While in treatment, it is most likely that you will be involved with many groups. Groups can be psychoeducational, creative, experiential, and recreational. Groups provide insight, help with isolation, and can be the genesis of new friendships and lifelong support. Group therapy at Vogue Recovery Center allows people to connect with each other through peer support. This is a proven technique for people in substance abuse treatment, mainly due to that the nature of substance abuse keeps people isolated from others, with feelings of shame and guilt. There are three divisions in the process of group therapy and group dynamics. These are:
When a group first joins, it is in the forming stage. This may also be when a new member is introduced to an existing group, it will need to readjust and reform to allow for the new member. In the forming stage, the members are usually on their best behavior, they are polite, have a tendency to not want to speak up or altogether honestly, they try and find out what’s safe to say and the personalities of others.
Stage 1 – Forming
During the forming stage, it is imperative that the group facilitator or therapist lays down the ground rules in regards to confidentiality of members. What is said in the group, stays in group. The group needs to set up an initial feeling of trust with the others in the group before they can safely move on to the next stage.
Stage 2 – Storming
The next phase is, Storming is where group members will act more real, conflicts can arise, people are more honest and show their true personalities and deeper feelings. This can happen as early as the second or third group session of the members are in residential treatment together and get a lot of time and/or many groups through the day, but may need to adjust between the phases due to new intakes.
Stage 3 – Norming
The final stage of group dynamics is Norming; a groups phase where they find acceptable ways of how they can tolerate differences. Conflicts in the Storming phase can often be beneficial for the group to become more cohesive in the Norming stage as the group can help each other emulate a family system, or social dynamic otherwise difficult to navigate through.
Group therapy can bring up “scapegoating” meaning where the group turns on one person and places the blame. The members turn on one person but cannot see their part and responsibility in it. The facilitator will bring the group back into the now, and point out what they are doing. Scapegoating is a defense mechanism where people do not want to take responsibility for their own actions or inactions of a situation. Sometimes it is true that one member causes the group to have a consequence. In that case, it is a perfect opportunity for the group to find a solution and preventative measures from it happening again and can allow for the individual in question to change their behavior.
Expectations for Group Therapy
Often groups will be led by one facilitator, but in certain cases, there will be additional leaders, especially if the group is large or is conducted by a third party, non -therapist. For example, an adventure therapy instructor and the clinician from Vogue Treatment will co-lead a session. Depending on your treatment center size (often people admit to a 6-bed facility), and how many there are admitted at the time of your stay will dictate the size of the group. At-large treatment centers a group can be between 12 and 16 people usually, in order for each person to be able to get benefit out of the group. At the IOP phase, groups can come together after residential treatment and can also be larger than residential. Typically, a group session is done 2-3 times a day in residential, 2-3 week at IOP and are 1-2 hours in length. At residential treatment, the program will vary the groups and group times daily and should post a weekly calendar so you know what to expect. However, it is good to note and be reminded that the nature of residential treatment, things may change daily, and to keep an open mind and flexibility when it comes to scheduling. Most groups meet in a room at the treatment center, or outside weather permitting and the chairs are arranged in a circle so each person can see each other. Other groups that involve outside activities will start and end in a similar fashion, but the activity will vary depending on what the group will be involved in. For instance, a group which does an adventure therapy ropes course will start with what to expect and identify any fears that may come up, will participate in the activity, and then process after the activity with the group. Groups are conducted by members of the treatment team which include the Clinical Director, therapists, counselors, and outside vendors such as yoga teachers, nutritionists, 12-Step speakers, or specifically trained group facilitators. The group facilitator will maintain an environment that is ethical, professional and respectful of others. The groups will stay free of discrimination, aggression, acting out, sexual behaviors. The facilitator will conduct the group free of harassment of others, name-calling, threats, or attacks- both verbally and physically. It is the responsibility of the group leader to make certain the group has a form, a purpose, a focus, and is productive in nature sans judgment for each member. Groups can be a variety of things that will help with understanding addiction and may utilize lecture, participation, video, and different props and tools. Groups may focus on education of substance abuse, neurological functioning, 12-Step understanding, role-playing, visualizations, narrative therapy, how to manage pain, stress reduction, working with other group members, improving social skills, music therapy, art therapy, reading, recreational activities and more.
The Benefits of Group Therapy in Recovery
Group therapy is very beneficial to people in recovery. There are some issues that someone may be having which are harder to talk about in individual therapy than it would be with their peers. Often people who are introverted or shy find great benefit from group therapy as they finally are able to talk to others about what they have been keeping inside. Often people find group therapy surprising on how it benefits them. Groups can help each other in many ways post experience; there’s a natural networking that has been established and a continuation of connection in the transitionary stages. There are five main benefits to group therapy in treatment:
- Finding your voice
- You’re not alone
- Support from others
Finding your voice
In the initial stages of recovery, it is difficult to have a voice, speak up, or share feelings with others. Through the process of group therapy, essentially each group will help facilitate the members to share experiences and opinions in a safe and non-judgmental environment. The majority of people who enter therapy or rehab come from dysfunctional family systems and can find their authentic voice away from that dynamic in the group therapy process. Finding one’s voice can mean speaking the truth to literally speaking aloud the feelings that you’re having in the moment, with a clear, honest and articulate expression of self and those around you. It can be a platform on which core beliefs will change and give a sense of empowerment and confidence.
You’re not alone
With substance abuse, it may feel like no one else knows what you’re going through, and it group, that gets dispelled. Finding commonalities with others who realize and understand what you’re going through helps with the isolation of the disease. When we are in the throes of addiction, behaviors may lead to dangerous and self- demoralizing incidences, where we may feel a large amount of shame. Working with a group that shares similar feelings and stories, can often lessen the effect we have on our memories and events form the past. We are able to let go through a shared experience. Although everyone has unique experiences and pasts, by sharing the feelings around them, group therapy will often prove that no one person in unique in recovery and that itself can be the number one idea which changes a using addict into an addict in recovery. Other than a very low percentage in human personalities, most people strive to be connected with others. Finding commonality is the first step to a connection. Upon entering treatment, you will find that the other clients and many of the staff will have at least one thing in common: that they are in recovery from drugs and alcohol.
Support from others
Individuals in group therapy will also hold each other accountable for what they are saying, especially working closely in the treatment process and living together. If there are clients with dual-diagnosis of mental issues and substance abuse, they often find it beneficial to be able to explain who they are without judgment, and it becomes easier to do so with people they start to get to know through treatment.
The group dynamic is often the most beneficial when there is diversity among its members. Having people from different geographic, socio-economic, age, gender, and ethnicity can be educational, eye-opening, and assist group members to see different perspectives. It can also bind people together who otherwise wouldn’t see an initial commonality or potential friendship, but come to realize they do through having the same issue and feelings of substance abuse. It can create a greater tolerance for others and self, through the recovery process as each individual will open up and share their story, experience, fears, and vulnerabilities. Members providing honest feedback to each other can lead to a catharsis of self-understanding. Having diversity will help determine outside strategies otherwise not thought of in order to make the positive change needed in drug and alcohol treatment. People often have their biggest breakthroughs in group therapy.
For group dynamics and group therapy sessions to be a success, there MUST be a system and protocol set up that establishes safety. Without safety, none of the above benefits will work. The overall safety of the group is set up by the therapist or facilitator. If a client has a felling that the group is unsafe, this is a perfect opportunity to find and use their voice to speak up about it. For instance, if a group member is becoming increasingly agitated and looks like they may escalate into a rage, the group facilitator would be able to handle it in a professional manner. If they cannot for whatever reason, the group should terminate and reconvene at a more appropriate time after the individual has been confronted and deescalated. This may happen in group dynamics where someone feels triggered or has a mental health issue which they cannot control. Often times these explosions can lead to a group session where each member will be able to process their feelings and stabilize, returning to homeostasis and creating safety once more. At recovery treatment centers, the group leaders are highly trained to deal with this dynamic if it may occur and have procedures in place to help each individual and the group as a whole.
The Origin of Group Therapy
Gathering in groups, clans, ensembles and teams has been around since the beginning of mankind. We humans run in packs. However, joining in groups for constructive therapeutic purposes was popularized about 1940 from the effects World War II was having on combat soldiers. Research of group dynamics and therapy had been researched and studied quite a bit earlier, though it was put into practice at this time. In 1895 Gustave Le Bon wrote and published a study about crowds and behaviors. He believed that an individual can change their behaviors and personality when in a group by observation. Groups, therefore, can take on their own life, set of values, and behaviors where members may lose their awareness of individual actions. Take soldiers for example, who work together in a set of rules and codes in order to perform in combat where they might not individually choose similar actions. Crowd rioting can become frenzied and out of control where members might never act in the same way on their own. Therefore, if groups can change behavior to negative, irrational, or oppositional behavior, group therapy believed that groups could also learn to benefit from positive change as well.
Multidisciplinary Treatment at Vogue Recovery Center
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