Chapter 5 - Phase I: Psychoeducational Group Sessions

Phase I is a structured, psychoeducational group that is offered for 90 minutes per session for the first 12 weeks of treatment. The psycho-educational group is designed to enhance knowledge regarding addiction and recovery. During this early period in recovery, many cocaine-dependent clients experience postacute withdrawal symptoms, struggle with their motivation to change, and are only beginning to abstain from cocaine and other substances. Therefore, they need support and encouragement in addition to information about addiction and recovery.

Phase I group sessions are designed to provide clients with relatively frequent, supportive contact with the counselor and other men and women in recovery; introduce clients to key concepts about addiction and the recovery process; help clients understand how they may set themselves up to relapse; and help clients develop strategies to reduce their relapse risk. The group program helps empower members to establish and maintain abstinence, develop a sense of personal responsibility for their recovery, develop supportive interpersonal relationships, and continue participating in a self-help program such as AA, NA, CA, or other support groups.

Each weekly Phase I group session focuses on one of the following recovery topics:

• Session #1: Symptoms of Cocaine Addiction
• Session #2: The Process of Recovery: Part I
• Session #3: The Process of Recovery: Part II
• Session #4: Managing Cravings: People, Places, and Things
• Session #5: Relationships in Recovery
• Session #6: Self-Help Groups
• Session #7: Establishing a Support System
• Session #8: Managing Feelings in Recovery
• Session #9: Coping With Guilt and Shame
• Session #10 Warning Signs of Relapse
• Session #11: Coping With High-Risk Situations
• Session #12: Maintaining Recovery

1. Check-in period:
At the beginning of each group session, clients introduce themselves by stating their names, admitting that they are addicted to cocaine (and other substances, if relevant), indicating the last day they used addictive substances, and briefly discussing strong cravings, close calls, or actual episodes of drug use. This usually lasts 10 to 20 minutes.

2. Review of session topic and objectives:
The group counselor briefly introduces the topic and the objectives of the group session so that members have an idea of the specific issues that will be covered. The group counselor passes out handouts to group members and asks them to complete the checklists or answer the questions on these handouts. This usually takes about 10 minutes.

3. Review of curriculum and members’ responses to questions on handouts:
The group counselor introduces the topic and objectives for the session and leads the group in a discussion of the topic. Group members are encouraged to share their experiences, and the group counselor attempts to highlight the connection between group members’ input and the identified topic.

4. Review of the plan for the upcoming week:
The group counselor asks each member to briefly state what actions he or she plans to take in the upcoming week in his or her recovery from cocaine addiction. Group members can mention self-help meetings they plan to attend and other steps they will take in their recovery. This usually takes 5 to 15 minutes.

5. Reciting the Serenity Prayer:
The group ends after members join hands and say the Serenity Prayer out loud. The Serenity Prayer states: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” After the prayer, the leader encourages all members to return for the group session next week.

Since the therapy groups are small, consisting of fewer than 10 clients, it is preferable to cover the educational curriculum interactively by involving the group members. However, the leader can give “mini-lectures” by presenting particular issues or points in an educational way during the course of the GDC session. The group counselor should refrain, however, from spending too much time lecturing. While information on addiction and recovery is important, mutual support, sharing one’s own experiences, and discussing clients’ reactions to the material are also important in GDC sessions. Often the most effective teaching is done in an interactive format because clients learn most from what they think about and contribute in the group.

Appendix E of this manual provides a list of other suggested recovery materials that can be used in group sessions. Appendix F provides a list of suggested educational videos.

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