Maryland Wellness and Recovery

Caring Support Services

Group Counseling and Therapy

Group counseling allows programs to balance the cost of more expensive individual counseling services. A group approach supports clients by:

Providing opportunities for clients to develop communication skills and participate in socialization experiences; this is particularly useful for individuals whose socializing has revolved around using drugs or alcohol
Establishing an environment in which clients help, support, and, when necessary, confront one another
Introducing structure and discipline into the often chaotic lives of clients
Providing norms that reinforce healthful ways of interacting and a safe and supportive therapeutic milieu that is crucial for recovery
Advancing individual recovery; group members who are further along in recovery can help other members
Providing a venue for group leaders to transmit new information, teach new skills, and guide clients as they practice new behaviors

Outpatient Groups for Recovery

Educational Support Groups

These groups provide a supportive environment in which clients learn about substance dependence and its consequences. These time-limited groups may be initiated at the beginning of treatment. They feature:

Low-key rather than emotionally intense environment.
Rational problem-solving mechanisms to alter dysfunctional beliefs and thinking patterns.
Various forms of relapse prevention and skills training. Didactic components often are supplemented by videos or slides to accommodate different learning styles.

Skill-Building Groups

These groups offer clients the opportunity to practice specific behaviors in the safety of the treatment setting. Common types of skills training include

Drug or alcohol refusal training. Clients act out scenarios in which they are invited to use substances and role play their responses.
Relapse prevention techniques. Using relapse prevention materials, clients analyze one another's personal triggers and high-risk situations for substance use and determine ways to manage or avoid them.
Assertiveness training. Clients learn the differences among assertive, aggressive, and passive behaviors and practice being assertive in different situations.
Stress management. Clients identify situations that cause stress and learn a variety of techniques to respond to stress.

Support & Process Groups

These groups include clients in the same recovery stage—usually a middle to late phase of treatment—who are working on similar problems. Members focus on immediate issues and on :

Pragmatic ways to change negative thinking, emotions, and behavior
Learning and trying new ways of relating to others
Tolerating or resolving conflict without resorting to violence or substance use
Looking at how members' actions affect others and the function of the group

Interpersonal Groups

Single-interest groups. These groups—usually organized at a later stage of treatment—focus on an issue of particular significance to and sensitivity for group members. The issues include gender issues, sexual orientation, criminal offense, and histories of physical and sexual abuse.
Family or couples groups. These groups assist clients' relatives and other significant individuals in learning about the detrimental effects of substance use on relationships and how these effects can be ameliorated or resolved.

Key Topics in Recovery Education

Treatment engagement

Understanding motivation and committing to treatment
Counteracting ambivalence and denial
Determining the seriousness of the drug or alcohol problem
Conducting self-assessment, setting goals, and self-monitoring progress
Overcoming common barriers to treatment

Early recovery

Learning about biopsychosocial disease and recovery processes
Understanding the effect of specific drugs and alcohol on the brain and body
Placing symptoms of substance use disorders in the context of other behavioral health problems
Learning about early and protracted withdrawal symptoms for specific drugs and alcohol
Knowing the stages of recovery and the client's place in the continuum of care
Learning strategies for quitting and finding the motivation to stop
Minimizing risks of HIV/AIDS, hepatitis C, and sexually transmitted diseases (STDs)
Identifying high-risk situations that are cues or triggers to substance use: people, places, and things
Identifying peer pressures and compulsive sexual behavior as triggers
Understanding cravings and urges, learning to extinguish thoughts about substance use, and coping with cravings
Structuring personal time
Coping with high-risk situations
Understanding abstinence and the use of prescription and over-the-counter medications
Understanding the goals and practices of various 12-Step or other mutual-help groups
Identifying and using positive support networks

Maintenance and continuing care

Understanding the relapse process and common warning signs
Identifying tools to prevent relapse
Developing personal relapse plans
Counteracting euphoria and the desire to test control
Improving coping and stress management skills
Learning anger management and relaxation techniques
Enhancing self-efficacy for handling risky situations
Responding safely to slips and avoiding escalation
Finding recovery resources
Structuring leisure time and finding recreational activities
Knowing the importance of personal health: diet, exercise, hygiene, and checkups
Taking a personal inventory
Handling shame, guilt, depression, and anxiety
Understanding family dynamics: enabling and sabotaging behaviors
Rebuilding personal relationships
Understanding sexual dysfunction and healthy sexual behavior
Developing educational and vocational skills
Learning daily living skills: money management, housing, and legal assistance
Embracing spirituality and recovery and finding meaning in life
Recognizing grief and loss and the relationship to substance use
Learning about parenting: basic needs of children and their developmental stages and developmental tasks
Maintaining balance in life