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There is a crucifix in the room and a bookshelf containing Bibles and other religious texts, but the room is otherwise free from religious decorations.
Number of members
The desired size for the group is 10 members. A group with 10 or fewer members is small enough to allow for individual attention, but large enough to provide for some diversity and anonymity in the group setting. However, if there are not sufficient referrals to meet the desired 10-member group size, the group should be able to function with as few as 5 members. Moreover, if there is a greater interest in the group, it should be able to function with up to 15 members. Therefore, group size is somewhat flexible. In addition, some of the weeks will involve education for family members, and attendance is expected to double or triple on those nights.
Open or closed
This group will be closed, which is another feature separating it from the standard 12-step addiction treatment program. The point of the group is education and the curriculum builds from week-to-week. Allowing a participant to join once the group was already in progress would not only deprive that member of the full group experience, but might also prove disruptive to existing group members.
Selection of group Members
The marketing method will help determine selection of the group members. Because potential members will have some legal problems that are linked to addiction, there will be more than a client's perception that he or she has a substance abuse problem recommending them to the group. In fact, the participants will not need to be able to acknowledge having a problem in order to be in the group. The facilitator will be working with the assumption that people who do not have drug or alcohol abuse problems are not going to engage in criminal behavior linked to drugs or alcohol. This may not be true in all cases, but illegal behavior related to substances is an indication of maladaptive behavior.
The group will be held on Thursday nights from 7pm to 9pm. The time has been chosen intentionally because the church location has a 12-step support program available from 9pm to 10pm in the same location, and many of the desired members will be attending that program on the advice of their attorneys. The group will last for a set period of four weeks, with a different learning topic scheduled for discussion each week.
The group will be free of cost. There is minimal overhead to the facilitator, because the church has offered use of the meeting space at no-cost. Furthermore, the church will actually provide refreshments including coffee, juices, and sweets, for the meetings.
Type of therapy
The type of therapy that will be used in the group is psychoeducational group therapy. This therapy differs significantly from traditional group therapy in that it is not aimed at providing support, but aimed at providing education. This difference will be made clear to group members during the first meeting. However, the temporal proximity to the standard 12-step program gives the participants the opportunity to seek out a traditional support group if that is something that they feel they need in order to achieve recovery. The goals of the therapy are: to teach people the signs of addiction, help deal with denial about addiction, teach why recovery is important, suggest treatment options, and identify other community resources that exist to help the addict.
The first week introduction would focus on distinguishing between substance use and substance abuse. It would talk about the fact that any person who has encountered a legal problem related to substance abuse has demonstrated a certain lack of judgment in the substance use that suggested a substance abuse problem. The facilitator would also ask the participants to consider other instances in their lives when substance use had interfered with life functioning. The goal of week one would be to help silence the objections of the people who really did not think that they needed to be attending the group.
The second week would be a family week and family members and addicts would learn more about the different signs of addiction. It would discuss physical and emotional signs of addiction in the addict. However, the class would also talk about the signs of addiction in the family and the impact that addiction can have on the friends and family members of addicts. Many times family systems are either in denial of the addiction or are actively working to help the addict maintain the addiction, and the group lessons would be aimed at informing the families about enabling and teaching them methods of reducing the enabling activity.
The third week would introduce different methods that addicts can use to help them become sober and maintain sobriety. It would cover the broad range of addiction-interventions, from medication to residential treatment programs and 12 step programs. Moreover, the educational aspect would give the pros and cons of the different programs. For example, heroin addicts are frequently placed on methadone, which is, in and of itself, an addictive drug. However, its impact is far less than the impact of heroin. Giving the addicts a broad range of available interventions will help them decide which, if any, of those interventions are best tailored to their approach.
The fourth week will inform the group about the various community resources available in the specific intervention types. The facilitator will ask representatives from local organizations to come speak to the group and be available to enroll members in treatment programs. The fourth week will also involve administration of the exit interview/survey.
Because the goal of the group is to educate its members, rather than provide counseling, the facilitator could be either an education professional or a professional counselor, but would ideally, a counselor with education experience. The facilitator should have a broad understanding of addiction and its issues, and comfortable confronting people about denial. Furthermore, the facilitator should have experience with establishing strong boundaries, because the goal of the treatment is not to establish a therapeutic relationship with the clients, but the group setting might encourage clients to try to establish that type of relationship with the facilitator.
There are various ways to measure the efficacy of substance abuse treatment programs. According to the National Institute on Drug Abuse, there are several key principles that should form the basis of any effective treatment program, so one would believe that examining a program to see if those principles are present would help demonstrate efficacy. These principles are:
No single treatment is appropriate for everyone. Treatment needs to be readily available. Effective treatment attends to multiple needs of the individual, not just his or her drug abuse. Remaining in treatment for an adequate period of time is critical. Counseling -- individual and/or group -- and other behavioral therapies are the most commonly used forms of drug abuse treatment. Medications are an important element of treatment for many patients, especially when combined with counseling and other behavioral therapies. An individual's treatment and services plan must be assessed continually and modified as necessary to ensure that it meets his or her changing needs. Many drug -- addicted individuals also have other mental disorders. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long -- term drug abuse. Treatment does not need to be voluntary to be effective. Drug use during treatment must be monitored continuously, as lapses during treatment do occur. Treatment programs should assess patients for the presence of HIV / AIDS, hepatitis B and C, tuberculosis, and other infectious diseases as well as provide targeted risk -- reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases (National Institute on Drug Abuse, 2009).
While those principles may be helpful, it is clear that they are beyond the capabilities of a short-term psychoeducational group. Moreover, they are very difficult concepts to measure.
In order to measure the efficacy of this short-term psychoeducational support group, group members will be asked to fill out entry and exit questionnaires. Both entry and exit questionnaires will ask the members to state whether they are in or have recently completed a recovery program, are on any anti-addiction medications, and are currently sober. If a greater number of people are seeking treatment or are sober at the conclusion of the small group, then the group will be considered a success. It is important to keep in mind that the group's purpose is not to get people sober. Simply having people get into a treatment program will be considered a measure of success. The facilitator will also keep records to determine attendance at the group meetings, to help determine if failure to attend any proportion…[continue]
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