Research Paper on "Group Addiction Counseling"

Research Paper 5 pages (1570 words) Sources: 5 Style: APA

[EXCERPT] . . . .

Group Counseling Using Client-Centered Therapy / Adlerian Group Therapy

There are a number of theories in use in the psychological / therapeutic milieu when it comes to working with addictive behaviors, substance abusers and others, but for this paper client-centered group therapy and Adlerian Group Therapy will be reviewed and critiqued.

Client-Centered Counseling / Therapy

Mary Law, associate professor in the School of Rehabilitation Science at McMaster University in Canada, gets right to the point about client-centered therapy in her book Client Centered Occupational Therapy. A characteristic of the client-centered strategy -- setting it apart from other approaches -- is "…based on an invitation from the client to the therapist to participate in a relationship" (Law, 1998, p. 115). Law states that there should never be an assumption that an invitation automatically exists; that invitation must be solicited by the therapist by starting out the conference with, "How can I help you?" The client is apt to reply, "I don't know, what do you do?" (Law 115).

At that point in the client-centered dynamic, the therapist -- whether in a group session or one-on-one with the client -- explains that he helps people working towards their goals, and he would be pleased to help the client approach those goals. The client may respond by saying she has no idea what goals are important or attainable -- or she may add, "what I can do" (Law, 115). Law insists correctly that once the therapist has requested an invitation (and received one), and described his role in this substance abuse therapeutic relationship and explained his goals (to encourage the client to put forward his goals), the "goaling process" can begin (Law 117).

In the event the client shrugs off the initial offer of help ("I don't want any help"), the therapist then gently, professionally states that the client has been referred for therapy and one of the goals will be to reduce the amount of alcohol (or other substances) the client consumes, and asks, "Is that something you would like some help with?" The response of the client is pivotal at this point, but the key in the earlier dialogue is the fact that the therapist "ignored the declaration of the client and pushed forward to establish a likely therapeutic goal," Law explains on 117.

Law offers four steps in the "goaling process": a) structured interview in which the therapist listens carefully on goals proposed by the client; b) developing priorities (the client selects only important goals from the list); c) significant other review (list of goals is taken home for input from wife or significant other); and d) publishing final goal list (client has copies printed, gives one to each member of the group or others the therapist and client agree upon) (Law 118). If Law can so quickly turn a recalcitrant client's negativity into cooperative spirit she is truly performing a near-miracle. Her narrative, while descriptively lively, and no doubt honestly presented, seems to be a bit of a stretch vis-a-vis client cooperation at the outset.

Dr. Jeffrey Zeig believes that by employing client-centered therapy in a group setting the therapist is a "facilitator of change, of growth, of learning, of self-empowerment for the other" (Zeig, 1987, p. 191). The group facilitator is not an elite know-it-all but rather a "companion to each member of a group on the journey of self-discovery and growth" (Zeig, 191). On page 193, the author, Founder and Director of the Milton H. Erickson Foundation, insists that client-centered counseling and therapy must first "move away from the medical model," from the "quick dependence on [prescribing] drugs," and from the "doctor knows best" arrogance. Zeig's description of client-centered group therapy explodes with sincerity and realism.

Zeig hangs his professional hat on one of Carl Rogers' most vital intervention conditions necessary in order for "constructive personality change" to take place: "Unconditional positive regard" (193). To emphasize the holistic, deeply sincere meaning of unconditional positive regard, Zeig chooses a quote from Rogers: "As the awareness of the self emerges, the individual develops a need for positive regard" (Zeig quoting Rogers, 193). The client's need for positive regard, Zeig continues, is based on Rogers' belief that once the client moves away from his self-concept as an "unworthy, unacceptable, and unlovable person" and arrives through client-centered therapy as an "accepted, respected, and loved" person the facilitator has done a good job.

Readers clearly get the sense of Zeig and Rogers' humanity in this book; to wit, they understand that "love" is "the most useful term" to describe the "basic ingredient for the therapeutic relationship" (194). Zeig's book was published in 1987, but by using Rogers' theories and employing holistic strategies the author appears to be as contemporarily relevant as any author (before or after Zeig's book was published) this writer has reviewed in this process.

Professors Linda and Mark Sobell have written a book on group therapy for substance abusers, and among their featured strategies is "motivational interviewing," which is a "non-confrontational, non-judgmental" approach that embraces client-centered therapy. Linda Sobell explains that motivational interviewing has been found to receive "less resistance" and "increased compliance" -- as well as lower "dropout rates, better attendance during treatment, and better overall treatment outcomes" -- from clients (Sobell, 2011, p. 26). Motivational interviewing is a "goal-directed, client-centered counseling style" that seeks to bring out the client's desire and motivation to change (Sobell, 26). The way in which change is achieved in this process is by "exploring and resolving a client's ambivalence about changing risky/problem behaviors" (Sobell 26).

In a very real way motivational interviewing follows Rogers' path; that is, the therapist is not telling the client what he should do, but rather it uses strategies to "get clients to verbalize their need to change" (Sobell 26). The psychology employed inspires clients to "identify discrepancies" between their present behaviors (substance abuse, for example) and their "desired goals." If that sounds like Rogers and Zeig, it should; that is because motivational interviewing is a strategy that uses "empathy" (think Rogers' use of "love") in the context of complimenting the client rather than denigrating him. Motivational interviewing allows the client to make his own choices, as opposed to having therapists and counselors dictate to the client what he should do (Sobell 27).

The truth about this approach to therapy -- as psychologists Miller and Rollnick explain in Sobell's narrative -- is that it is more of an "interactional counseling style" than it is an actual intervention (27). Indeed, this is a very progressive approach to drawing the client out in the open to review his needs. It is a style, rather than a hard-and-fast therapeutic intervention. Sobell insists that motivational interviewing -- like Rogers' version of client-centered therapy -- holistically coaxes the client to "give voice to the need to change" (28). On page 28 the authors juxtapose a non-motivational interviewing question ("Do you have a drug problem?") next to a question that is used in motivational interviewing ("Do you mind if we talk about your recent drug use?"). At the risk of over-simplifying the strategy, Sobell's work boils down to embracing refinement, humanity, and empathy in a therapeutic approach, and whether it is called an intervention or just an interactional counseling style, if employed correctly, it can facilitate positive change.

Advantages of Group Therapy

Arnold Washton is 100% sold on group therapy as an appropriate setting for treating addiction. The successful facilitator's work is "neither cognitive, behavioral, psychodynamic, interpersonal, 12-step nor client-centered," he asserts; but rather, successful group therapy is all of the above (Washton, 2001, p. 239). Group therapy must embrace a non-dogmatic, open-minded strategy that maintains "unfailing respect for the client, for his or her autonomy, sensitivities, defenses, and personal strengths"; and moreover, the therapist must begin where the client is, "not where you… READ MORE

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