle-Corliss
(2009) note that when members come to understand that the group is beginning to end, it is not
uncommon for them to begin distancing themselves from the group experience as a whole and
there comes a predisposition to avoid examining what they learned and how it can affect their
behavior in the real-world. In order to optimize Sam’s treatment in the final stage of group and
address his overwhelming sense of loss, Allie-Corliss & Allie-Corliss (2009) suggests alerting
him to this possibility earlier rather than later and encourage him to share his feelings of loss
openly with the group. Since grief and sadness are common in a group’s termination, a
supportive climate is key for him to experience these emotions freely (Allie-Corliss & AllieCorliss, 2009).
It is important to measure the outcome of therapy so that an individual knows if the
therapy is working. Tracking progress or outcomes in group therapy helps to determine whether
one should continue spending the time and/or effort on the process or if they should possibly try
something or someone different. According to Duncan & Miller (2000), in group therapy, to
profoundly improve therapy outcomes, measuring growth, effectiveness or outcomes, and using
that evidence to help guide or adjust treatment, is crucial. Measuring the amount of growth or
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effectiveness during the time spent in group therapy allows both the member of the group and the
leader to figure out what seems to be working, what doesn't seem to be working, and if any need
for changes to the treatment process should be made. Sometimes, a different approach, different
focus, different therapist, or even an intervention other than therapy should be discussed if the
current intervention is not working (Duncan & Miller, 2000). In Sam’s case, there would have
been a written treatment plan which includes clear long-term and short-term goals and objectives
that he has developed. A long-term goal for Sam could include, Sam will be able to gain insight
into his addiction and will recognize patterns that lead to abuse. A short-term goal for Sam could
include, Sam will attend drug support groups, for example, Narcotics Anonymous, one time per
week. These goals and objectives would be discussed throughout the course of group therapy in
individual sessions to determine progress and completion of treatment.
At the end of the day, everyone is responsible for their own lives and Sam seems to be
going on a downward spiral that could potentially lead to him overdosing and possibly dying.
Although Sam is court-ordered to be in this group, it is going to be very important for him to take
it seriously. From his initial interview, it seems as though he wants the help but may not believe
in the process of group therapy. With interventions in place and a strong group leader that is
able to recognize and meet Sam where he is at, it is possible for him to change his ways and have
a successful rest of his life.
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References
Alle-Corliss, Lupe, and Randall Alle-Corliss (2009). Group work: A practical guide to
developing groups in agency settings. John Wiley & Sons.
Corey, G. (2016). Theory and practice of group counseling (9th edition). Cengage Learning.
Duncan, M., & Miller, S. (2000). The heroic client: Principles of client-directed, outcomeinformed therapy. Jossey-Bass.
Substance Abuse and Mental Health Services Administration (2005). Center for Substance
Abuse Treatment. Substance Abuse Treatment: Group Therapy. Treatment Improvement
Protocol (TIP) Series 41. DHHS Publication No. (SMA) 05-3991. Rockville, MD.