8 Substance Use Disorder Group Topics for Addiction Treatment Counselors

Almost 21 million adults in the US struggle with at least one addiction, and drug overdose deaths have more than tripled since 1990. Despite that, only around 10 percent of people receive treatment for their addiction. So what’s contributing to this huge disparity in care?

Considering how prevalent addiction actually is, there’s still a huge stigma associated with seeking treatment. In many medical circles, addiction is still looked at as something that the person is personally at fault for, rather than an illness. As a result, many people with addiction are dismissed by their providers, and not offered the treatment they need. 

Focus on Creating a Safe Space

As mental health providers, it’s important to create a safe space for growth and recovery, and that’s especially true when you work with people struggling with addiction. While individual counseling is essential in someone’s recovery, attending substance use disorder groups can also be beneficial. Listening to and learning from peers who are on the same difficult journey and also committed to sobriety brings an entirely different element into the counseling process.

Group therapy can encourage a deeper sense of self-reflection. It also teaches participants how to relate to others, challenge their own perceptions, and build relationships, which they may have had trouble doing while struggling with addiction. As clinicians, your key to facilitating engaging group sessions is choosing substance use disorder group topics that your clients will connect to and be able to reflect on even after the session is over. Here are eight topics and tools that you can implement in your group sessions. 

Substance Use Disorder Group Topics to Try in Your Practice

1. Start with an icebreaker.
Sometimes, the toughest part of group therapy is just getting your clients to open up. Anxieties are high for new groups, and even those that have been together for a while can go stale and need something to reinvigorate the atmosphere. Icebreakers at the beginning of any group help to break the tension and facilitate more personal connections between participants. 

2. Discuss triggers.
One of the most significant substance use disorder group topics is triggers. Individual attendees will all have different triggers, which you should discuss to ensure they have adequate and appropriate coping mechanisms. But by listening to their peers, they might identify secondary, smaller triggers that they hadn’t considered in their own lives, and plan accordingly for those
as well.

3. Make a list of stay-busy activities.
Encourage your clients to keep a list of things they can do when they’re confronted with triggers or are feeling vulnerable or anxious. Cravings can come on at any time and in any situation, so pass out index cards and pens. Then encourage the group to take notes on distractions and coping methods—such as phoning a friend, going for a jog, cooking a healthy snack or meal, listening to healing music, or writing in a journal.

4. Prepare a speech.
Ask your clients to think about what they would say if they had the opportunity to speak to a group of middle-school children about staying away from drugs. In this exercise, have them consider what stories would be appropriate to share. You can also challenge them to think about whether their speech would change depending on who they were speaking to. What would they say to high schoolers or college students? To other adults? 

5. Challenge their perceptions.
Everyone perceives experiences and interactions differently. For this topic, give each person a card detailing a situation or conversation, and have them read it to the group. Ask them to explain what they think is happening or how they think the characters on their card feel. Then, have the group follow up to discuss whether they agree or disagree with the reader’s perception and why.

6. Reflect on their role models.
Ask everyone in the group who their role models are or were, and what about their behavior or personality they admire. If they bring up a person who used to be their role model, but no longer is, make sure they address why their opinion changed. As the facilitator, you can ask follow-up questions such as, “Do you think you could emulate these traits?”, “Do your heroes have faults?”, and “How do their flaws make you feel about them?”

7. Practice mindfulness.
Some of your clients may be resistant to the idea of mindfulness at first, but encourage them to be open-minded. Walk through some of the basics of what mindfulness really means, and plan some activities that they can do to help ground themselves and stay present in stressful situations. These activities can happen as a group in your sessions, but make sure to also give them the tools to continue that practice on their own time after the session is over. 

8. Plan for self-care.
Ask the group, “What’s the worst thing that could happen if you were to use drugs or alcohol again?” Since everyone has their own experiences when using, this is bound to bring up different answers. Then, follow up by asking how they plan on caring for themselves to prevent relapse. Self-care means different things to different people, and some people might have trouble putting a plan in place. Discuss some healthy ways they can take care of themselves while also remaining committed to recovery.  

At the end of the day, you know your clients and the group dynamics best. You’ll know when an activity won’t resonate with your group, or notice when another elicits an incredibly impactful and engaging conversation. Having a large repertoire of substance use disorder group topics ready to go will make it easy for you to choose the one that’ll have the best outcome for your clients.

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