Interpersonal process group is a type of group psychotherapy that’s widely and successfully used in addiction treatment programs. The process group model for addiction treatment is based on a large body of research and theory. It focuses on the dynamics and processes of a group to facilitate healing and positive change. Groups are led by a specially trained therapist and can range in size from three to 12 or more people.
HOW PROCESS GROUPS WORK
The therapist’s role is largely one of observation and facilitation as group members discuss a range of topics that arise. Interpersonal therapy takes a psychodynamic approach to helping individuals create change in their lives. Under this approach, the process group by nature becomes a microcosm of how group members relate to the people in their daily lives. The group forms bonds and becomes a community with its own unique culture and identity.
During discussion, the therapist continually monitors three dynamics:
- The psychological functioning of each individual group member
- How group members are relating to one another
- How the group as a whole is functioning
As the group discusses an issue, the therapist helps keep the conversation productive and may ask questions to help clarify participants’ statements, make a point or move the conversation in a relevant direction. Any intervention the therapist chooses to use will impact all three group dynamics, and the goal is to strike a balance so that each dynamic receives optimal attention and serves the needs of each individual and the group.
The therapist’s primary role in the group is to promote and probe interactions that carry a lesson or a point. The level of the therapist’s participation in the conversation and chosen interventions depend on a variety of factors:
- What the therapist observes in the group dynamics
- How leadership and hierarchies are emerging in the group
- What strengths each member brings to the group
- How each individual’s resistance to change affects the group’s functioning
THE PSYCHODYNAMIC APPROACH
The psychodynamic approach draws on knowledge of the way people function psychologically and recognizes that conflict in the mind determines a person’s behavior patterns. Members’ behavior and thought patterns eventually become apparent in the group. As the group progresses, members begin to recognize these patterns in themselves and others and work to develop healthier patterns of thinking and behaving. This leads to real and meaningful change.
The psychodynamic approach is based on several principles, including:
Early Experience Impacts Later Experience
Each member brings personal, cultural, psychological and spiritual histories to the group, and these histories have shaped their experiences.
Perceptions Can Distort Reality
People often generalize their life experiences and apply those generalizations to their current situation, even if it’s counterproductive to do so. This can keep people mired in habits that don’t serve them well.
Unconscious Processes Influence Behavior
As participants in the group become aware of formerly subconscious processes that support unhealthy or unwanted behaviors, this information can be used to improve dysfunctional relationships. Participants learn that all behavior is determined–no behavior is without cause.
We Choose Our Behaviors To Adapt To Situations And Avoid Harm
Every behavior is influenced by an individual’s makeup, environment and experiences and is an attempt to adapt to a situation while staying as safe and comfortable as possible.
Participants in process groups begin to understand themselves better within the framework of the group dynamics and the relationships they develop in the group. The interactional nature of process groups and the “here and now” focus on the relationships allow members to examine the unconscious processes of the group and use them to become more self-aware. In this way, the group itself becomes the agent of change and helps members understand how their behaviors affect others and how others’ behaviors affect them .
BENEFITS OF PROCESS GROUPS
Group therapy in general is highly effective for treating addiction, and process groups are no different. According to the Substance Abuse and Mental Health Services Administration, process groups are: 1
Process groups focus on results rather than abstract concepts and theories. They offer swift, positive outcomes, which is particularly important in the early stages of treatment.
Process groups can be modified by the therapist, who has an arsenal of strategic tools that are easy for group members to acquire and use. The process group model offers enough structure to keep discussions productive, but it’s neither leader-dependent nor leader-oriented, which serves to reduce resistance among group members.
Process groups work extremely well in treatment settings, providing an additional layer of emotional support and another pathway to self-discovery. Participants generally identify positively with process groups, and they experience important changes in character and behavior as they participate in the group and develop beneficial relationships within it.
Working in groups in treatment helps people reduce their ambivalence toward treatment and recovery. It also reduces denial and increases motivation for important changes in thought, behavior and lifestyle. The interactions with the group address clients’ emotional issues, including anxiety and depression. In group settings, including process groups, clients increase their ability to anticipate, recognize and cope with high-risk situations that may lead to substance abuse.
Other benefits of group therapy include helping individuals:
- Reframe key issues in their lives
- Practice reflective listening
- Experience feelings of hope
- Relate to others going through similar circumstances
- Develop higher emotional intelligence
- Experience a sense of belonging, which reduces isolation
People in group therapy share information, strategies and resources to help one another navigate the early weeks and months of recovery.
OTHER TYPES OF GROUP THERAPY USED IN TREATMENT
Interpersonal process group therapy is just one of five main types of group therapy used in addiction treatment, according to the Substance Abuse and Mental Health Services Administration. 2 In practice, these therapies often overlap, each drawing on elements of the others to provide a holistic experience that addresses a wide range of issues and needs.
The other four types of group therapy are psychoeducational groups, skills development groups, cognitive-behavioral/problem-solving groups, and support groups.
Psychoeducational groups are leader-focused and designed to educate clients about addiction and the myriad issues it encompasses. Participants in a psychoeducational group learn about issues that have a direct impact on their lives, such as mental illness, cravings, health issues, and community resources. These groups help clients incorporate information that will help them maintain abstinence and lead to healthier choices in their lives.
Skills Development Groups
The most common type of skills development group is coping skills training. People with substance use disorders generally lack a range of essential coping skills, such as the ability to cope with negative emotions or anger, the ability to relax, or the ability to refuse offers for drugs. Group therapy is particularly suited to skills development, since many of the skills people with addiction struggle with are interpersonal in nature.
Cognitive-behavioral groups are particularly suited to early recovery and focus on cognitive restructuring as the basis for change. Members of cognitive-behavioral groups examine their thought patterns and how these affect their behaviors. They examine their beliefs and perceptions and learn how to change dysfunctional ways of thinking. These groups are goal-oriented and focus on immediate problems.
Support groups are widely used in substance abuse treatment and draw on the understanding that major lifestyle change is a long-term goal, and community support helps to facilitate the development of significant lifestyle changes. Support groups offer acceptance, reflection, and open, honest interactions with others who are going through similar circumstances. Support groups offer friendship, resources, and strategies. They increase self-esteem and self-confidence and reduce feelings of loneliness and isolation, which are major relapse triggers.
Other Types Of Groups
Group therapies that don’t fall within the five frameworks include specialized therapies like relapse prevention therapy; culturally specific groups like gender-based or LGBTQ groups; and expressive therapies like art therapy, horticultural therapy or adventure therapy.
VITAL TO TREATMENT & RECOVERY
Process groups and other types of group therapy are an integral part of a high quality addiction treatment program. They help to engage clients in their treatment plan, which is crucial for increasing retention in treatment. According to the National Institute on Drug Abuse, staying in treatment for an adequate period of time is central to the best possible outcomes.3
The Substance Abuse and Mental Health Services Administration stresses that community support is one of the four pillars of successful recovery.4 Process groups and other group therapies provide a high level of support and community participation from the very start, and they continue to support individuals as they progress through treatment, helping to increase self-awareness and improve interpersonal functioning, which are crucial for successful, long-term recovery.