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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 Seven: Values of a Working Group

A working group values autonomy over dependence. Participants not only want to recover from their disease, they want to learn how to treat themselves. They’re wary of relying on authority figures such as a designated group leader. They want information about addiction and how to treat it– not to follow someone else’s instructions, but to apply the knowledge for themselves, independent of another person.

While working group participants continue to want encouragement and feedback from a leader, they want the recognition for their own work. They value the time they’re investing not in terms of hours spent on the activity, but in the quality of the interaction and how it helps them in their efforts to understand and treat their addiction.

Here again is the “resistant” group’s dialog versus a working version:

Resisting Change
Working Group
Jeremy: I don’t know how you can say I don’t try hard enough to get better– I’ve been to every group for three months and it’s cost me a lot to keep coming.

Vince: We’re not saying you haven’t gotten anything out of the group– just that you hardly ever say anything.

Jeremy: I talk. Not as much as you, maybe, but if I have something to say I say it.

Vince: Yeah, but the point is whether you’re getting enough to stay sober when you do stop coming. Are you?

Jeremy: Hey, I do my part. The judge said come, and I’m coming. I didn’t want to, but I’ve been pretty consistent. Sometimes I think it’s okay, sometimes I don’t like it. But I’m here.

Vince: Okay, you get some credit for that, anyway.

Jeremy: Damn Straight.

Jeremy: Hey, I do my part. The judge said come, and I’m coming. I didn’t want to, but I’ve been pretty consistent. Sometimes I think it’s okay, sometimes I don’t like it. But I’m here.

Nadine: This isn’t a movie, Jeremy. You sound like we’re supposed to keep you entertained for two hours.

Vince: Here in body, but not in mind, my friend.

Jeremy: I listen to everything.

Nadine: And respond to zilch. Dude, you could leave here, start drinking again and get another DUI.

Jeremy: Nuh-uh. I promised I won’t ever drive after 6 p.m. I give the car keys to my wife as soon as I get home from work.

Vince: Is that alcoholic enough for you? Faced with the choice between giving up drinking and giving up driving, he turns over the car keys.

Working groups don’t prioritize using group time for socializing. Members might be friends outside, but they don’t engage in social chat during the sessions. Roles can be flexible; group members pass ‘leadership’ around according to skill and inclination. And they respect boundaries and group norms that facilitate the effectiveness of the sessions:

Traditions: A working group will tell newcomers “This is how we do it here.” Effective working groups can continue their traditions through surprising changes in location, membership, etc.

Structure: Though they may superficially look rigid, working groups are capable of evolving when change is necessary. A nonworking group will collapse in the face of external challenges, working groups adapt.

Mentality: In a working group, only work is acceptable.

Culture: The momentum of culture helps a working group continue its work– whatever that may be– in spite of attempts to disrupt it by individual members.