Group Exercises for Addiction Counseling

Geri Miller

• Publisher: Wiley
• Year: 2012
• ISBN:
  9781118228791
• Edition: 1
• Topic: Psychology
• Subtopic: Addiction in Psychology
• Index: Psychology

An indispensable collection of ready-to-use, proven exercises

Providing immediately useful group counseling suggestions and tips for addictions counselors, Group Exercises for Addiction Counseling offers powerful techniques that can be adapted to any clinical practice.

Written in the author's gentle yet purposeful voice, this reader-friendly resource is filled with guidance for developing an addictions counseling group; handling Stage 2 confrontations of the leader; and building group member awareness. In addition, the author helps counselors enhance client awareness of addiction-related stressors and how to cope with those stressors.

Group Exercises for Addiction Counseling contains valuable information on:

• Addiction recovery
• Family, relationships, and culture
• Feelings exploration
• Group community building
• Recovery skills
• Values
• Opening and closing each group session

Fostering care, respect, and honesty in the group counseling setting, the techniques found in Group Exercises for Addiction Counseling allow counselors to help their clients break out of dysfunctional interaction patterns and live better lives.

1

Introduction

PERSONAL REFLECTIONS

This book, Group Exercises for Addiction Counseling, has a lot of meaning for me personally as well as professionally. I believe that group therapy, as practiced by experienced, trained counselors, saved my life—which is why I am writing a book about it. In group therapy, I learned, in the moment when I was engaging in specific behaviors, exactly which behaviors were inhibiting my ability to connect effectively with others and to set up a community of support with others. That is a nice way of saying counselors and fellow clients confronted me on destructive behavior when I was doing it, and I could hear, see, and feel the impact of that behavior on others through their confrontation of me. I hated group therapy because I lived in fear of it. I was terrified of learning about my blind spots and hidden spots and having them pointed out in front of others. However, I also felt cared about in group therapy. Counselors and other clients cared enough about me to tell me hard things—hard things for them to say, hard things for me to hear. People took risks to tell me things that I did not want to hear and cared enough about me to extend their own vulnerability as expressed in their honesty. They also nurtured me and supported me after the confrontation and reminded me that progress, not perfection, is important in living.

I learned a lot about myself in group therapy that has helped me immeasurably to live and work with others in the world. I came out of the experience knowing my flaws as well as my strengths. I believe it is easier for me to live in the world and, hopefully, easier for others to live with me after the experience of group therapy. That is why I believe in the importance of this workbook. My hope is that counselors can find in these tried-and-true group exercises ways to help their clients understand themselves better, thereby offering them more choices about how they can live their lives and break out of dysfunctional interaction patterns with others. My simple hope is that the techniques may be used by counselors to help their clients live better.

MAIN SECTION POINTS

1. Addiction is a significant problem.

2. Treatment of addiction requires a biopsychosocial perspective and a balance of grassroots-based assistance and research findings.

3. This book, Group Exercises for Addiction Conseling, is a complementary book to Learning the Language of Addiction Counseling, containing exercises used by experienced addiction counselors.

4. Group therapy is commonly used in addiction treatment because it offers interpersonal learning, a community of support, cost effectiveness, and a history of effectiveness with addicted clients and their loved ones.

5. Counselors are encouraged to adapt these exercises to their own practice.

OVERVIEW

The addiction problem in the United States has reached alarming significance. This widespread problem of addiction results in many clients having an active or historical problem with addiction themselves or having family members who have struggled with addiction. If clients have not had to address addiction in themselves or their family members, they often are aware of someone in their daily lives (e.g., boss, friend, neighbor) whose addiction problem impacts their life. Because many clients are impacted by addiction, all counselors need to have the skills to work effectively with addiction issues. Counselors who work primarily in mental health settings need to be prepared to work with the issues of addiction that these clients bring to counseling, as well as addiction counselors who work directly with addicted individuals and their significant others.

Currently, it is almost impossible to effectively treat addiction issues as an isolated problem because of intrapersonal, interpersonal, and societal issues intertwining with the addiction. Intrapersonally, the addiction may be in response to a trauma experienced before the onset of addiction (e.g., physical abuse, sexual abuse, dysfunctional family dynamics). Also, the addiction in the individual may be in response to some other interpersonal (e.g., domestic violence) or societal (e.g., homelessness) problem. Counseling, then, requires a biopsychosocial perspective, where the interaction of biological, psychological, and social factors in the individual and his or her significant others are examined. A biopsychosocial perspective can assist the counselor in addressing issues related to the maintenance of the addiction, thereby enhancing the effectiveness of treatment for the addiction.

Accurate, research-based knowledge of the dynamics of addiction is needed to provide effective addiction counseling. Currently, counselors may practice counseling on a continuum, where at one extreme is the grassroots (self-help) emphasis and at the other is the abstract research emphasis. In terms of the grassroots emphasis, the addiction counseling field essentially evolved out of a grassroots network that is still alive today through self-help groups based on abstinence. Because of this grassroots basis and a large body of self-help literature on addiction recovery, counselors may be exposed to myths about addiction that are not founded in any clinical research and then unknowingly apply such myths to their clinical practice. At the other extreme, counselors may be exposed to research findings on addiction but not know how to apply or integrate these findings into their clinical work.

These concerns regarding the training of counselors in the addictions field led to publishing my textbook with Wiley, Learning the Language of Addiction Counseling (3rd edition) in June 2010. This textbook is one of the few books attempting to find a balance between the grassroots emphasis and the abstract research emphasis, resulting in a research-based clinical application approach to addiction counseling. Counselors require practical guidelines and suggestions that stem from a theoretical and research-based knowledge base so that they do not inadvertently enable addicted individuals in an active addiction or enable their significant others to directly or indirectly facilitate the presence of the addiction. The third edition of Learning the Language of Addiction Counseling presents knowledge that is current, emerges from a biopsychosocial perspective, and is in a user-friendly, practical application format (case examples and exercises), facilitating the integration of knowledge into practice by counselors or counselors-in-training. The book, then, is being used by students and practitioners in the mental health field.

This book, Group Exercises for Addiction Counseling, is meant to complement Learning the Language of Addiction Counseling (3rd edition). In Learning the Language of Addiction Counseling (3rd edition), the fifth chapter of the book, “The Treatment Process for Addictions,” has a section on group counseling that describes group types, stages of development, techniques, issues, and therapist self-care, as well as a case study and exercise. This section of the book is helpful to readers because it provides an overview of the basic concepts of group work and some group techniques (including nine group exercises provided at the end of the chapter). However, because the textbook does not focus on group techniques, there is limited information available to counselors on specific group techniques that have been helpful in working with addicted clients. A workbook was needed in addition to the textbook to assist counselors in treating addicted clients. The rationale for the workbook is as follows.

Group therapy is commonly used in addiction treatment centers in the United States. It is sometimes seen as the preferred treatment approach with addicted clients, because they can learn about themselves interpersonally through their interaction with other group members and learn how to set up a community of support, which is so critical for their addiction recovery. Also, group therapy is often used in treatment because of its cost effectiveness: More individuals can be treated in a short period of time by one or two therapists than is possible through individual work. This cost effectiveness is appealing to organizations that, because of mental health funding cuts in the current economic times, have the need to operate as efficiently as possible. Finally, addiction treatment has had a historical record of using group treatment in working with addicted clients and their loved ones because of both the effectiveness of the treatment and the community of support for recovery.

A workbook of group exercises specifically designed for the addicted population is needed for several reasons. First, many counselors are being asked to facilitate groups focused on addiction even though they may have limited experience in the field of addiction counseling. Second, many experienced addiction counselors are leaving the field as a result of retirement or in response to current budget cuts, thereby taking their clinical knowledge base with them and leaving neophyte counselors to work with limited mentoring in addiction counseling. Third, counselors are increasingly asked to hit the ground running, so they do not have time to develop group exercises of their own and additionally are often asked to run several treatment groups per week that require them to use different exercises in their groups.

The group exercises in this workbook are tried and true by counselors working in the field of addiction counseling. They have resulted from trainings I provided to experienced addiction group counselors at institutes held once or twice a year with 20 to 40 participants since 1999. During trainings, experienced practitioners described one favorite group counseling technique that they used with various addicted clients in terms of gender, ethnicity, age, and so on, depending on their clinical population. A few of these exercises were chosen for this book and rewritten to make them more useful for counselors working in various settings. This workbook is a collection of powerful exercises that can be adapted to a counselor’s own practice. In addition, readers of this text are encouraged to shape these exercises in a manner that fits their population. Because the main concern of our work is the welfare of the client, counselors need to shift exercises to fit the needs of the group and the population being served. For example, homework assignments are not noted with the exercises because the counselor, setting, and/or group members may not be a good match for homework. However, the leader may choose to involve homework with an exercise.

This adaptability extends to the materials included in the exercises. The exercises in this workbook are primarily process exercises requiring minimal materials that are typically available in an office or practice (e.g., paper, pens). Any specific, unique materials (e.g., hula hoops) can be substituted with materials that are readily available (e.g., chairs). That is why this workbook does not have descriptions of materials required for the exercises, because counselors can change all of the materials needed for the exercise to meet the needs and interests of the population being served.

I wanted this workbook to be easily accessible for busy clinicians who simply want to pull something off the shelf in order to do something different in their next group session. Therefore, there are no sections on goals, objectives, conclusions, processing questions, stages of the group, and so on that one might find in other workbooks. When I buy workbooks on group counseling, I typically do not read those sections; instead, I immediately look at the exercises to determine if I can use them in a group context and carefully read those sections. I made a choice to keep the exercises short because I wanted the book to be user-friendly to busy clinicians who probably do not have time to read a lot about the group application but who want to use exercises that have been used effectively before with addicts/alcoholics and their family members/significant others. Nonetheless, in the second section of this workbook, I include some of my philosophy of group work, with general suggestions and cautions as related to the field of addiction counseling, in order to provide readers with a general framework on my perspective of group work.

Additionally, in each exercise I have fused methods and directions so that the workbook reads more like a recipe book. Metaphorically, then, the counselor is the cook: Explicit directions on how to boil water and the like are not being given, but the how-to on combining the components are provided. This workbook will not meet the need for group work training, although there is a general section describing my approach. I am assuming that readers have had training in group work, and these exercises serve to augment that training. Ideally, readers will have also had training in group work in the addictions field because of the unique flavor that disease brings to the application of group counseling. If readers do not have general training or addiction-specific training in group work, you are encouraged to obtain that training, because one can be an effective counselor in general, but it is very important to understand how group counseling operates so clients (as well as counselors) are not hurt in the powerful process of group counseling.

Group Exercises for Addiction Counseling is designed for prospective and practicing counselors who work with addicted individuals in a group setting. Several broad purposes guided the development of this book:

1. To provide addictions counseling group techniques to counselors in a language that is easy to understand and readily usable.

2. To provide addictions counseling group techniques to counselors in a format that is easy to access.

3. To assist in the treatment of addiction-related issues by providing tried-and-true group counseling techniques that address common issues counselors frequently need to address with their clients.

4. To encourage the use of techniques that enhance client awareness of addiction-related stressors and how to cope with those stressors.

5. To provide a basic group counseling workbook that can be used in many different addiction treatment settings.

There are 11 categories in Section 3 of the workbook: Icebreakers, Addiction Recovery, Family/Relationships/Culture, Feelings Exploration, Group Community Building, Self-Esteem, Recovery Skills: Communication/Mindfulness/Problem Solving , Values, Openers, and Closers. These categories were chosen because they are useful in group development (Icebreakers, Openers, Closers, and Handling Stage 2 Confrontations of the Leader) or because they are issues commonly faced by addicts/alcoholics (Addiction Recovery, Family/Relationships/Culture, Feeli...