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Quantum Units Education

Group Therapy Treatment for Substance Abuse (Revised)

Groups and Substance Abuse Treatment

1. Which of the following is an advantage of group therapy over other modalities?

A. Positive peer support

B. A reduction in clients’ sense of isolation

C. Real-life examples of people in recovery

D. All of the above


Groups Commonly Used in Substance Abuse Treatment

2. Which group model delves into major developmental issues that contribute to addiction or interfere with recovery?

A. Psychoeducational groups

B. Interpersonal process groups

C. Skills development groups

D. Cognitive-behavioral groups


Criteria for the Placement of Clients in Groups

3. Because recovery is a long, nonlinear process, the type of therapy chosen should always be subject to re-evaluation.

A. True

B. False


4. It is essential that all clients in a group have similar:

A. Needs

B. Genders

C. Cultures

D. Ages


Group Development and Phase-Specific Tasks

5. Which of the following has been described as the single most important factor contributing to the success of outpatient therapy groups?

A. A group member’s acceptance of the contract prior to entering a group.

B. When the group leader meets individually with each prospective group member to begin to form a therapeutic alliance.

C. The group member’s motivation to abstain from drug and alcohol abuse.

D. The group member making it through the first month of group therapy without relapse or discontinuation of treatment.


Group Leadership, Concepts, and Techniques

6. Effective group leadership requires which of the following specific personal qualities and professional practices?

A. Active listening

B. Spontaneity

C. Humor

D. All of the above


7. Which type of intervention deftly points out inconsistencies in clients’ thinking?

A. Nonstop talking

B. Confrontation

C. Interrupting

D. Declining to participate


Introduction

8. People who abuse substances often are more likely to remain abstinent and committed to recovery when treatment is provided in groups.

A. True

B. False


Modifying Group Therapy To Treat Substance Abuse

9. Group therapy is equivalent to individual therapy and 12-Step program practices.

A. True

B. False


10. Modifying group therapy to make it applicable to and effective with clients who abuse substances requires all of the following improvements, except for:

A. Specific training and education for therapists so that they fully understand therapeutic group work and the special characteristics of clients with substance use disorders.

B. A clear answer to the question, “Why is group therapy so effective for people with addictions?”

C. The encouragement, coaching, support, and reinforcement of participants as group members undertake difficult or anxiety-provoking tasks.

D. The adaptation of the group therapy model to the treatment of substance abuse.


Psychoeducational Groups

11. Psychoeducational groups inform clients about psychological issues and aim at intrapsychic change.

A. True

B. False


12. The major purpose of psychoeducational groups is to:

A. Motivate the client to enter the recovery-ready stage.

B. Help clients incorporate information that will help them establish and maintain abstinence and guide them to more productive choices in their lives.

C. Expand the awareness about the behavioral, medical, and psychological consequences of substance abuse.

D. Counteract clients’ denial about their substance abuse, increase their sense of commitment to continued treatment, effect changes in maladaptive behaviors, and support behaviors conducive to recovery.


13. As part of a larger program, psychoeducational groups have been used to help clients:

A. Reflect on their own behavior.

B. Learn new ways to confront problems.

C. Increase their self-esteem.

D. All of the above.


14. All of the following are primary areas that leaders should possess knowledge and skills in, except for:

A. Leadership skills.

B. How people interact within a group.

C. Interpersonal relationship dynamics.

D. Basic teaching skills.


15. Leaders should do all of the following, except:

A. Foster an environment that supports active participation.

B. Foster an environment that encourages passive note taking.

C. Limit lecturing in duration and extent.

D. Facilitate group discussion, especially among clients who are withdrawn and have little to say.


Skills Development Groups

16. It is crucial for leaders of skills development groups to be sensitive to the struggles of group participants, hold positive expectations for change, and not demean or shame individuals who seem overwhelmed by the task.

A. True

B. False


Cognitive-Behavioral Groups

17. In cognitive-behavioral groups, it is important for the leader not to yield to the temptation to become the expert in how to think, how to express that thinking behaviorally, or how to solve problems, but instead to allow group members to use the power of the group to develop their own capabilities in these areas.

A. True

B. False


Support Groups

18. The leader is responsible for:

A. Recognizing interpersonal blocks or struggles between group members and ensuring they do not hinder the development of the group or any member of the group.

B. Resolving interpersonal blocks or struggles between group members.

C. Pointing out interpersonal blocks or struggles between group members.

D. None of the above.


Interpersonal Process Group Psychotherapy

19. All therapists using a “process-oriented group therapy” model continually monitor which dynamic?

A. The psychological functioning of each group member.

B. The way people are relating to one another in the group setting.

C. How the group as a whole is functioning.

D. All of the above.


20. In interpersonal process group therapy, the leader’s job is:

A. To be a skill builder.

B. To function as problemsolving director.

C. To promote and probe interactions that carry a point.

D. To be a client booster.


Communal and Culturally Specific Groups

21. All of the following are problems that pervade particular cultures, and have an impact on the incidence of substance abuse, are appropriate focuses for intervention in substance abuse treatment, except for:

A. Racism

B. Poverty

C. Intimate partner violence

D. Unemployment


Expressive Groups

22. Client self-reports suggest the value of psychodrama for all of the following clients in treatment for alcoholism, except for:

A. Those that are highly educated

B. Those that are male

C. Those that are extroverted

D. Those that are verbally expressive


Groups Focused on Specific Problems

23. Problem-focused groups are intended to increase client insight, mostly emphasizing self-exploration.

A. True

B. False


24. A problem-focused group is commonly used in the early stages of recovery to help clients:

A. Engage in treatment

B. Learn new skills

C. Commit to sobriety

D. All of the above


Assessing Client Readiness for Group

25. Which type of client may be inappropriate for group therapy?

A. Clients who refuse to participate.

B. People in the throes of a life crisis.

C. People who can’t control impulses.

D. All of the above.


Primary Placement Considerations

26. Recent studies have shown that women do better in women-only groups than in mixed gender groups.

A. True

B. False


27. Clients with low levels of motivation to abstain should be placed in _____ groups.

A. Psychoeducational

B. Interpersonal process

C. Skills development

D. Cognitive-behavioral


28. A poor match between group and client will always be apparent at the outset.

A. True

B. False


Diversity in a Broad Sense

29. Primary characteristics are more important than secondary characteristics.

A. True

B. False


30. A set of congruent behaviors, attitudes, and policies that come together in a system, agency, or among professionals that enable them to work effectively in cross-cultural situations, is:

A. Cultural awareness

B. Cultural competence

C. Cultural knowledge

D. All of the above


31. If a leader believes that cultural traditions might be a factor in a client’s participation in group or in misunderstandings among group members, the leader should check the accuracy of that perception with the client involved.

A. True

B. False


Diversity and Placement

32. Before placing a client in a particular group, the therapist will need to do which of the following?

A. Address the substance abuse problem in a manner that is congruent with the client’s culture.

B. Appreciate that particular cultures use substances, usually in moderation, at specified types of social occasions.

C. Assess the behaviors and attitudes of current group members to ascertain whether the new client would match the group.

D. All of the above.


33. If a group member has had experiences with people of the same ethnicity as the therapist, the group member may transfer to the therapist the feelings and reactions developed with others of the therapist’s ethnicity.  The therapist first should detect these misconceptions and then reveal them for what they are to dispel them.

A. True

B. False


Ethnic and Cultural Matching

34. Recent research suggests that an ethnic match between therapist and client consistently improves outcomes and has been determined the most important factor.

A. True

B. False


Revolving Membership Groups

35. If a group becomes too large, more than _____, group interaction breaks down and the clients become a class made up of individuals, rather than a single, cohesive, therapeutic body.

A. 10

B. 15

C. 20

D. 25


Pregroup Interviews

36. Therapists should be careful to distinguish treatment groups from AA’s self-help approach, which, having no formal leadership, cannot provide meaningful accountability.

A. True

B. False


Increasing Retention

37. Retention rates are affected positively by:

A. Client preparation.

B. Maximum client involvement during the early stages of treatment.

C. Prompts to encourage attendance.

D. All of the above.


38. A very successful tactic therapists can use to try to forestall premature termination is by persuading clients who plan to leave group to attend just one more session.  This gives other group members the opportunity to persuade the restless member not to drop out.

A. True

B. False


Identifying the Need for Wraparound Services

39. The first step toward wraparound services is to:

A. Recognize that wraparound services retain clients in therapy longer.

B. Document the need for them.

C. Recognize that wraparound services seldom flourish in isolation.

D. Search existing community resources that may identify services already in place.


Group Agreements

40. A group member’s acceptance of the contract before entering a group has been described as the single most important factor contributing to the success of outpatient therapy groups.

A. True

B. False


Confidentiality

41. Group members should know what information about them might be shared and why, how, and when this sharing occurs, so they do not feel betrayed when someone outside the group knows about something said within the group.

A. True

B. False


Physical Contact

42. Touch in a group can be positive, negative, or neutral, and the leader should evaluate carefully any circumstances in which physical contact occurs.

A. True

B. False


Introductions

43. Many clients treated for substance abuse also have histories of emotional and physical abuse, and merely directing attention toward them can trigger feelings of shame, thus, while it is extremely important to make connections between and among group members and to involve them in the process, the sensitive leader will not insist on recitations.

A. True

B. False


End Phase - Reaching Closure

44. Termination is a time for:

A. Putting closure on the experience.

B. Examining the impact of the group on each person.

C. Acknowledging the feelings triggered by departure.

D. All of the above.


45. Every group facilitator working with substance abuse should understand and be prepared to deal with clients going through which process?

A. Denial

B. Anger

C. Grief

D. Depression


Adjustments to Make Treatment Appropriate

46. Interventions that work well early in treatment may be ineffective, and even harmful, if applied in the same way later in treatment.

A. True

B. False


Therapeutic Strategies in Early Treatment

47. Which therapeutic factor contributes to healing by liberating clients as they learn how to express feelings and reveal what is bothering them?

A. Catharsis

B. Interpersonal learning

C. Imitative behavior

D. Altruism


48. Each of the following existential factors aid clients in coming to terms with hard truths, except for:

A. Life can be unfair.

B. Life can be painful and death is inevitable.

C. Life isn’t faced alone if you have others you are close with.

D. Each of us is responsible for the ways in which we live.


49. Clinicians should view relapse as all of the following, except:

A. Failure of both the group leader and the client.

B. A clinical opportunity for both group leader and clients to learn from the event.

C. A chance to integrate the new knowledge.

D. A chance to strengthen levels of motivation.


Leadership in Early Treatment

50. During early treatment, the effective leader will focus on immediate, primary concerns, such as all of the following, except for:

A. Achieving abstinence

B. Affect regulation

C. Preventing relapse

D. Learning ways to manage cravings


Leadership in Middle-Stage Treatment

51. Confrontation, if done too punitively or if motivated by a group leader’s countertransference issues, can severely damage the therapeutic alliance, and inappropriate confrontation may even strengthen the client’s resistance to change, thereby increasing the rigidity of defenses.

A. True

B. False


52. The leader can support the process of change by:

A. Drawing attention to new and positive developments.

B. Pointing out how far clients have traveled.

C. Affirming the possibility of increased connection and new sources of satisfaction.

D. All of the above.


Constancy

53. All of the following are specific behaviors that group facilitators can emphasize the reality of constancy and security, except for:

A. Group leaders should sit next to a different client at each meeting as to not single out any particular client.

B. Group leaders should maintain specific start and end times.

C. Group leaders should maintain ground rules for speaking.

D. Group leaders should wear the same style of attire at each meeting.


Empathy

54. One of the feelings that the group leader needs to be able to empathize with is _____, which is common among people with substance abuse histories.

A. Guilt

B. Shame

C. Denial

D. Anger


Leaders Vary Therapeutic Styles with the Needs of Clients

55. To determine the type of leadership required to support a client in treatment, the clinician should consider the client’s:

A. Capacity to manage affect

B. Level of functioning

C. Social supports

D. All of the above


Handling Emotional Contagion

56. When the group pressures a member to disclose information, the leader should remind the group that members need only reveal information about themselves at levels with which they are comfortable.

A. True

B. False


Leaders Overcome Resistance

57. The group members should experience feelings at a level of arousal wherein feelings are undeniable and the group member is overcome.

A. True

B. False


Leaders Maintain a Safe Therapeutic Setting

58. A client can be severely damaged by emotional overstimulation.

A. True

B. False


59. If a client obviously is intoxicated at the beginning of the group, that person should be asked to leave and return for the next session in a condition appropriate for participation.

A. True

B. False


60. When physical boundaries are breached in the group, and no one in the group raises the issue, the leader should not call attention to the behavior.

A. True

B. False


Leaders Encourage Communication Within The Group

61. Which of the following is an appropriate intervention used to help group members engage in meaningful dialog with each other?

A. Praising good communication when it happens.

B. Noticing a member’s body language, and without shaming, asking that person to express the feeling out loud.

C. When someone has difficulty expressing a thought, putting the idea in words and asking, “Have I got it right?”

D. All of the above.


Confrontation

62. Evidence is strong that direct, forceful, aggressive approaches are perhaps the most effective way to help people consider new information and change their perceptions.

A. True

B. False


Transference and Countertransference

63. Which form of countertransference is experienced when treating highly resistant populations, and cause leaders to feel powerless, demoralized, or even angry?

A. Feelings of having been there.

B. Feelings of helplessness when the therapist is more invested in the treatment than the client is.

C. Feelings of incompetence due to unfamiliarity with culture and jargon.

D. All of the above.


64. Countertransference is all of the following, except for:

A. Inevitable

B. A way to support the group process

C. Bad

D. Countertransference is all of the above


Resistance in Group

65. The effective leader will:

A. Ignore resistance.

B. Attempt to override resistance.

C. Welcome resistance as an opportunity to understand something important going on for the client or the group.

D. None of the above.


66. Sometimes resistance can be induced by leaders who are:

A. Passive

B. Guarded

C. Weak

D. Any of the above


Biopsychosocial and Spiritual Framework - Treating the Whole Person

67. It is particularly important to make the 12-Step program’s encouragement of “unquestioning acceptance” a focus of analysis in group therapy early in recovery.

A. True

B. False


68. Sponsors of 12-Step members may distrust therapy and discourage group members from continuing in treatment.

A. True

B. False


69. The 12-Step philosophy opposes therapy and medication.

A. True

B. False


Medication Knowledge Base

70. The pregroup interview for long-term groups should ask what medications group members are taking and names of prescribing physicians so cooperative treatment is possible.

A. True

B. False


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