Group Counseling

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Group Counseling for Substance Abuse

Group Counseling for Substance Abuse


Substance abuse is a critical problem in the United States across allsegments of the population and impacts in some way all members ofour society. It is the most prevalent mind disorder, the number onecontinuing health problem, and the number one prison problem in theUnited States (Inaba, Cohen, and Holstein, 2003). The significantnumber of the United States population having substance abuseproblems is indicated by approximately 6% abusing illegal drugs, 12%having problems with drinking, 25% being addicted to nicotine and,conservatively, 10% addicted to prescription medications. All counselors no matter what their specialty or setting willencounter clients with presenting or related problems of substanceabuse. However, counselor education programs and their accreditingbodies do not require knowledge or skill development in this area.Thus, it is critical that we implement strategies to insure that allcounselors in practice and in counselor preparation programsunderstand the process of substa

Substance abuse is defined as the categories classified in the Diagnostic and Statistical Manual IV (DSM-IV) (American Psychiatric Association, 2006) as Substance-Related Disorders and Substance-Induced Disorders. These disorders include the active use and/or dependency on any mood-altering substance. Substances include alcohol, sedatives, amphetamines, cannabis, cocaine, hallucinogens, inhalants, opiods, caffeine, nicotine, and prescription drugs, as well as legal drugs. Similar addiction processes to those of substance abuse include experiences such as eating, gambling, sex, and work addiction. Addictive behavior is characterized by preoccupation with the substance or the experience, withdrawal symptoms after not engaging in the substance or experience, increased tolerance for the substance or activity in order to achieve the same effect, and continued use despite negative consequences. While similarities of behavior exist across all types of substance abuse, individuals cannot be categorized, defined, and treated in relation only to their substance abuse problem. An individual with a substance abuse problem is unique in his/her history, pattern of use and abuse, and counseling and related treatment needs.

While many models of causation of substance abuse have been proposed, no clear etiology has been identified. Models emphasize morality or individual conscious choice, biological or disease vulnerability, behavioral learning patterns, cultural-environmental concerns, or biopsychosocial impact. The biopsychosocial model views substance abuse as a complex interaction of all of the other models and endorses multiple strategies for counseling from these models as appropriate. Counselors need to review these models to develop a conceptual position regarding causation upon which he/she can make consistent therapeutic assumptions and decisions to guide counseling practice.


Conclusions regarding effective counseling strategies for counseling individuals with substance abuse are limited in that this counseling specialty area has been driven more by experience and clinical intuition than by research. As a result, most traditional substance abuse treatment programs (e.g., Alcoholics Anonymous, alcoholism education, half-way houses and therapeutic communities utilizing confrontation, group counseling, individual counseling, and use of medication) have not demonstrated their efficacy. Some successful treatment outcomes have been linked to short-term interventions, aversion counseling, stress management, solution-focused brief counseling, and social skills training, yet seldom are these methods utilized in traditional ...
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