Transcript HLSC 2120 Oct 30

Early Stage of Group Treatment
getting the client to recognize,
admit and move past their
high levels of ambivalence
and denial.
Early Stage of Group Treatment
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understand the relationship between their
addiction and their present difficult in life.
Early Stage of Group Treatment
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rebellious,
suspicious
and manipulative behaviour
Early Stage of Group Treatment
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During the early stages of treatment the
goal of the therapist is to:
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1) to discover themselves and others as
feeling people
2) identify their defenses
Early Stage of Group Treatment
Ego Defenses:
 denial
 rationalization
Early Stage of Group Treatment
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The art of treating addiction is to
overcome the enormous denial and
resistance that most addicts possess.
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Confrontation
How confrontation is used is critical ~
there can be constructive and destructive
Early Stage of Group Treatment
Washton (1992)
Guidelines for Effective Confrontation
 giving feedback as you see it
 most useful when spoken with empathy,
concern, and respectful voice
 be descriptive (what you observed, give
examples)
 expressing concern about the person’s
dangerous and self-defeating behaviour
Leaders Responsibility
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Assessing when to/ not to intervene
Allowing some tension for group to grow
Helping members assume responsibility
for their own drug related problems
Modulating anxiety in intense situations
Dealing with destructive resistance: fleeing
Treating the group as a mirror, microcosm
Reinforcing Group Norms
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Feedback
Risk-taking
Openness
Acceptance
Confidentially
Impulse Control & Self-Disclosure
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Manage members difficulties with impulse
control
Members inexperience in regulating closeness
and intimacy
Appropriate/inappropriate self disclosure
Risk of self-disclosure ~ vulnerability
Too little, too much: indiscriminate selfdisclosure
Tolerance and readiness of the group/individual
Integrating New Members in the
Open Group
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Introduce how the group works to new
comers
No set ways or rituals for integrating new
members
Impact of new members on group
development
Impact of relapse and returning members
on group process
Middle Stage of Treatment
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Action stage of treatment
Awareness of the stages of change for
individual members and the group as a
whole
Middle Stage of Treatment
Group leader should consider:
 Equal distribution of time in group
 Activity focuses and invites group
members to participate
 Focus on topics that are meaningful
 Prevents rambling patient from derailing
the group
 Provides a clear direction for the group
Corrective Emotional Experience
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Strong expression of emotion
Group supportive enough to permit risk
Reality testing of the incident
Inappropriateness of certain feelings
Inappropriateness of avoiding behaviour
Facilitation to interact with others more
deeply and honestly (Yalom, 2005)
Late Stage Change
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Emphasis will focus on addressing
characterological makeup of the client
Helping the person become aware
That’s who I am
I wnt ot cange but can’t
Here I go again
Whey change? What is in it for me?