In addition to specific problems related to recovery or the lives of the group members, problems are also commonly encountered in the group process.

These problems require the group counselor to intervene to make sure the group addresses them. Following is a discussion of some of the more common group process problems and suggested strategies for the group counselor to undertake:

1. A group member dominates the discussion or always brings the discussion back to his own problems or issues. The group counselor can thank the member for the contributions and then elicit opinions and experiences from other group members.

If the group member persistently tries to dominate group discussions or always turns the discussion back to his own problems or issues, this behavior pattern can be pointed out by the group counselor to make this member and other group members aware of the behavior. The other members can be asked how they feel about the member??Ts dominating the discussion, and how they want to deal with this in a way that is satisfying to everyone in the group.

Even though this creates a problem on one level, on another level some group members find that it creates a safety net for them because they may believe they don??Tt have to disclose personal problems or feelings as long as another member is taking up the group time.

2. A member does not disclose any problem or open up in the group session. The group counselor can share his observations about the member??Ts behavior and generalize the issues by asking group members to talk about difficulties that contribute to problems in self-disclosing (e.g., shame, shyness, social anxiety). Discussion can then focus on ways this member (or other group members who have trouble disclosing) can gradually learn to trust the group to disclose personal thoughts, feelings, problems, or concerns.

3. A member consistently rejects the input, advice, or feedback of other group members. The group counselor can point out this pattern and engage the group in a discussion of why this pattern is occurring. Members who offer help and support only to have their attempts rejected can be asked to talk about what this feels like so that the member who rejects their help is aware of the impact this behavior has on others.

4. A member can only pay attention when the discussion focuses on his problems, or he interrupts others when they talk. The group counselor can point out what he observes about the group member and discuss the reasons for this behavior.

The group can then discuss the effects of this behavior (e.g., upsets other members, turns them off, makes them feel as if their problems aren??Tt important). The group can also discuss the importance of ??ogiving and receiving??? mutual support by listening to each other??Ts concerns and problems.

5. A member wants easy answers to problems or is quick to provide easy solutions to others when they discuss personal problems. The group counselor can share his observations of the behavioral patterns of this group member and ask the group to discuss the importance of taking responsibility for finding solutions to their problems and to identify more than one strategy to address a particular problem.

The leader can emphasize that while there are many different ways to resolve specific problems, seldom are there easy or simple solutions, and that group members need time, patience, and persistence to adequately resolve problems. When a group member provides an easy solution, the group counselor can acknowledge that this is one strategy that may help some people, but it is also helpful to have other strategies.

The group counselor can then engage the group in a discussion of other strategies to address the problem under discussion. Finally, the group counselor can emphasize that learning how to think about problem solving is just as important as dealing with specific problems because everyone in the group will continue to face problems in his or her ongoing recovery.

6. A member tries to engage the group counselor in individual therapy during the group session. The group counselor can ask other group members to comment on the problems or issues this member presents. If the group member asks the group counselor how to handle a specific problem, the counselor first can encourage the member to identify possible coping strategies, then ask other group members for their ideas for dealing with the problem.

7. A member arrives late for the group session or wants to leave during discussions. The leader and group members should develop a rule about arriving late for group sessions.

Sometimes, there are legitimate reasons for being late (e.g., the bus a member takes was running 15 minutes late, the member got a flat tire, etc.). Members may be given a break once or twice for being late. However, the group may establish a rule that states that a member cannot join the group after a certain time (e.g., more than 10 minutes after the start of the group session).

If time limits are not set, the group counselor can predict that some members will be late often. Members who are persistently late can be asked to discuss this pattern of behavior, how it is repeated in other areas of their lives, and what they think needs to be done to change this pattern.

Group members should never leave a counseling session unless there is an emergency (e.g., they have a minor illness and need to use the restroom). Routinely allowing people to walk in and out disrupts the flow of the conversation and gives the message that what members say is not important. Members may want to leave group sessions because they are bored, feel like the discussions don??Tt relate to them, or want to avoid discussing their own problems or concerns.

8. The group talks in generalities and avoids exploring specific problems in depth. The group counselor can point out this dynamic to the group and ask members to discuss why they aren??Tt talking about specific problems or concerns in recovery.

The counselor can ask members to set the agenda in a concrete way so that specific problems or concerns are identified for discussion. It isn??Tt uncommon for group members to view counseling groups as no different than free floating discussions held in some CA, NA, or AA meetings. However, Phase II group sessions are designed to explore and address problems and not simply be a repetition of 12-Step recovery meetings.

9. The group avoids confronting a member who behaves inappropriately. The group counselor can point out this dynamic and ask group members what they think about the inappropriate behavior and why they have avoided discussing it.

Other problems may occur during the group time, but those described above are some of the more commonly occurring ones. While the ??ocontent??? (i.e., problems and issues discussed) of the group is important, if the ??oprocess??? bogs down, not much will be accomplished.

In addition, some group members may miss sessions or drop out as a result of group process problems that aren??Tt addressed. Unfortunately, group members may avoid bringing up the issues so the group counselor won??Tt always know the reasons for a member??Ts poor attendance or early drop out from the group.

It is not uncommon for members to be upset over process issues. A ??opreventive??? strategy is to periodically engage the group in a discussion of the group process. The group counselor can ask what members think about the group sessions, what they like and dislike about how the group has been going, and what changes they would like to see occur in the group.

Reasons for Dropping Out of Group Treatment

One of the assessments used in the CCTS study was called ??oReasons for Early Termination of Treatment.??? This assessment aimed to find out specific reasons why clients left outpatient treatment before completing it.

While clients gave numerous reasons for dropping out of the individual and group treatment conditions, the most common reasons they gave for dropping out of group treatment were:

Time problems 42.7%

Using cocaine again or wanting to use cocaine 30.7%

Group sessions not helpful 30.7%

Want a different treatment (individual) 30.7%

Problems improved 18.7%

Other unspecified reasons 18.7%

Unwilling to participate in treatment 16.0%

Needed hospitalization 13.3%

Clients who participated in group treatment were more likely to find that group sessions alone were not as helpful as group sessions combined with IDC, CT, or Supportive Expressive therapy.

This reinforces the point that clients generally do not like to participate in group-only treatment. They both want and need individual sessions, so a combination treatment is preferable when possible.

--------

article source: Chapter 6 - Phase II: Problem-Solving Group