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Philip J. Flores, Ph.D.
Consensus Panel Chair
Jeffrey M. Georgi, M.Div., CGP, CSAC, LPC, CCS
Consensus Panel Co‐Chair
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
1 Choke Cherry Road
Rockville, MD 20857
Numerous people contributed to the development of this TIP (see pp. ix, xi, and appendices F, G, and H). This publication was produced by The CDM Group, Inc. (CDM) under the Knowledge Application Program (KAP) contract number 270‐99‐7072 with the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS). Karl D. White, Ed.D., and Andrea Kopstein, Ph.D., M.P.H., served as the Center for Substance Abuse Treatment (CSAT) Government Project Officers. Christina Currier served as the CSAT TIPs Task Leader. Rose M. Urban, M.S.W., J.D., LCSW, CCAC, CSAC, served as the CDM KAP Executive Deputy Project Director. Shel Weinberg, Ph.D., served as the CDM KAP Senior Research/Applied Psychologist. Other CDM KAP personnel included Raquel Witkin, M.S., Deputy Project Manager; Susan Kimner, Managing Editor; James Girsch, Ph.D., Editor/Writer; Michelle Myers, Quality Assurance Editor; and Sonja Easley, Editorial Assistant. In addition, Sandra Clunies, M.S., I.C.A.D.C., served as Content Advisor. Jonathan Max Gilbert, M.A., Susan Hills, Ph.D., and Mary Lou Rife, Ph.D., were writers.
The opinions expressed herein are the views of the Consensus Panel members and do not necessarily reflect the official position of CSAT, SAMHSA, or DHHS. No official support of or endorsement by CSAT, SAMHSA, or DHHS for these opinions or for particular instruments, software, or resources described in this document are intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized client care and treatment decisions.
All materials appearing in this volume except those taken directly from copyrighted sources are in the public domain and may be reproduced or copied without permission from SAMHSA/CSAT or the authors. Do not reproduce or distribute this publication for a fee without specific, written authorization from SAMHSA’s Office of Communications.
Copies may be obtained free of charge from SAMHSA’s National Clearinghouse for Alcohol and Drug Information (NCADI), (800) 729‐6686 or (301) 468‐2600; TDD (for hearing impaired), (800) 487‐4889, or electronically through the following Internet World Wide Web site: www.samhsa.gov.ncadi.
Center for Substance Abuse Treatment. Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series 41. DHHS Publication No. (SMA) 05‐3991. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005.
Practice Improvement Branch, Division of Services Improvement, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857.
DHHS Publication No. (SMA) 05‐3991 Printed 2005
Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best‐practice guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to a growing number of facilities and individuals across the country. The audience for the TIPs is expanding beyond public and private treatment facilities as alcohol and other drug disorders are increasingly recognized as a major problem.
CSAT’s Knowledge Application Program (KAP) Expert Panel, a distinguished group of experts on substance use disorders and professionals in such related fields as primary care, mental health, and social services, works with the State Alcohol and Drug Abuse Directors to generate topics for the TIPs. Topics are based on the field’s current needs for information and guidance.
After selecting a topic, CSAT invites staff from pertinent Federal agencies and national organizations to a Resource Panel that recommends specific areas of focus as well as resources that should be considered in developing the content for the TIP. Then recommendations are communicated to a Consensus Panel composed of experts on the topic who have been nominated by their peers. This Panel participates in a series of discussions; the information and recommendations on which they reach consensus form the foundation of the TIP. The members of each Consensus Panel represent substance abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Panel Chair (or Co‐Chairs) ensures that the guidelines mirror the results of the group’s collaboration.
A large and diverse group of experts closely reviews the draft document. Once the changes recommended by these field reviewers have been incorporated, the TIP is prepared for publication, in print and online. The TIPs can be accessed via the Internet at the URL: www.kap.samhsa.gov. The move to electronic media also means that the TIPs can be updated more easily so that they continue to provide the field with state‐of‐the‐art information.
While each TIP strives to include an evidence base for the practices it recommends, CSAT recognizes that the field of substance abuse treatment is evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey “front‐line” information quickly but responsibly. For this reason, recommendations proffered in the TIP are attributed to either Panelists’ clinical experience or the literature. If research supports a particular approach, citations are provided.
This TIP, Substance Abuse Treatment: Group Therapy, presents an overview of the role and efficacy of group therapy in substance abuse treatment planning. The goal of this TIP is to offer the latest research and clinical findings and to distill them into practical guidelines for practitioners of group therapy modalities in the field of substance abuse treatment. The TIP describes effective types of group therapy and offers a theoretical basis for group therapy’s effectiveness in the treatment of substance use disorders. This work also will be a useful guide to supervisors and trainers of beginning counselors, as well as to experienced counselors. Finally, the TIP is meant to provide researchers and clinicians with a guide to sources of information and topics for further inquiry.
Philip J. Flores, Ph.D.
Consensus Panel Chair
Jeffrey M. Georgi, M.Div., CGP, CSAC, LPC, CCS
Consensus Panel Co‐Chair
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Public Health Service
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
1 Choke Cherry Road
Rockville, MD 20857
Numerous people contributed to the development of this TIP (see pp. ix, xi, and appendices F, G, and H). This publication was produced by The CDM Group, Inc. (CDM) under the Knowledge Application Program (KAP) contract number 270‐99‐7072 with the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (DHHS). Karl D. White, Ed.D., and Andrea Kopstein, Ph.D., M.P.H., served as the Center for Substance Abuse Treatment (CSAT) Government Project Officers. Christina Currier served as the CSAT TIPs Task Leader. Rose M. Urban, M.S.W., J.D., LCSW, CCAC, CSAC, served as the CDM KAP Executive Deputy Project Director. Shel Weinberg, Ph.D., served as the CDM KAP Senior Research/Applied Psychologist. Other CDM KAP personnel included Raquel Witkin, M.S., Deputy Project Manager; Susan Kimner, Managing Editor; James Girsch, Ph.D., Editor/Writer; Michelle Myers, Quality Assurance Editor; and Sonja Easley, Editorial Assistant. In addition, Sandra Clunies, M.S., I.C.A.D.C., served as Content Advisor. Jonathan Max Gilbert, M.A., Susan Hills, Ph.D., and Mary Lou Rife, Ph.D., were writers.
The opinions expressed herein are the views of the Consensus Panel members and do not necessarily reflect the official position of CSAT, SAMHSA, or DHHS. No official support of or endorsement by CSAT, SAMHSA, or DHHS for these opinions or for particular instruments, software, or resources described in this document are intended or should be inferred. The guidelines in this document should not be considered substitutes for individualized client care and treatment decisions.
All materials appearing in this volume except those taken directly from copyrighted sources are in the public domain and may be reproduced or copied without permission from SAMHSA/CSAT or the authors. Do not reproduce or distribute this publication for a fee without specific, written authorization from SAMHSA’s Office of Communications.
Copies may be obtained free of charge from SAMHSA’s National Clearinghouse for Alcohol and Drug Information (NCADI), (800) 729‐6686 or (301) 468‐2600; TDD (for hearing impaired), (800) 487‐4889, or electronically through the following Internet World Wide Web site: www.samhsa.gov.ncadi.
Center for Substance Abuse Treatment. Substance Abuse Treatment: Group Therapy. Treatment Improvement Protocol (TIP) Series 41. DHHS Publication No. (SMA) 05‐3991. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2005.
Practice Improvement Branch, Division of Services Improvement, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857.
DHHS Publication No. (SMA) 05‐3991 Printed 2005
Treatment Improvement Protocols (TIPs), developed by the Center for Substance Abuse Treatment (CSAT), part of the Substance Abuse and Mental Health Services Administration (SAMHSA) within the U.S. Department of Health and Human Services (DHHS), are best‐practice guidelines for the treatment of substance use disorders. CSAT draws on the experience and knowledge of clinical, research, and administrative experts to produce the TIPs, which are distributed to a growing number of facilities and individuals across the country. The audience for the TIPs is expanding beyond public and private treatment facilities as alcohol and other drug disorders are increasingly recognized as a major problem.
CSAT’s Knowledge Application Program (KAP) Expert Panel, a distinguished group of experts on substance use disorders and professionals in such related fields as primary care, mental health, and social services, works with the State Alcohol and Drug Abuse Directors to generate topics for the TIPs. Topics are based on the field’s current needs for information and guidance.
After selecting a topic, CSAT invites staff from pertinent Federal agencies and national organizations to a Resource Panel that recommends specific areas of focus as well as resources that should be considered in developing the content for the TIP. Then recommendations are communicated to a Consensus Panel composed of experts on the topic who have been nominated by their peers. This Panel participates in a series of discussions; the information and recommendations on which they reach consensus form the foundation of the TIP. The members of each Consensus Panel represent substance abuse treatment programs, hospitals, community health centers, counseling programs, criminal justice and child welfare agencies, and private practitioners. A Panel Chair (or Co‐Chairs) ensures that the guidelines mirror the results of the group’s collaboration.
A large and diverse group of experts closely reviews the draft document. Once the changes recommended by these field reviewers have been incorporated, the TIP is prepared for publication, in print and online. The TIPs can be accessed via the Internet at the URL: www.kap.samhsa.gov. The move to electronic media also means that the TIPs can be updated more easily so that they continue to provide the field with state‐of‐the‐art information.
While each TIP strives to include an evidence base for the practices it recommends, CSAT recognizes that the field of substance abuse treatment is evolving, and research frequently lags behind the innovations pioneered in the field. A major goal of each TIP is to convey “front‐line” information quickly but responsibly. For this reason, recommendations proffered in the TIP are attributed to either Panelists’ clinical experience or the literature. If research supports a particular approach, citations are provided.
This TIP, Substance Abuse Treatment: Group Therapy, presents an overview of the role and efficacy of group therapy in substance abuse treatment planning. The goal of this TIP is to offer the latest research and clinical findings and to distill them into practical guidelines for practitioners of group therapy modalities in the field of substance abuse treatment. The TIP describes effective types of group therapy and offers a theoretical basis for group therapy’s effectiveness in the treatment of substance use disorders. This work also will be a useful guide to supervisors and trainers of beginning counselors, as well as to experienced counselors. Finally, the TIP is meant to provide researchers and clinicians with a guide to sources of information and topics for further inquiry.
KAP Expert Panel and Federal Government Participants
1 Groups and Substance Abuse Treatment
2 Types of Groups Commonly Used in Substance Abuse Treatment
3 Criteria for the Placement of Clients in Groups
4 Group Development and Phase‐Specific Tasks
6 Group Leadership, Concepts, and Techniques
Appendix B: Adult Patient Placement Criteria
Appendix C: Sample Group Agreement
Appendix E: Association for Specialists in Group Work Best Practice Guidelines
Appendix G: Cultural Competency and Diversity Network Participants