STAGE 5. Defining the action plan

What steps should be completed?

Step 1: Specify intervention actions

TREATMENTS APPLIED IN GROUP FORMATS (GROUP THERAPIES)

Therapeutic interventions during treatment for drug addictions are often applied in a group format within the framework of various programmes and with different procedures. This aims to take advantage of the social reinforcement offered by dialogue between people who share similar problems to make patients feel comfortable and reduce resistance to getting involved in treatment. They also provide a setting where patient deficits in the field of social interaction can be evaluated, allowing more experienced group members to act as role models and offer coping strategies that that are unfamiliar to the therapist. They can also help to detect warning signs of possible relapse (enabling early intervention) and prevent the relapse itself, for fear of having to admit to it publicly (role of the group as external control).

Group interventions are often viewed positively by both therapists and patients, and the American Psychiatric Association¹ considers them an important treatment tool for many patients with substance use disorders. However, no significant differences have been found between individual or group application of different types of treatment (relapse prevention, cognitive behavioural therapy in alcohol and other drug addicts), demonstrating that both modalities are effective, although group interventions seem to improve initial adherence to treatment.^2,3 With regard to treatment for smoking, group therapy is better than self-help and other less intensive interventions,⁴ but it is not clear whether groups are better than individual or other advice to help smokers stop smoking.⁵

Group interventions can improve efficiency (improving the cost-effectiveness of treatments) and guarantee the principles of universality and fairness of access to treatment in services financed by public funds, especially when a high demand for treatment is combined with limited availability of technical personnel. In these cases, individual interventions may not be an appropriate option (at least, not usually) as it prolongs the time that elapses between appointments, affecting treatment efficacy. However, in the case of adolescents, group treatment of substance use problems may involve a risk of iatrogenic or undesirable effects.³

 

References:

1 APA Work Group on Substance Use Disorders. (2007). Treatment of patients with substance use disorders (2nd Edition). American Psychiatric Association. American Journal of Psychiatry. Apr;164(4 Suppl):5-123.

2  Becoña E & Cortés T. (Coords.). (2008). Guía clínica de intervención psicológica en adicciones. Guías clínicas Socidrogalcohol basadas en la evidencia científica [Clinical guide to psychological intervention in addictions. Socidrogalcohol clinical guides based on scientific evidence]. Barcelona: Socidrogalcohol

3 National Institute on Drug Abuse (NIDA). (2010). Principles of drug addiction treatment: a research-based guide. Washington: National Institute on Drug Abuse.

4 Stead LF & Lancaster T. (2006). Group behaviour therapy programmes for smoking cessation (Cochrane Review). In The Cochrane Library, Issue 4. Chichester, RU: Wiley and Sons, Ltd.

5 Pereiro C et al. (2008). Tabaquismo. Guías clínicas Socidrogalcohol basadas en la evidencia científica [Smoking. Sociodrogalcohol evidence-based clinical guides]. Barcelona: Socidrogalcohol.