Group Therapy for Substance Use Disorders: A Motivational Cognitive‐behavioural Approach

Steve Freeman (Research Nurse & Solution Focused Approaches Manager, Combined Healthcare NHS Trust, Lecturer and Teaching Fellow, Keele University, Staffordshire, UK)

Drugs and Alcohol Today

ISSN: 1745-9265

Article publication date: 16 September 2011

Issue publication date: 16 September 2011



Freeman, S. (2011), "Group Therapy for Substance Use Disorders: A Motivational Cognitive‐behavioural Approach", Drugs and Alcohol Today, Vol. 11 No. 3, pp. 162-163.



Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

This book gives details of the guided self‐change (GSC) model. The model has been proven by the authors in clinical application and the first chapter gives a detailed review of their evidence and some context. It is clear throughout that the book has been written by skilled and experienced practitioners, with clients' needs at the forefront. Not all books in this field give the same impression. The book could be used as a manual to implement GSC into practice or a resource manual for techniques and ideas on not only substance misuse, but also other areas of behaviour change.

The use of drugs, including alcohol and nicotine, is a significant social and clinical issue. The problem is evident in all areas of health and social care, in education and in society generally. Each area where drug use is seen is an opportunity for a brief intervention. Methods detailed in this book could be introduced easily and effectively. Safeguarding is an area of note: vulnerable adults, domestic violence, parents and children, carers and cared for are all environments in which drug use can be seen and yet perceived as needing specialist intervention. Whilst this may be true, there is scope for practitioners to influence thinking and behaviour by adopting some of the proposed ideas.

Unless the reader is an ardent research fan it may be worth starting at Chapter 2 which gives a great overview of Motivational Interviewing (MI) and going back to Chapter 1 later. There is an explanation of the transition of GSC from individual to group therapy use and a useful analysis of some of the difficulties, which are part of this move for any model. The comparison of efficacy for individual vs group therapy makes interesting reading. The findings may not be a surprise to everyone and yet will be useful data for both advocates of group therapy and those considering its use in practice. Each chapter is clearly laid out and ends with a succinct summary. The examples of dialogue are particularly good and will be useful for people relatively new to the field of addictions intervention as well as those needing a refresher for their practice. The authors' inclusion of potential client challenges and suggestions of ways to deal with this is a nice touch that is often absent from books of this type.

The authors have made available a variety of assessment and intervention forms which can be “freely copied.” These include handouts for both facilitators and clients. Readers need to beware that some useful pages are not free to copy and are marked as being available for individual use only.

There are a couple of observations worth noting before using the book. America and Britain have been described as two countries separated by a common language. Parts of the book need some translation and/or adjustment. Some drug names used in the assessment forms translate from America to the UK, but others do not. Statistics presented in the section “Where do you fit in?” show consumption rates for the USA and are not directly applicable to the UK and European populations. More notably, and area of concern, is that the book deals with “standard drinks” where the UK is more accustomed to units of alcohol. Illustrations in the book and the examples of “standard drinks” average 1.8 units, but could be interpreted as ranging from one to two UK units if the data/calculation is not addressed carefully. Caution would need to be exercised when using the free to copy AUDIT questionnaire and other assessment tools which includes this exemplar.

Purist Cognitive Behavioural Therapists or MI practitioners may have some reservations about the authors' integration of the two approaches. In practice, however, the evidence is that different approaches are merging, adapting and integrating. This is due to both theoretical alignment and practitioners who take the best and most appropriate parts of several models and adapt them to the needs of the individual before them.

There is a clear purpose in the presentation of material and evidence in the book. The authors wish to share their success with the integrated GSC model. The evidence provided in Chapter 1 and throughout the book is good and yet would benefit from a broader viewpoint at times. A mention of other models, which have been used successfully with individuals and groups would be useful and give balance. The link between MI, addiction, behaviour change and Prochaska & DiClemente's cycle of change model is well established and would be a valuable addition to this book.

As the authors note in their introduction, this book is of interest to both those working in the field of substance misuse and people with an interest in the integration of Cognitive Behavioural Therapy and MI into group therapy. I would go further and say that the book will appeal to practitioners at all levels who are looking to help the change process in a range of settings.

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