Abstract
Drug addiction is a disease that has biological, psychological, and social underpinnings. A loss of control is characterized by willpower over consumption, psychological state, and social life. Causes for the development of addiction might come from problems in childhood. Helen Petrakis, a 52-year-old heterosexual married woman of Greek descent, says she feels overwhelmed and depressed. She also reports dependence on drugs killing pain. The client asked for help at the suggestion of a close friend who thought Helen would benefit from having someone who could listen to her. Although she was uncomfortable talking about her life with a stranger, Helen said she decided to come to therapy because she was worried about burdening her friends with her problems. Helen met with a social worker four times, twice a month, for individual therapy in 50-minute sessions. Cognitive group therapy is a possible method to help Helen and patients with similar problems.
Introduction
Purpose
The primary purpose of any therapeutic group is to provide a support network for a patient and ensure him/her that it is possible to rely on others and ask for support when needed. At the same time, it might help to understand the scope of the problem and the specific similarities between different clients and find the motivation to overcome the major difficulties. At the same time, the treatment group helps clients to feel more confident and avoid fears when interacting only with a psychologist (Cruise, 2021). For this reason, it remains a potent method of working with individuals with destructive or undesired behaviors.
The central aim of the proposed group is to support drug-addicted individuals, such as the client, who require help and cannot avoid using harmful substances on their own. For this reason, it is expected that the cognitive behavioral group consisting of 10 clients with similar issues and a leader should be established. The leader should be a qualified psychologist with experience and skills in cognitive behavioral therapy (National Institute on Drug Abuse, 2018). She/he should also possess the necessary communication skills to organize the group’s work and ensure clients are engaged in the collaboration aimed at reconsidering their habits and acquiring new, healthier ones.
Membership
It is expected that the group should consist of individuals with specific backgrounds and current issues. First, all clients should have the experience of living in a disadvantaged family with no clear behavioral norms drinking parents, or abusive behaviors. It would help to find common ground and discuss the problems from the past that contributed to the emergence of drug addiction and its further development. Second, patients addicted to pain medication should be included (Cruise, 2021). It would help to work together and address the problem by analyzing its roots, mechanisms of addiction development, and the current state.
There are no strict demands on the population comprising the group. Individuals should be of the full age and realize the problem impacting them. The cultural characteristics are unimportant, and the group can consist of representatives of various cultures and religions. Sexual orientation, age, and gender are not critical, as the activities will be focused on other aspects of clients’ lives. At the same time, the involuntary group members cannot be included (National Institute on Drug Abuse, 2018). All clients should have the desire to change their thinking patterns and learned behaviors to build healthy lifestyles and avoid the further development of dependence. These peculiarities should be considered when creating the treatment group.
Statement of Need
Children from socially disadvantaged families are most often at risk. Factors such as environment and genetic predisposition play a role here. In families where parents drink, there are both factors. In such families, children are at much greater risk of becoming addicted to drugs and alcohol (National Institute on Drug Abuse, 2018). The same risk group includes children from families with no clear norms of behavior and are left to themselves. However, those who set too rigid limits or overprotect children are also at risk (National Institute on Drug Abuse, 2018). One of the risk factors is personal problems: conflicts with parents and problems communicating with peers. Such upbringing models do not provide the child with the necessary conditions for personal growth and are a source of the child’s maladaptive behavior. In the future, such children face a higher risk of becoming addicted to various substances or start using painkillers to cope with depression. For this reason, the treatment group addressing the problem might be useful for the community and help individuals with similar issues.
Leading a treatment group requires extensive planning from the clinical social worker. Therapeutic groups focus on a specific emotional and behavioral problem negatively affecting a person’s life. A therapeutic group differs from a support group or task force in that it requires a professional to act as a leader. The clinical social worker must use evidence-based methods and plan a group appropriate for the participants. In addition, the clinical social worker must consider all aspects related to group therapy, such as membership, purpose and goals, and monitoring. For the case, the client, Helen Petrakis, reports living in a socially disadvantaged family when she was a child. For this reason, it is expected that the cognitive behavioral group would help her and similar patients to alter their thinking patterns and acquire healthy behaviors necessary for her recovery and rehabilitation.
Recruitment
A leader can recruit members for the proposed treatment groups using several methods. First, it is possible to place the advertisement in the local newspaper and journals. It might help to attract the attention of potential clients looking for support and assistance in struggling against their addiction. Second, the local social center can be used to advertise the group and make referrals (Brown et al., 2019). It can popularize the planned sessions and attract attention to them. Self-referral practices can also be used as they demonstrate high effectiveness in finding potential members (Brown et al., 2019). Furthermore, it is vital to perform screening procedures to ensure that clients with the necessary features and similar problems are selected. For this reason, it is possible to use the pre-group screening with individual interviews (Brown et al., 2019). It would provide the leader with an enhanced understanding of every case and its peculiarities and conclude whether the group therapy would help to address the discussed behavior and promote positive outcomes. Altogether, the outlined approach will help to select 10 participants with similar issues and start group therapy.
Composition & Contract
As stated previously, the group will consist of 10 individuals. The primary inclusion criteria are full age, dependence on painkillers, the experience of living in a disadvantaged family in childhood, and the desire to promote positive change. These factors might guarantee higher involvement and motivation levels and ensure the clients will continue working to achieve the goal. The exclusion criteria are involuntary participation, age under 18, and other types of addictive behaviors. It is planned that the group should be closed with no new members that can join later. It would help to build trust relations between all participants and move together towards the achievement of the shared goal (Wilson et al., 2018). The course of treatment implies a 15-week session with meetings every seven days. It is expected to help all clients and trigger the process of reconsidering their negative behaviors (Wilson et al., 2018). Each group meeting will last 60 minutes to discuss all relevant problems and outline methods for their addressing and management. The clients should provide their agreement and informed consent form to take part in the work of the group.
Orientation
Participation in the work of the group requires providing the informed consent form. The clients can either send them via email or handle the physical copy to the group leader. It will ensure that no ethical issues will emerge. Additionally, the informed consent form should list the major rules regulating the group’s work and its members’ behaviors. Signing the form means a client accepts the rules and is informed about them. Furthermore, the leader’s responsibilities include ensuring confidentiality for every group member. First, only names should be used during the group meetings. Second, personal or vulnerable information can be shared only if the client agrees and there is a therapeutic need for it. Third, all participants should accept the rules stating that information discussed during sessions cannot be shared with third parties (National Institute on Drug Abuse, 2018). These requirements are central to aligning the practical work of the group. They would help establish an atmosphere of trust and cooperation, with no extra pressure or fear (Cruise, 2021). The orientation should be performed before the main activities start.
Intervention Framework
As outlined above, the group implies using cognitive behavioral therapy to address the addiction to painkillers and ensure that progress is achieved. The approach conceptualizes dependency as a learned behavior that can be modified using various interventions (Zamboni et al., 2021). It implies an identification of specific conditioned stimuli linked to addictive behavior, avoiding these stimuli, and creating enhanced contingency management strategies (Zamboni et al., 2021). The cognitive behavioral groups work to alter this learned behavior by altering thinking patterns, beliefs, and perceptions (Zamboni et al., 2021). As a result, clients become more conscious about their choices and can control their desire to use an addictive substance again (Zamboni et al., 2021). The choice of the framework is justified by the existing research, proving its increased effectiveness for clients suffering from addiction to painkillers (Zamboni et al., 2021). Moreover, group cognitive behavioral therapy effectively addresses the thoughts, decisions, and assumptions of individuals with problematic backgrounds (Zamboni et al., 2021). As a result, using this method, it is possible to address the outlined problem and ensure there are positive shifts and dynamics.
Evaluation Methods
Progress evaluation is one of the major tools necessary to control the treatment and ensure the intervention is effective. Speaking about group therapy, it is vital to ensure that patients benefit from sessions and feel improvement. First, the Drug Abuse Screen Test (DAST) can be used as an effective assessment tool (“Drug use screening tests,” 2021). It contains ten questions about how much and how often a person takes drugs and asks if it causes problems in personal life and health spheres (“Drug use screening tests,” 2021). The tests’ results can be compared at the beginning, middle, and end of sessions. The results will indicate if any progress is achieved and additional measures are required. Second, the progress can be monitored by using observational methods. Participant observation is a potent tool for evaluating the progress of a specific group (Cruise, 2021). It implies entering a team of people with a shared problem to understand their dynamics and how the problem is managed (Cruise, 2021). Combining these two methods, it is possible to ensure the practical assessment and collection of data necessary for concluding the effectiveness of group therapy.
Conclusion
Altogether, cognitive behavioral group therapy can be viewed as an effective method to help patients with addiction to painkillers. In numerous cases, addictive behaviors evolve because of the problems in childhood and living in problematic families. For this reason, it is vital to create a treatment group for individuals with similar backgrounds and ensure they can benefit from the provided assistance and support. It can consist of 10 individuals with similar experiences and a leader managing the cooperation and ensuring progress. The progress can be evaluated by using the DAST tool and participant observation methods. It would help to collect data necessary for concluding about the efficiency of selected methods and introduce additional interventions if needed. The choice of framework for working with this group of patients is proven by the existing body of literature and data from recent findings. In such a way, the proposed group can help the community and other members with similar issues.
References
Brown, J., Murphy, C., Kelly, J., & Goldsmith, K. (2019). How can we successfully recruit depressed people? Lessons learned in recruiting depressed participants to a multi-site trial of a brief depression intervention (the ‘CLASSIC’ trial). Trials, 20(1), 131. Web.
Cruise, P. (2021). Cognitive behavioral therapy: Worksheets for drugs and alcohol abuse. Independently Published.
Drug use screening tests. (2021). MediLine. Web.
National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (3rd ed.). National Institute on Drug Abuse.
Wilson, D., Mackintosh, S., Nicholas, M. K., Moseley, G. L., Costa, D., & Ashton-James, C. (2018). Are group size and composition associated with treatment outcomes in group cognitive behavioral therapy for chronic pain?Pain, 159(4), 783–792. Web.
Zamboni, L., Centoni, F., Fusina, F., Mantovani, E., Rubino, F., Lugoboni, F., & Federico, A. (2021). The effectiveness of cognitive behavioral therapy techniques for the treatment of substance use disorders: A narrative review of evidence. The Journal of nervous and mental disease, 209(11), 835–845. Web.