Drug Addictions and Group Work

Author: Kathleen Casagrande

A Support Group had been advertised on the display board of the local Drug and Alcohol Treatment Centre in the City where the Counsellor had been seeing each of the members for private counselling prior to the start of the programme.

Ten clients enrolled in the group but by 7:15pm only 5 of the ten group members allocated for the 7pm time-slot, had arrived. Cancellations and rescheduling unfortunately are an issue with people who are challenged with substance misuse. The 5 members present, included:

• Gemma, whose partner died from drowning in a pool next to her at a party where there were many drugs being used of all types; mainly ecstasy, fantasy and speed.
• Wesley, who has been out of prison for six months now. He has been addicted to morphine and heroin and has since taken up alcohol (because it’s legal).
• Cobi, previously a paramedic who was diagnosed with A.D.H.D. and used amphetamine/methamphetamine (speed) because it used to get him through the horrors of his nights.
• Effie (Frangelica), who has deep-seated self-esteem issues. She used to smoke cannabis, just to take her away from reality and ultimately aiming to de-stress her.
• Jasmine, who became an alcoholic when her husband died in her arms from an operation that went terribly wrong.

The goal of the group was to share ideas and strategies associated with the maintenance and well-being of each group member. Each week a member would be expected to deliver a positive idea or event that happened to them during the previous week.

Introduction

Group Facilitator will be abbreviated to GF.

GF: Good evening. I am the facilitator of this group where we will be predominantly working with the effects of addictions. We have all decided to create a support group for sharing our experiences, our strengths and our weaknesses so that we begin to understand that we are not alone in our situations. Because some of us have journeyed along a path that has been amazingly eventful, we all want to know that our stories are all confidential and must not be shared with others outside of this room.

If you choose to elaborate on a story that belongs to somebody else, please be aware that it is expected you do not use that person’s name.

Please remember that my duty of care, as it exists for us in counselling, also applies here. So if I consider that you, or another person, are at risk of harm, I am obliged to uphold your safety and the safety of others. This may mean that I will need to disclose information to people outside of this group. Of course, where possible I will seek your support on this before acting. Is that understood?

GF: (Addressing the group as a whole) I would like to find out what everyone in the group thinks about the issues of addictions in their own lives. Let’s move around the circle now starting with you, Wesley.

Wesley: While I was in jail I was medicated most of the time because of my aggressiveness, I just wanted to fight everybody because I hated myself. I’ve been hated all my life from when I was a little kid, my mother would tell me all the time how much she hated me ’cause I looked like my Dad.

So after five years of being given morphine for pain from many beatings and then heroin when I got out I didn’t want to start stealing again to keep feeding my habit so I slowly went off heroin with anti-depressants I got from the doctor, then I became addicted to Valium and used that too much with rum to wash them down. I know I was just swapping the witch for the bitch to cover my own self-loathing.  I realise this but I have all this anger inside me.

“Prescribing a drug also gives doctors the illusion that they have solved the problem while, in fact, all they have done is to postpone it, and they may have created a new problem in the process.” (Parkes, et al., 1996)

GF (after some further sharing from group members, initiate a break): What we’ll do at this point is take a short break with some deep-breathing exercises to relax those who have shared so far and for those who have not yet had the opportunity and may be getting a bit apprehensive about sharing.  So to begin let’s just close our eyes for a while and focus on a very safe place we have visited or would like to visit, it can be anywhere you want as long as you are feeling peaceful and relaxed.

(The GF gently touches the CD player and calming music filters out, soft orchestral slow tones mixed with bushland sounds of birds chirping and the sound of water trickling along a stony path).  “Many groups, particularly those with members suffering from high levels of mental and/or physical stress, find it useful to include periods of time devoted to relaxation.” (Brown, 1994)

Break for Supper

Two members head outside to the street to have a cigarette and when they rejoin the group they have brought in the two other members who were late because they got “side-tracked”. Curtis and Stolli have stated that they would like to join in because they’ve heard this is a group to help them get off drugs. Stolli states he wants to bring his girlfriend Chloe in who is waiting outside.

The facilitator settles the group when the members become quite agitated at this turn of events. The two new people have the procedures and rules of the support group explained to them. They must make an appointment by phoning the office the next day during business hours and they will be quite welcome to join in with the next lot of participants in four weeks time.

The first Monday of every month is designed for new members joining. This way the previous participants can continue with the support group however they must make allowances for the new participants as they arrive.  Under no circumstances are there to be anyone joining the group who is presently using any type of illicit drug.

Curtis and Stolli appeared to be using some stimulant and this created chaos with the members in attendance. This only enhanced their craving which endangered their safety and sobriety. They had come this far and having people join in who could possibly sabotage their safety was beyond their expectations.

Curtis and Stolli are not permitted to join in halfway through the group. This is a serious exercise for the participants who have made quite an enormous decision to participate in a group that has the potential to change the shape and destiny of their lives as they know it.

Effie has been quiet up to this point and just as the time came for her to disclose her story, Jasmine who was sitting beside her and beside the counsellor/facilitator, jumped up and screamed pointing to Effie’s shirt. With this loud interruption from Jasmine who had sat silently the entire time, created havoc in the group. The participants all jumped around not knowing why they were jumping around, some almost in a state of panic.

It took some time to settle the group and it was revealed that Effie had brought her pet rat along inside her shirt for comfort. She was so attached to this pet that she did not want to leave it at home for fear of its safety. Jasmine hated crawly things she stated and said it was ridiculous that this girl should have this rat in the group. Trying to calm the group once again, the GF asked what the rat’s name was.

There was quite a bit of discussion around Effie’s pet rat with a suggestion being offered that members bring along photos of their pets for the following week. Unfortunately Effie’s pet rat would have to stay at home through the following support group evenings and enjoy his time out.

Time for Jasmine (the group’s quietest member). She disclosed that ever since her husband had died five years previously she had used alcohol as a sedative to help her sleep. The alcohol had allowed her to block memories of him dying in her arms and all other previous memories that led up to that time and since that time, so that each day merged into the other.

Last month she made a promise to one of her sons that she would stop drinking before his wife had their first child. She stated she did not wish to elaborate at this time, for fear of losing control of herself and ending up a blubbering mess.

According to Parkes, et al. (1996), “Some group leaders adopt a structured approach, moving from the discussion of facts, to thoughts and then feelings about what happened.  We prefer a more spontaneous approach, allowing group members to decide upon the group’s priorities and intervening only if the group becomes bogged down or dominated by one particular individual or faction. It is important that everybody has the opportunity to be heard, even though some may prefer to remain silent.”

Conclusion

GF: Thank you all for sharing; this has been a tremendous first night. We will meet again next week as planned, please be on time because the two hours fly by so fast.

And now to end this session of group work let’s conclude with the Serenity Prayer.

You may wish to join in as you remember the words:

“God grant me the serenity to accept the things I cannot change, courage to change the things I can, and (the) wisdom to know the difference.” (Niebuhr)

References

• Brown, A. (1994). Groupwork (3rd ed.), London: Ashgate Publishing Ltd.
• Parkes, C.M., Relf, M., & Couldrick, A. (1996). Counselling in terminal care and bereavement. UK: British Psychological Society.
• Posthuma, B. (1996). Small groups in counselling and therapy: Process and leadership, (2nd ed.), USA: Allyn and Bacon.