Support groups, such as 12-step communities (Alcoholics et al., for example), take advantage of some of the healing potential of group therapy, but they do not take full advantage of it. A demanding educational background in group therapy and years of experience are necessary to take full advantage of the above benefits. Support groups offered by associations offer much to patients but cannot be matched or replaced by professional groups. Lack of experience and training can lead inexperienced therapists to react intuitively by adapting their poor knowledge or experience (not their professional experience).
There are indeed few psychotherapists with solid postgraduate training in group therapy and extensive addiction experience. Many therapists trained in group therapy have no addiction training, and vice versa. Group therapy is also used to treat other psychiatric disorders and symptoms; For example, there are groups on stress and anxiety reduction, obsessive-compulsive disorder, depression, grief, psychosis, anorexia nervosa, bulimia nervosa, binge eating disorder, etc. Each diagnostic category has some peculiarities and specific needs that are convenient. Group therapy for grieving people is different from those with psychosis or addictions. Therefore, addiction group therapists need to be specialized in group therapy and addiction.
Even within addictions, there are different stages. The needs of people thinking of giving up drinking differ from those of people who have been abstinent for more than six months. Therefore, the groups can be classified according to the phase of addiction in which the patients are. However, in mutual support and self-help groups, patients in different phases of their illness and recovery meet.
Likewise, there are differences between substances consumed. Generally, the needs of a person who uses intravenous heroin are different from those of a person who drinks alcohol or a person who is addicted to playing online poker. For this reason, and here it does coincide with mutual support and self-help groups, people are usually divided into groups by substance.
In group therapies, classifications are usually made according to age. For example, it is common for adolescents and young adults to be in a different group than middle-aged people. It is logical to think that the ideology of an adolescent, his sense of life, his concerns and his aspirations have little to do with those of a middle-aged person. On the contrary, no distinctions are usually made about the age of those attending the meetings in mutual support and self-help groups.
Finally, some populations may have specific needs, and making specific groups with people who belong to this population is required. For example, groups are made with people who have addiction and HIV, with people who have an addiction and a mental illness, with people who have an addiction and are homosexual, with people who have an addiction and are at risk of social exclusion, etc. However, associations’ self-help and mutual support groups rarely make these distinctions. This is good on the one hand because it does not exclude anyone and accepts everyone equally. However, on the other hand, it may not cover the special needs of these populations that may require addressing certain issues more specifically.
Multifamily group therapies
Multifamily therapy is halfway between family therapy and group therapy. It means bringing patients with the same condition and their families together in the same space. These groups have very complex interactions and are difficult to manage, but they can be very useful for patients and their relatives who suffer from the disease in the background. These groups aim to improve family dynamics, especially about the patient’s main problem: addiction.
Patients with addictions to alcohol or other drugs tend to externalize their discomfort with actions (acting out) precisely with their consumption that everyone sees. However, family members who are not users tend to go unnoticed, hiding their pathology from others and not externalizing it (acting in). Non-consuming family members learn that it is preferable to go unnoticed in a dysfunctional family environment without provoking the consuming family member, who usually acts by consuming more or presenting behaviour problems. Family group therapists must be alert to identify these family members because they can also suffer from many discomforts and, sometimes, mental disorders such as depression or anxiety.