Group therapy is one of the universal cornerstones of effective treatment for substance abuse. Treatment centers worldwide employ this simple framework as one of their key therapeutic modalities – this is unlikely to be the first time you have heard of it.
However, unlike other therapeutic structures offered to support addiction recovery, group therapy is quite vague if understood from the name alone.
So what is it? Group therapy is a therapeutic session where one or two mental health professionals lead up to five people through guided group discussions, role-play, psychoeducational lectures, or experiential therapies like trust-building activities.
Group therapy sessions present a safe space to process trauma and mental health challenges, plan healthy coping strategies, and connect with others who share similar struggles with mental health or substance abuse.
What To Expect
Group therapy at Cirque Lodge runs in small sessions with the guidance of a trained therapist. Depending on whether it is a group therapy session intended to center addiction or mental health, those in the room may share similar substance use disorders or other co-occurring disorders.
If you are new to recovery, the prospect of being asked to enter a room with other clients and share these innermost thoughts and stories can be a daunting one. Often, therapists employ recreational therapies to open up space for honesty and compassion in the session. You may begin with trust-building activities such as the human knot or two truths and a lie before you segue into any of the discussion questions.
The exact structure and topics discussed in a group therapy session will depend on the type of treatment you are receiving. There are five categories of group therapy that help overcome addiction:
- Psychoeducational group. With addiction, knowledge is power – psychoeducation works to educate you on the science and psychology of addiction to help you build better, informed coping skills.
- Skills development groups. Sober living often requires you to adjust to the way you socialize and plan your daily life. These group therapy sessions are focused on helping you build practical behavioral and interpersonal skills that you can rely on when you leave treatment. Most therapy groups involve role-playing.
- Cognitive-behavioral groups. Focus is on the learned thinking patterns that contribute to and uphold addictive behaviors during cognitive-behavioral therapy groups. While the therapist ultimately guides the topic ideas, discussions between group members can direct the group session and allow each participant to offer helpful input and reinforce changes.
- Interpersonal process groups. In a process group, dynamics between participants in the session are understood as microcosms of how group members act in their daily lives. The process group aims to unearth the developmental background of participants’ current behaviors.
- Support groups. A support group offers a free, open, and non-judgmental space for group members to vocalize needs, struggles, aspirations, and thoughts in recovery. These groups are often more free-form than other types of group therapy, allowing participants to feel connected and receive support from one another.
Substance Abuse Group Therapy Topics
As you can probably tell by now, role-playing and group activities may be included, but what really makes group therapy stand out as a modality is the interest each form has in sparking discussion. In practice, the topics often addressed in group sessions at Cirque Lodge have been as infinite as our clients’ personal experiences.
Below, we have shared just a few group therapy topics.
When new members join support groups, it is common for them to share where they are in their recovery journey. These stories are unique and help build the foundation of trust between group members that is necessary to move forward in later sessions.
Recovery stories may involve talking about why you decided to enter rehab, what you have accomplished so far, what has been difficult, and how you feel about where you are. This may be a good opportunity for skills sharing, especially for group members that are further in their recovery journeys. Still, you also may want to dedicate this group topic to reflection.
One of the most common group therapy topics to come up in a session is the subject of triggers. People, places, situations, or even just thoughts and emotions set off a cascade of reactions in the nervous system of people who struggle with addiction, often leading to relapse.
Not being able to anticipate, prepare for and handle triggers when they arise is a leading cause of relapse. Group sessions help you do all of this by providing a space to discuss personal triggers and what you find challenging about them. You will also find that group members support one another in developing strategies to deal with triggers before they arise.
Post-traumatic stress disorder (PTSD), dysregulation, and addiction are closely linked topics in mental health, and as such many group discussions center around trauma.
Group therapy activities aimed at exploring trauma may be psychoeducational in nature. In these lectures or activities, a mental health professional presents helpful information about the nature of trauma in the brain and body, as well as strategies for managing it.
In other therapy groups, the conversation may circle around the subject of pain and regulation. For example, a support group exercise may ask participants to discuss their social expectations and biases to which they feel they need to conform in their own handling of pain, fear, or discomfort.
The 12 Steps
The 12-step program is an actionable set of ideas enshrined in the Big Book that can help people heal from drug or alcohol abuse. When this program was developed 50 years ago, it was groundbreaking – a treatment rooted in compassion that recognized addiction as a disease at a time when it was commonly believed to be a moral failing.
Now, it continues to be one of the best and most effective paths towards recovery available, no matter what substance of abuse you have lost control over.
At Cirque Lodge, we offer therapies that are informed by the original 12 steps – you can expect discussions of this framework to come up as one of your group therapy topics early in your stay with us.
From labeling to self-talk, negative thoughts are powerful drivers impacting how we imagine ourselves, our abilities, and subsequently act.
For example, individuals who think of themself as a ‘failure’ in recovery are already undermining their own emotional sobriety. When a trigger arises, thoughts and beliefs about their own resilience will have sabotaged their ability to overcome it. For this reason, there are many benefits to improving self-esteem in recovery.
Addiction fills many people’s heads with negativity, but group therapy offers a unique chance to start voicing and replacing this thinking. Helpful group activities can help you see yourself through others’ eyes, including ones focused on positive descriptions or ones that ‘spin’ negative self-talk.
Group therapy topics often attempt to uncover the driving causes of addiction, so sooner or later, you can expect some sessions looking at family. Unsupportive family dynamics, codependent or mismatched familial roles, and attachment theory are all thought to contribute in their own ways to the development of substance use disorder.
In your group therapy sessions, you may discuss:
- Parent-child relationships
- Sibling relationships
- The family as a system with roles and functions
- Other family members related to drug use
- Attachment theory
If you discover in process groups or elsewhere that family dynamics may be contributing in a significant way to your struggle with addiction, you may want to ask your relatives to come to specialized group therapy.
Family therapy is one of many ways the loved ones of people struggling with substance abuse can build trust, mend relationships, and truly support the recovery journey.
Forgiveness is central to the 12-step path to recovery. Addiction leaves many of us mired in resentment towards others, who often fail to understand or support us, or towards figures in our pasts, which we may blame for leading us to addiction. Addiction also causes us to resent ourselves for the harm we’ve caused to our own and loved ones’ lives.
In a group therapy session, you may discuss forgiveness and why and how to forgive. Each group member might speak in order and describe what grudges they have been holding on to. Role-playing activities between group members and the group leader, representing the people in each person’s lives, can also help build empathy towards friends and loved ones.
Finally, many group therapy activities, particularly in recreational group therapy, will involve metaphors for subjects in your life. You may find yourself working through the subjects of forgiveness and letting go through reflective play as well.
Gratitude is key to acceptance and commitment, and while it is one of the foundational emotions to cultivate in recovery, its benefits extend through many aspects of our lives. Working in a group setting can help you practice the skills of gratitude with other clients. Members who participate in sessions together support one another and have a lot to be grateful for in their new relationships.
During sessions, you may discuss what gratitude is, how and why it is best expressed, and of course, what you are grateful for. Simple as it is, practicing extending gratitude every day is one of the most essential skills for maintaining a recovery mindset.
When triggers arise, how do you manage them? Group setting observations and role-play offer a chance to answer this question with the input of other trusted participants. Group therapy also enables you to seek advice on how to get better at stress and anger management.
Many stressors in recovery are hard to avoid, whether they come from personal relationships and family dynamics or are external facts of life like seasonal affective disorder or chronic conditions. In these cases, many coping skills can be cultivated to help you stay prepared for inevitabilities when they surface.
Coping skills can also be preventative. In group therapy, you may receive advice on how to improve self-care in recovery and start taking action to improve your physical and mental health. Group activities may include discussing health habits, sleep, nutrition, and exercise – understanding that meeting these foundational needs is key to maintaining emotional health.
Recovery can feel like becoming a new person. When the haze of addiction is lifted, you will find yourself experiencing your own emotions, thoughts, wants, and imaginations with clarity that, in some cases, even feels unfamiliar. Asking and questioning who you think you are now and who you want to be can help you stay grounded in your sense of self and open to the possibilities that recovery brings.
Do you want to heal your relationships? Move forward with a hobby or passion? Go back to school? Change your job? Group therapy activities can help you with all of these elements by exploring new goals and passions inside and outside of your session, enabling you to get to know your true self again. Group participants may be asked to try out goal visualization or other activities that aim to flesh out potential aspirations.
On a more pragmatic level, support group activities can address the subject of new hobbies by helping you find what sober pastimes are engaging for you. Group members are wells of knowledge when it comes to substance-free activities and can help one another get started having fun in recovery.
Why It Works: Group Therapy Topics For Addiction
Addiction itself is a lonely experience. On the one hand, substance abuse is far more likely to develop in individuals whose psychosocial needs are going unmet. Still, beyond that, as the addiction progresses, it often pushes friends and family away. While this is happening, you may even be too distracted to process the magnitude of social loss.
When you finally choose to seek help and start down the path to recovery and sobriety, new challenges arise. Recovery from substance use is hard, sometimes isolating. Work that brings negative thoughts to the surface requires you to reflect on personal experiences that your close loved ones do not necessarily share. If you have experienced a lot of damage to your social network, it gets even harder.
Group therapy opens up a safe space to start building the skills of communication, trust, and care necessary for healing and allows you to tap into the power of unity and community. The bonds of mutual support created in group therapy sessions are a great resource that can carry participants down the path to recovery in the months or years ahead.
Getting the most out of group therapy doesn’t mean you have to show up to your sessions with perfect knowledge of the topic discussed. Instead, come ready to be surprised and challenged and prepared to be honest regardless of where the conversation leads.