Interview with social worker: Ms. A My interview was with Ms. A, a substance abuse counselor, who organized group meetings for people in recovery from drug and alcohol abuse. She described the work as challenging but rewarding. Very often people who are recovering from addictions have an ambivalent attitude towards the recovery process. While some are willing, others are compelled into the group because of legal reasons (such as a conviction for DWI) or because of family pressures. Ms. A must be mindful of these different attitudinal perspectives on the process of navigating recovery. It cannot be assumed that everyone 'wants to be there' and that everyone consciously wants to rid him or herself of addiction.

Group therapy can be valuable for individuals in substance abuse recovery because it enmeshes members in a supportive environment of people who understand what they are going through. It can be very difficult for non-users to comprehend how someone can go through rehab and then go back to using drugs within a few days of being released. Group members understand the temptations of other members and can empathize while still supporting one another to take a more positive view of a future without drugs. This means that when members are engaging in self-deceptive behaviors, other members of the group are aware of the negative thinking patterns of addiction and can highlight this when someone is attempting to justify lapsing into old behavior patterns. Group therapy also provides a vital support system to replace that of the friends fostered by drug and alcohol addiction. Instead of finding a social life in drug culture or a bar, group members now...

This is one reason why group therapy is often more beneficial than individualized therapy alone for substance abusers.
The group therapy of Ms. A is informed by a cognitive behavioral approach (CBT). One of the advantages of CBT is that it is highly structured and designed to set specific goals for group participants. The theory behind CBT is that if people change negative and unproductive thinking patterns, they can change their behaviors. Individuals struggling with substance abuse often have difficulty changing their behaviors because of self-defeating thought patterns such as: "I can't get through my day without using x drug." Or "everyone else is having a few drinks, why can't I?" CBT identifies irrational thinking patterns and forces the person being treated to view their lives with a more rational, less black-and-white attitude. As well as changing thinking patterns, CBT also stresses the need to change actual behaviors in the real world. Group members are often given goals from session to session, such as staying away from potentially dangerous situations and people who encourage them to use. They have positive goals that help them to develop more better coping mechanisms to deal with stress, such as talking to a spouse or child who is irritating, rather than taking a drink.

Although the CBT model is the dominant modality of the approach taken by the social worker, Ms. A stressed that she was not a slave to the theory and its highly structured approach. Each session contained an element of individualization to the group members' needs. Some groups were better…