Early Stage of Group Treatment

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Early Stage of Group Treatment

• getting the client to recognize, admit and move
  past their high levels of ambivalence and denial.

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Early Stage of Group Treatment

• understand the relationship between their
  addiction and their present difficult in life.

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Early Stage of Group Treatment

• rebellious,
• suspicious
• and manipulative behaviour

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Early Stage of Group Treatment

• During the early stages of treatment the goal of
  the therapist is to
• 1) to discover themselves and others as
  feeling people
• 2) identify their defenses

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Early Stage of Group Treatment

• Ego Defenses
• denial
• rationalization

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Early Stage of Group Treatment

• The art of treating addiction is to overcome the
  enormous denial and resistance that most addicts
  possess.

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• Confrontation
• How confrontation is used is critical there can
  be constructive and destructive

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Early Stage of Group Treatment

• Washton (1992)
• Guidelines for Effective Confrontation
• giving feedback as you see it
• most useful when spoken with empathy, concern,
  and respectful voice
• be descriptive (what you observed, give examples)
• expressing concern about the persons dangerous
  and self-defeating behaviour

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Leaders Responsibility

• Assessing when to/ not to intervene
• Allowing some tension for group to grow
• Helping members assume responsibility for their
  own drug related problems
• Modulating anxiety in intense situations
• Dealing with destructive resistance fleeing
• Treating the group as a mirror, microcosm

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Reinforcing Group Norms

• Feedback
• Risk-taking
• Openness
• Acceptance
• Confidentially

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Impulse Control Self-Disclosure

• Manage members difficulties with impulse control
• Members inexperience in regulating closeness and
  intimacy
• Appropriate/inappropriate self disclosure
• Risk of self-disclosure vulnerability
• Too little, too much indiscriminate
  self-disclosure
• Tolerance and readiness of the group/individual

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Integrating New Members in the Open Group

• Introduce how the group works to new comers
• No set ways or rituals for integrating new
  members
• Impact of new members on group development
• Impact of relapse and returning members on group
  process

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Middle Stage of Treatment

• Action stage of treatment
• Awareness of the stages of change for individual
  members and the group as a whole

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Middle Stage of Treatment

• Group leader should consider
• Equal distribution of time in group
• Activity focuses and invites group members to
  participate
• Focus on topics that are meaningful
• Prevents rambling patient from derailing the
  group
• Provides a clear direction for the group

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Corrective Emotional Experience

• Strong expression of emotion
• Group supportive enough to permit risk
• Reality testing of the incident
• Inappropriateness of certain feelings
• Inappropriateness of avoiding behaviour
• Facilitation to interact with others more deeply
  and honestly (Yalom, 2005)

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Late Stage Change

• Emphasis will focus on addressing
  characterological makeup of the client
• Helping the person become aware
• Thats who I am
• I wnt ot cange but cant
• Here I go again
• Whey change? What is in it for me?

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