Individual vs. group therapy
In comprehensive recovery programs, individual and group therapy are combined to produce optimal outcomes for the client. These two approaches are not at odds with each other; instead, the skills and insights gained in individual sessions complement those of group therapy, and vice versa. Effective treatment plans incorporate both approaches to therapy from the early stages of recovery through aftercare and beyond.
What can you expect from therapy when you enter an addiction treatment program? Understanding the strengths, shortcomings, and benefits of both individual and group therapy will help you achieve recovery goals such as:
- Gaining a deeper understanding of the disease of addiction
- Increasing your motivation to lead a drug-free life
- Improving your coping skills in high-risk situations
- Learning healthy ways to manage stress
- Creating stronger relationships with others
- Building a stronger sense of self-worth and self-efficacy
Exploring the roots of addictive behavior can be a frightening prospect. A therapist trained in substance abuse treatment can make the process more manageable by providing guidance and encouragement, both in one-on-one sessions and in group settings. As you come to understand the disease of addiction, therapy can also teach you valuable coping strategies that will help you get sober and avoid relapse.
A leading recovery program integrates evidence-based modalities into individual or group therapy. Most of these modalities can be incorporated into one-on-one or group sessions. Listed below are several of the most widely used therapeutic strategies in substance abuse treatment:
- Motivational interviewing. Motivational interviewing, or MI, is a philosophy of treatment as well as a series of therapeutic practices. In MI, the therapist partners with the client to encourage and inspire the client to get clean and sober on his or her own terms. MI takes a positive, nonjudgmental stance on addiction treatment, addressing addiction as a disease that can be managed rather than as a moral failing.
- Cognitive behavioral therapy. Cognitive behavioral therapy, or CBT, is one of the most widely used evidence-based modalities in the field of addiction treatment. In CBT, the therapist helps clients change destructive behaviors by identifying and correcting negative thought patterns. Originally developed to treat patients with severe depression, CBT is now popular in the treatment of drug addiction, alcoholism, eating disorders, and many other conditions. According to Psychiatric Clinics of North America, CBT has proven effective at helping recovering clients learn new coping skills and reduce their risk of a relapse. CBT is used both as an isolated therapy and in combination with other treatment modalities.
- Dialectical behavior therapy. Dialectical behavior therapy, or DBT, was developed to help severely suicidal patients find meaning and purpose in life. Today, the therapeutic techniques of DBT have been successfully applied to the treatment of eating disorders and substance use disorders. Addiction Science & Clinical Practice states that in substance abuse treatment, DBT helps patients by enhancing their motivation to change, helping them build self-acceptance, and reducing the urge to abuse drugs or alcohol. Based on the practice of mindfulness, DBT can relieve anxiety and depression by teaching clients how to relax in the moment. Through simple mindfulness exercises, clients can learn how to cope with destructive urges and hard-to-control emotions, increasing their chances of a successful recovery.
- Relapse prevention training. Learning how to reduce the risk of a relapse is one of the most critical goals of rehab. Relapse prevention training focuses on teaching the client practical coping skills to deal with triggers and stressors of everyday life. Relapse prevention training, or RPT, groups may continue to meet in the aftercare phase of recovery to provide support for clients who have rejoined the community.
How individual therapy works
In individual therapy, a client works with a mental health professional in private sessions to acquire self-knowledge, insight into addiction, and a stronger sense of inner strength. Sessions can be held on a one-to-one basis, usually in a therapist’s office, but sometimes in a meeting room, classroom, or even in an outdoor environment. A typical therapy session lasts from 50 minutes to an hour. Frequency of therapy depends on the client’s needs, but most programs require that the client attend at least one individual session each week.
Individual therapy sessions are structured according to the patient’s needs. Patients who need inspiration and encouragement may be guided through a series of questions to help them discover their own personal motivation to get sober. A therapy session can touch on many topics, but most therapists will focus on the subjects that are currently preoccupying the client, such as:
- Their progress in rehab
- Personal obstacles to recovery
- Interactions with others both inside and outside the facility
- Cravings or withdrawal symptoms
- Experiences with new coping skills
- Their goals for the immediate future
A therapy session will often end with the client and therapist working together to set goals for the days ahead. These goals might include staying sober for a certain number of days, attending a specific number of meetings, or trying a new recovery activity. In some recovery programs, therapists use a therapeutic approach called contingency management to motivate their clients. In exchange for achieving a certain number of sober days or reaching another personal goal, clients may receive tokens or other tangible rewards.
In the contemporary view of substance abuse treatment, therapy is a collaborative process. The therapist does not condemn, judge, or criticize the patient, or tell him or her what to do. Instead, the therapist and client work together to move the client forward through the stages of recovery. The therapeutic philosophy of motivational interviewing is very different from older therapeutic approaches, which were much more aggressive and confrontational. Today, individual therapy sessions focus on helping the client build self-esteem and increase the desire to recover.
Who performs individual therapy?
In a recovery program, the professional who leads individual therapy should be extensively trained in substance abuse treatment. Understanding the psychological issues that underlie substance abuse — compulsive behavior, obsessive thoughts, guilt, remorse, depression, and cravings — requires education and experience in treating patients with addictive disorders. The therapist who leads individual sessions may hold one or more professional titles, including:
- Marriage and family therapist
- Substance abuse counselor
- Addiction treatment therapist
A therapist’s credentials should meet the requirements for the state or national board that oversees health professionals. All therapists should hold some form of licensure or certification, in addition to specialty credentials in specific topics, like substance abuse treatment. In a program dedicated to treating co-occurring disorders, or the existence of a psychiatric illness combined with substance abuse, therapists must be cross-trained in mental health services and substance abuse treatment in order for therapy to be effective.
How does group therapy work?
Group therapy gives recovering addicts the opportunity to learn new coping techniques, practice their communication skills, and gain hope and strength from their peers. For many addicts, their interpersonal relations have been reduced to interactions with dealers and other drug users. In group therapy, they can meet men and women like themselves who are facing the same struggles with substance abuse. Many profound friendships are formed in group therapy, where addicts learn how to develop trusting, sober relationships with others.
Group therapy sessions may involve the client’s significant others. In family therapy, spouses, partners, parents, or children join the counseling session. Significant others may be invited to private family sessions, or to open sessions or classes involving a group of peers.
In group therapy, clients get together in a session led by a trained mental health professional. Sessions typically last approximately one hour, and clients are asked to observe time limits when speaking so that everyone who wants to talk may have the opportunity. In a residential treatment program, group sessions are typically held three or more days per week. Topics vary depending on the format of the meeting, but common subjects include:
- Education on addiction
- Managing stressful situations
- Managing anger, shame, loneliness, and other difficult emotions
- Coping with substance abuse triggers
- Coping with cravings and withdrawal symptoms
- Living with grief and emotional trauma
- Handling a relapse if it does occur
- Forming and maintaining healthy relationships
- Understanding codependency
- Managing medications
- Dealing with mental illness (depression, anxiety, social phobias, bipolar disorder, and other psychiatric disorders)
Group therapy provides a safe, supportive environment where clients can discuss painful memories and emotions, celebrate their successes, and share their failures in recovery. These sessions reinforce one of the most important messages of rehab: that no matter what the outcome of treatment may be, the client is not alone in his or her experiences with addiction.
Types of group therapy
Group therapy is a versatile treatment modality, taking many forms according to the clients’ needs. There are several basic types of group therapy that are applied in many treatment programs:
- Support groups. Support groups provide mutual encouragement, feedback, and a safe environment to voice the frustrations of recovery. These groups can also help clients hone their communication skills, deal constructively with confrontation, and express their personal beliefs in a non-aggressive manner.
- Educational sessions. Addicts are frequently unaware of the neurological and psychological factors that drive the disease of addiction. Psychoeducational groups teach rehab clients about the nature of addiction and relapse. Family members and significant others may also take part in educational sessions.
- Cognitive behavioral groups. CBT is based on the premise that negative thoughts produce negative behaviors, and that by changing the way we think about ourselves and perceive the world, we can create healthier, more positive lives. Cognitive behavioral groups help clients identify their negative thought loops and substitute them with more constructive, self-affirming beliefs.
- Skills groups. Many addicts are so accustomed to turning to drugs or alcohol when they’re faced with a problem that they’ve forgotten how to resolve conflicts or manage stress effectively. Skills groups focus on acquiring new tools and strategies for dealing with day-to-day life. Some skills groups emphasize relapse prevention strategies, while others teach life skills like budgeting, shopping, or job-seeking.
- Experiential groups. Closely related to skills groups, experiential sessions take life skills one step further. Under the guidance of a therapist, clients practice their newly acquired coping skills through real-life experiences, like shopping, dining out at restaurants, and interacting with others in social settings. Many of these situations present triggers for the addict in recovery. Through the supportive presence of the group, clients can learn how to handle these day-to-day experiences in healthy, sober ways.
Who leads group therapy?
The therapeutic techniques for interacting with an individual client are different from the methods for leading a group. In order for group therapy to be effective, the leader must have specialized training in conducting group therapy sessions and managing group dynamics. Group therapy should be led by a licensed or certified mental health professional who is trained in substance abuse treatment. The leader may be a counselor, therapist, psychiatrist, psychologist, nurse practitioner, or other credentialed specialist who has been trained in both substance abuse treatment and group therapy techniques.
Group therapy is not the same as a self-help support group. In self-help groups like Alcoholics Anonymous or Narcotics Anonymous, meetings are led by a member of the community, with the goal of providing feedback, encouragement, hope, and motivation. The structure of these groups is usually less formal, and group members have more autonomy in their choice of format and subject. In group therapy, a trained professional directs the session in order achieve maximum benefits for all clients.
Pros and cons of individual and group therapy
Both individual and group therapy have their advantages and disadvantages. Ideally, a client in recovery should participate in both forms of therapy. Individual therapy allows the client to receive intensive, focused attention and to discuss difficult issues in a private setting. For clients who are struggling with intense shame, guilt, or emotional pain, individual therapy can provide a safe outlet for self-expression.
Group therapy takes advantage of our natural need to relate to others. Humans are social creatures, and in times of stress, we tend to seek out other people who can provide help, support, or understanding. Because addiction often destroys personal relationships, group therapy allows the client to develop new relational skills and build trust in others. In group settings, clients can practice their communication skills, learning how to talk and listen effectively and how to set healthy boundaries with others.
Combining therapies in treatment
There is no treatment modality that can “cure” the disease of addiction. In order to achieve recovery on a mental, physical, and spiritual level, a program must include a combination of therapies. In addition to individual and group therapy, advanced treatment programs offer medication therapy, nutritional therapy, exercise therapy, and expressive therapies. Holistic stress reduction practices like massage, yoga, and meditation are also included in a comprehensive treatment plan.
A truly effective treatment plan merges the strengths of individual and group therapy to give the client the very best chance at healing. To provide continuity and promote progress, a client’s individual therapist will often attend group therapy sessions. Individual therapy sets the stage for an in-depth exploration of the client’s experiences in treatment, while group therapy offers new opportunities for education, mutual support, and friendship.
The treatment plans at The Recovery Village are tailored to the needs of our clients. We promote overall wellness through a powerful combination of individual therapy, group therapy, experiential therapies, nutritional counseling, and more. To learn more about our advanced approach to recovery, call our toll-free number at any time.