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Stronger Together: Addiction Group Treatment

Groups are the dominant mode of treatment in many addiction programs, but they don’t always live up to their potential as powerful recovery tools. Reviewing some of the addiction-focused techniques in this article series can give clinicians the power to boost group effectiveness in many treatment settings.

Part Six: Climate of a Working Group

Work grows out of nonwork. We’ve never in all our years seen a group that works right from inception. Groups normally struggle through non-working stages and often still flirt with them on occasion. Working mode can make its appearance very early, even when the group seems most lost or resistant. If it can be identified and nurtured, the work mode has a chance of becoming the dominant form of interaction, making the group a “working group.”

One of the best ways to recognize working mode is a generalized (though unmistakable) change in group climate. When an addiction treatment group is working, the background climate reflects fear of the disease. Group members act as though they have an illness that merits full attention. It’s a major motivation for joining the group and consistently attending.

Here are two “case sample” dialogues that reflect interactions in resistant, versus working, modes.

Resisting Change
Working Group
Buck: So why are you here?Tammy: I was fighting a lot with my husband. When I got a DWI he used it to force me into treatment.Buck: Ouch. I had a couple of DWIs myself, but my lawyer got me off.Tammy: Well, that wasn’t all. I was drinking a lot. But it wasn’t anything I couldn’t have taken care of on my own if people would have left me alone.

Harry: That’s what everybody says, but it never works out. I tried to quit for ten years, don’t think I ever made it more than a few months.

Tammy: Well, that doesn’t mean I couldn’t have done it. You’re not me.

Buck: Yeah, I quit a whole year once when I was younger. Wish I hadn’t started back up again.

Tammy: (to Harry) You see? That’s my point. You just need the right set of circumstances.

Buck: Yeah, I quit a whole year once when I was younger. Wish I hadn’t started back up again.Ralph: Why did you, then?Buck: Broke up with my woman.Harry: That’s what I’m saying: There’s always something. You can be sober a week, a year, even ten years. But if you’re trying to do it on your own, it’s just a matter of time.

Tammy: You can say that about yourself, but I don’t see how you can say it about me. You hardly know me.

Ralph: He can say it about you, ’cause you’re an alcoholic, and that’s what alcoholics do, whether they want to or not. Me, I never wanted to get drunk, just to feel better for a while. But it never stopped with one drink– or even one night.

Harry: Me either. Look, Tammy– How long have you been trying to handle this on your own? How well has that worked out for you? How much more research you wanna do?

With this fear in the background, the overt climate usually reflects motivation, along the lines of “If we’re not working, we might drink/use again, and will we survive the next one?” However, in spite of this anxiety, morale in working groups tends to be high.

When a group has been mired in the hostile or helpless mode, and breaks through into work, you’ll see an almost tangible change in tone. Members begin to sense that they’re “getting somewhere” at last, and that they’ve begun to find their own way into recovery.