A Group Solution for Overcoming Substance Abuse

Written by John Mark Krejci, Ph.D.

Human beings are naturally social creatures. Being a member of a group is an essential part of the human experience. Our families of origin constitute the first significant social group to which we belong. Friends and peers in school offer the next opportunity for successful socialization. These early experiences shape our patterns of interacting with others and relating to the world. When traumatic experiences introduce problematic patterns including painful emotions or addictive behaviors, group therapy provides a space where solutions can emerge.

Group therapy provides a powerful venue to treat many psychological problems including substance use. Group therapy, also known as interpersonal process groups, differs from support groups such as AA. One major difference is the benefit of allowing members to interact with each other as well as with a therapist, who is a professionally trained communication facilitator. Support groups, on the other hand, discourage cross talk. While support groups benefit some individuals, group therapy grants experiences, which can be especially therapeutic for people seeking to stay sober.

Group therapy (herein referred to as “group”) offers assistance equal to or greater than individual therapy. How? Like individual therapy, group provides a non-judgmental space in which individuals share their stories of struggle and their hopes for the future. In contrast to individual therapy, group offers the advantage of the social dynamic. Members feel heard, get feedback, and experience the support of others sharing similar struggles. Group grows the idea that members do not struggle alone with their problems and brings out the similarities between themselves and others. The individual’s sense of isolation eases. Group members can experience the relieving feeling that we are all in this together.

Members learn from others’ experiences. They learn how others cope with difficult emotions and cravings. Active group participation develops some of the most important skills for success as a human being. It grows social skills and the ability to empathize. Members feel strengthened and encouraged by the rest of the group. In offering support to others, members feel good about themselves and can experience an increase in self-esteem. Those in later stages of recovery can inspire those in early stages (and vice versa). Such encouragement and support bridges the boundaries of age, gender, sexual orientation, and race.

A helpful group therapist actively facilitates healthy communication and positive interactions while navigating through challenging conversations. The therapist points out the value in what group members offer the group, in what they say, their strengths, and the example they provide for other members. Therapists may be remiss to admit that group clients often remember what other members say more than what the group leader does.

Solution-Focused therapy (SFT) — a simple but powerful form of therapy that focuses on solutions instead of problems — adds appealing qualities to the group format. The approach focuses on members’ strengths, allowing the group to see that problems never have 100% control of our lives. When using SFT, I ask the group what worked in the past. I ask the group how they might incorporate those past solutions into the present and potentially project them into the future. I ask what little things they can do this week to work toward their “miracle” solution.

A solution-focused group offers each member the freedom to choose their own goals. A solution-focused therapist gives each client the opportunity to come up with creative ideas based on their answer to the “miracle” question.

My version of this question is this: “I want you to use your imagination. I want you to imagine that a miracle happens that solves all your problems while you sleep tonight. When you wake up tomorrow and all your problems are miraculously dissolved, how is your life different — in big ways, little ways, or in any way you can think of?”

This question gives clients the opportunity to think of desired change without the pressure of thinking they are constructing a list of potential goals for therapy. Interestingly, stopping the use of substances is rarely the main miracle. Instead, it often serves as a means to achieve what they really want, such as a sense of peace, improved relationships, and feeling better about themselves and their lives.

Group is a welcoming, supportive space, where people can be themselves without fear of judgment. It results in understanding themselves and discovering what led them to their addiction. Group members learn strategies to strengthen their sobriety. They learn new and more productive ways of interacting with people, including how to better deal with family members. They feel less lonely or isolated and feel a sense of belonging. Solution-focused sobriety groups focus on strengths and past successes. Members find new solutions that can lead to the “miracle” in their lives.

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