1Comment by Perjessy, Caroline Substan

1
Comment by Perjessy, Caroline:
Substance use Anxiety Group Curriculum
Southern New Hampshire University
Clinical Mental Health Counseling Department, COU660
Dr. Caroline P.

Rationale for the group
In Massachusetts, we have several groups for substance use both
such as AA meetings and , NA meetings that are held in most
area areasjust not a sufficient amount. Some. So me groups are
also held at treatment centers by alumni which is a great thing
because it will provide members with great responsibility skills.
Some of the groups like psychoeducation and 12 steps meetings
are mainly for those who are going through andchallenges and
have a past with substance use. I plan to hold a group not only
for those who have been through it but also withhave family
members that are looking for resources and better understanding
of the disease. The need for substance use group in the Boston,
MassMassachusetts community is in high demand. Although
Boston is a wide community where the rent can be high and
have good paying jobs, many still struggle s with the everyday
life stressors that can lead to excessive drinking. In my
community I believe that the need for substance use group can
benefit so many specifically those in the poverty area, because
they are dealing with these issues every day. Also, due to
therapy being frown upon in their environment and some lack
the ability to seek professional help. Although some may have
the need but will not attend due to therapy being frown upon in
their environment. Comment by Perjessy, Caroline: Make sure
you are revising for clarity. I know you said this was a draft, so
keeping that In mind Comment by Perjessy, Caroline:
Revise for clarity
The purpose of substance use group is to help individuals who
are have dealing with anxiety and have an underlining issue like
anxiety. Substance use clients with underlining issues like
anxiety lack coping skills and the ability to perform everyday
tasks. Evidence by, the lack of motivatio n, traumatic event,
exposure to violence, withdrawal, and continuing alcohol or
drug use. However, the misuse of alcohol not only can lead to
neurological as well as anxiety. Several individuals who are
actively using have an underlining issue that has cause them to

use excessively rather its depression, bipolar, or anxiety. I will
be focusing mainly on anxiety. Anxiety can be something that
several deal with in silent or out loud, those who have been
impacted by the disease either way many are not getting the
help they deservemerit. Especially those who have been
impacted with the disease For example, not they feeling at time
they are not good enoughenough, the uncertainty of their job,;
and will they have their job back; doubts about being accepted
back into their familywill they have a family after. Comment by
Perjessy, Caroline: This is uinclear…how are they dealing with
anxiety and have an underlying issue of anxiety?
All those factors are negative impacts that can affect those who
are seeking recovery. things going through their mind as they
are seeking recovery which in fact can negatively impact their
recovery. The purpose of this group is to provide a helping hand
to those in substance use community to show them that there is
help, they are not alone, and others are here for them during
theseis uncertainty. time of need. The type of group I will be
proposing is substance use group for those with anxiety due to
the lack of The anxiety groups in the Brockton community .and
its worthwhile because they are not enough group in the
community for those who are dealing with substance use. In my
community although they’re groups but we lack them in certain
areas, and I think it would be beneficial to have several. It’s
also worthwhile because it will help and cut back some of the
relapse and provide more resources to those who need it and
desire to d it attend, those who wish to do so will be 7
provided with resourceful informationby attending this group.
According to the Article Journal of effective Disorders
“Substance use disorders (SUD) peak in prevalence in young
adults ages 18 to 25 years, with recent twelve-month prevalence
rates ranging from 15% (Substance Abuse and Mental Health
Services Administration, 2019) to 44% (Arterberry et al., 2019)
in this age group. Both young adults and adolescents with SUD
commonly have co-occurring psychiatric conditions
(Chan et al., 2008; Couwenbergh et al., 2006; Kandel et al.,

1997), often mood and anxiety disorders (Armstrong and
Costello, 2002; Grella et al., 2001; Lai et al.,
2015a; Lubman et al., 2007). Co-occurring mood and anxiety
disorders in individuals with SUD are associated with more
substance-related problems (e.g., Lubman et al., 2007). (P5).
The article Role of Anxiety misuse states “Ie n terms of opioid
misuse and dependence, results were generally in line with
prediction. Specifically, anxiety sensitivity significantly
explained the relation between pain intensity and opioid misuse
and dependence. Effect sizes can be characterized as moderate
across the studied models. These results are consistent with the
theoretical perspective that anxiety sensitivity may represent a
transdiagnostic mechanism underlying the relation between the
pain intensity and opioid misuse/dependence (O.PittelkowO.
Pittelkow,2015).
According to the article Group In order to increase ones
understanding different developmental process can develop a
negative impact in their adolescent development.therapy
“Psychoeducation to increase the parent’s understanding of the
cognitive, emotional and developmental processes underpinning
challenging adolescent behavior 2. An exploration of common
problematic interactional patterns and more helpful responses to
challenging behaviors 3. Discussion and practice of several key
relationship strategies from Project Air (M.Adrain).
Comment by Perjessy, Caroline: I would encourage you to
summarize/paraphrase instead of using so many direct quotes.
According to SUD is identified as a huge public health that
falls under the maladaptive problems which is a major clinical
hardship that can challenge one physically and psychologically.
SUD can be identified as a maladaptive behavior to control
anxiety. These behaviors can affect one’s social life. When
dealing anxiety, one is most likely to rely on strategies to help
with relieve the anxiety even if it’s for a short period of time.
These behaviors are listed maladaptive behaviors because some
do not deal with the root of the anxiety. At the time the relief is

only temporary and can surface other issues. Some maladaptive
behaviors are cancelling plans last minute, avoiding social
events, and more. the article Relationships between anxiety
“Substance use disorders are a major public health problem
characterized as ‘maladaptive patterns of substance use leading
to clinically severe impairment or distress’ that can affect
physical or psychological functioning, social relations, work
and other areas (Laudet, 2011). When coping, mentally it refers
back to how the individual acts and the environment is
important to ensure a change behavior occurs. Coping refers to
the cognitive, emotional and behavioral reactions every
individual makes in the process of managing the internal and
external demands of a person or environment (Lazarus &
Folkman, 1984). So many will use all tactics to successfully
control certain issues like mental Individualshealth and
challenges faced in life. use many coping mechanisms to
manage and overcome difficult life events, which include
struggles with mental illness (Holubova et al., 2015).
Lastly, I will attend to culture because my community is a black
dominant area and having this group there as a black person, I
can help them understand better that this group is worthwhile.
II’m ma also bilingual and those who speak Haitian creole will
benefit from this group, and can feel comfortable by attending
without worrying about the language barrier. Where the group
will be held has a great number of those who are as well
bilingual speaking both English and creole. I I will also attend
to the culture by being a young woman that is and others will
see that my outgoing, friendly, with a bubbly personality that
will provide draw them in and also making it modern learning
styles to attract all age and especially young adult. “Any time a
group is being formed, a number of considerations arise
regarding its membership (Corey, 2012). Once the population to
be served is determined (schoolchildren, hospital patients,
prisoners, clients of a mental-health center, or interested
persons in a community), the leader should decide whether the
entire population will automatically constitute the membership

or whether the members will volunteer or be selected”(Jacobs,
et el, 2016) (p74). Comment by Perjessy, Caroline: Do you
envision having a lot of Haitian group members? If not, then
this is not that helpful to group members.
Group objectives, planning, and screening
“One of the biggest problems faced by counselors in agencies
and institutions is that administrators do not let leaders select
the members; therefore, groups are often conducted with
members who should not be in the group. We encourage you to
lobby hard for the right to screen your members. Screening is
essential because not everyone is appropriate for every group”
Sonstegard and Bitter (2004). Many who are dealing with
substance use have underlining issues. They also lack the
motivation to complete treatment. They rate for attrition
increased in the area of those who are not attending treatment
and sessions as many times as they should. RTC is an important
part in recovery which allows the counselor to view the
readiness of the client and if they are ready to consider
treatment. According to the article Journal of substance abuse
“Individuals seeking substance use treatment who have one or
more co-occurring mental health problems tend to have lower
treatment engagement, higher rates of attrition, and poorer
treatment outcomes. Readiness to change (RTC) is an integral
construct in the recovery process, with higher RTC associated
with improved treatment outcomes. However, the impact of
HYPERLINK "https://www-sciencedirect-
com.ezproxy.snhu.edu/topics/neuroscience/psychopathology" o
"Learn more about Psychopathology from ScienceDirect's AI-
generated Topic Pages" psychiatric symptoms on RTC is not
fully understood, especially among specialty subpopulations,
such as military Veterans. Therefore, the aim of the present
study was to examine the associations of mental health
problems with RTC in a sample of Veterans initiating outpatient
substance use treatment” ((Bose, Hedden, Lipari, & Park-Lee,

2016; Chan, Dennis, & Funk, 2008; McGovern, Xie, Segal,
Siembab, & Drake, 2006; Watkins et al., 2004). “Importance to
change and self-efficacy one could change were assessed using
modified items from the Readiness Ruler. These self-report
measures asked participants to rate how important it was for
them to change their use of four specific substances and how
confident they were that they could change their use of each
substance” ( HYPERLINK "https://www-sciencedirect-
com.ezproxy.snhu.edu/science/article/pii/S0740547217305585"
l "bb0125" CASAA, 1995; HYPERLINK "https://www-
sciencedirect-
l "bb0315" Miller, 1999).
During the group sessions clients will continue to work the
effective issues such as, anxiety within substance use. While
counselors are not there to remove their problems, they will
work together by implementing the proper treatment on a case
by case basis to ensure successful outcome. The clients served
will be challenged with negative thoughts, cravings, lack of
motivation and many more. However, counselors will do their
best to help the clients serve to understand the importance of
their treatment and completing it entirely. “Planning a group is
often one of the areas not given enough attention in practice”
(p. 25). Corey (2012) states, “If you want a group to be
successful, you need to devote considerable time to planning. In
my view planning should begin with the drafting of a written
proposal” (p. 80). We agree that there are two aspects of
planning: pregroup planning and session planning both are very
important. Conyne and Diederich (2014)). While the planning
part of the group may seem to be the less stressful part it is
important and not given enough importance. When planning
clients should be addressed first with the different topics that
will be used during sessions. Not only it will increase interest
but also provided them with information they can keep for
different purposes and the choice of attending a certain topic or
not.“To date, relatively little research has examined the

associations between other mental health problems (e.g.,
anxiety, insomnia) with RTC substance use, despite these being
common co-occurring diagnoses. For example, anxiety has been
found to be as common, if not more common, in individuals
who use alcohol or drugs as depression ( HYPERLINK
"https://www-sciencedirect-
l "bb0205" Grant et al., 2004; HYPERLINK "https://www-
sciencedirect-
l "bb0270" Lasser et al., 2000; HYPERLINK "https://www-
sciencedirect-
l "bb0380" Seal et al., 2011).
Group objective
Planning is important when planning a group to ensure that all
objectives are met. Its also important because it ensures the
group to run smoothly with a successful outcome.
At the conclusion of the group client will:
1. Keeping a well-balanced life to reduce cravings and
developing healthy friendships Increased understanding of
anxious feelings by stating specific feelings. Comment by
Perjessy, Caroline: What about substance abuse? Isn’t that one
of the areas members will struggle with….and should be a part
of the objectives. Please revise these to make them measureable,
objective, and clear.
2. Counter negative thoughts by remembering positive situations
during a calm timeCheck for negative thoughts and irrational
thinking when triggered
3. Finding coping skills for anxiety along with the symptoms
Take Away for participants
Clients who have the privilege in participating in this group

bewill be able to identify specific triggers that lead to anxiety
symptoms. Clients will also be able to use effective coping
skills learned int to practice. Clients will gain knowledge of
anxiety and describe feelings with others or someone they trust.
After attending this group clients will also be able to develop
great communication skills and social skills with others that are
going through the same challenge. Clients will also learn how to
develop self-awareness by interacting with others in the group
and sharing their impactexperiences with anxiety. Client’s will
also be able to grow, engage in a positive continuous back and
forth from client and counselor, different methods on refraining
from relapsing, clients will learn new ways on how to manage
toxic friendships and many more. “Psychosocial interventions
such as family-based therapies, cognitive behavioral therapy,
motivational interviewing/motivational enhancement therapy,
and third-wave cognitive behavioral therapies are effective for
the treatment of young people with SUD [10]. These broad
psychosocial interventions may be particularly beneficial when
integrated in residential treatment for young people with SUD
because a range of co-occurring mental disorders are very
common in this population and difficult to treat, though
integrated care represents the most effective form of treatment
(Blum, 2009). Clients will also take way the privilege of being
able to merge both individual counseling and group if preferred.
Lastly, Clients will develop great support systems in the
community they are currently residing in. Comment by
Perjessy, Caroline: Again, this is not very applicable to this
section
General Group information
The group will be offered to about 6-8 participants. Prior to
attendance each client will be screened with questions regarding

anxiety level and substance use. This group is mainly for those
between the ages 21-50 years of age. Clients entrance of group
will be based on substance use history and anxiety. Clients will
be screened via zoom with sets of questions from the facilitator
of the group. Some of the tools will consist ofbe questionnaires
to ensure that each client is aware of what they are signing up
for. “The lifetime prevalence of any anxiety disorder is 38%
among women and 27% among men ( HYPERLINK
"https://focus-psychiatryonline-
org.ezproxy.snhu.edu/doi/full/10.1176/appi.focus.20180042" l
"B12" 12). The lifetime and 12-month prevalence of generalized
anxiety disorder among Americans ages 13 and older are 4.3%
and 2%, respectively, with generalized anxiety disorder being
more common among women than among men ( HYPERLINK
"B12" 12). Previous reports of the lifetime prevalence of
comorbid generalized anxiety disorder and substance use
disorder are 2%, which is equivalent to the lifetime prevalence
of generalized anxiety disorder without a substance use disorder
( HYPERLINK "https://focus-psychiatryonline-
"B13" 13). A meta-analysis by Lai et al. ( HYPERLINK
"B5" 5) also found that individuals with lifetime drug
dependence were as much as 2.9 times more likely to develop
illicit drug use and any anxiety disorder. Of interest, although
anxiety disorders are more common among women, men with
anxiety disorders appear to be more likely than women with
these disorders to have a comorbid substance use disorder (
HYPERLINK "https://focus-psychiatryonline-
"B12" 12)”(Key substance use, 2009). “Randomized controlled
trials (RCTs) have examined the efficacy of using buspirone in
treating anxiety symptoms and alcohol dependence. Results

indicated that buspirone performed better in alleviating anxiety
and decreasing the frequency and quantity of alcohol
consumption among persons with alcohol use disorder and
anxiety ( HYPERLINK "https://focus-psychiatryonline-
"B67" 67– HYPERLINK "https://focus-psychiatryonline-
"B70" 70). However, the long-term utility of buspirone in
reducing anxiety and substance use remains uncertain, and the
high placebo response rate makes detecting any possible effects
of the treatment difficult” (Key Substance, 2009). Comment by
Perjessy, Caroline: Please remove
“The interview form including questions on sociodemographic
and substance use along with scales were applied on the patients
in the case study and control groups at the beginning of the
study following a detoxification period of one week. The scales
were reapplied at the time of discharge following a
hospitalization period of about one and a half months during
which psychodrama and SAMBA group studies were performed.
Urine drug test was carried out during the months following
discharge with regard to remission/relapse state, during which
repeated substance use, daily activities and social states of the
patients were recorded. Negative substance (opioid) metabolites
in the controls of the patients for at least three months were
evaluated as “early remission”. Patients for which substance
(opioid) metabolite in the urine was tested as positive during
any period were accepted as relapse” (Öyekçin,2017).
Logistics
The group sessions will be taken place once every two weeks on
Wednesday evenings form 5:30p-7:30pm at the church basement
in Bridgewater, Massachusetts in the community room
downstairs. Prior to start of meeting instructor will contact
building and proper party to ensure the room will be available at

the time. In case of emergency the meeting location is nearby a
firefighter station and along with a with the police
departmentment is also nearby. The fFacilitator will ensure that
a cellular device is at reach and with active Wi-Fi in case of any
emergency that may occur along with a Narcan if necessary.
Clients will have access to bathroom during meetings ifs
needed. Ffacilitator will have a projector available to along with
a laptop in order to utilize and share resources and information
with clients during session. Facilitator will provide light
refreshments without any nuts to prevent from any allergy
reaction. The classroom will be furnished with chairs and desk
considered client will be utilizing. Each client will be provided
with writing utensils and a notebook for keeping notes and any
other written assignments to ensure active participation in
group. Any assignment that has been collected from client will
be safely secured by facilitator to ensure confidentiality.
Screening
“Although client’s who are participating in the group
sessions will benefit greatly from this session it is a voluntary
group no participant will be forced to participate against their
own will. During screening a list of questions will be asked to
participant. Screening is essential because not everyone is
appropriate for every group (Sonstegard and Bitter, 2004)”.
Screening is conducted also to allow that client are sure that
this is the right treatment for their recovery. During the
recruiting process facilitator will discuss specific topics that are
beneficial to clients, each topic will be tailor to an individual
need, Clients will also meet one on one with facilitator and
discuss why they are a best fit for the group. Although during
session rules will be recited, it will also be recited during the
entrance interview to stress the importance of attendance. They
will also be task to ensure if certain things like sharing
feedback, discussing symptoms, experiences, is something they
feel comfortable with. Clients will be contacted via email,
questionnaire and will be distributed via email with personal
information like diagnose, history of substance use, after the

number of participants selected the group will close and open
for members only to allow focus, refrain from distractions, and
confidentiality.
ItIt is also important for leaders to ensure that clients are there
to learn and not to create distractions. The personal interview
method will take place in a room with both the leader and the
participant. Participant will also complete a separate screening
frorm that will include demographic information such as, age,
gender preference, occupation, years of sobriety, illness,
diagnose, and any further medial issues that could be life
threatening. Clients will also be informed that some assessment
will be provided considered this is an anxiety base group on
substance use. If more than 6-8 clients are present the remaining
will have to be placed in a waitlist for the upcoming class.
Client will be tasked to complete assignments such as take-
home assignments and participate during groups. Client’s will
be placed in groups to work with others on different topics for
feedbacks and group work that will be beneficial for each other.
Those individuals who are on the waiting list will be provided
proper resources depending on their need. Those who have been
in attrition due to capacity of group will be task to seek
counseling elsewhere and will be reached out by counselor
when space become available. Client’s will also be approached
in a polite and respectable way when lost by attrition.
Considered the ACA code of ethics each client will be task to
sign a ROI to ensue privacy and confidentiality and it also
protects the leader as well. Lastly, risk assessment will also be
completed for any clients that are observed unstable or
mentioned any suicidal thoughts. The assessment that the
facilitator will conduct is the BAI (Beck Anxiety Inventory).
“Previous DIF studies of the Beck Anxiety Inventory (BAI)
have only assessed bias across age, sex, and disease duration in
monolingual samples. We expand this literature through DIF
analysis of the BAI across age, sex, education, ethnicity,
cognitive status, and test language” (Journal of Affective
Disorders, 2021). “BAI is valid for assessing anxiety across age

and sex while contributing new evidence of its clinical
relevance across education, ethnicity, cognitive status, and
English/Spanish test language. The Beck Anxiety
Inventory (BAI) is a valid and reliable tool, supported in both
clinical and research settings, that is used to screen for 21
anxiety symptoms on a scale of 0–3 (None, Mild, Moderate,
Severe) (Beck et al., 1988). A recent psychometric meta-
analysis across 192 scholarly works demonstrated strong
evidence of high internal consistency and test-retest reliability
of the measure, but highlighted the need for further work on
cross-cultural considerations (Bardhoshi et al., 2016). Some of
the questions that will be asked by participants as listed below
are:
1. What brings your attention to this group?
2. What do you hope to take out of this group?
3. Have you attended group before? And what were they like?
4. What are some personal concerns for you while attending this
group?
5. What are some challenges you have and that you need help
with?
6. Is there a particular person you rather not be in a group with?
7. What are some positive aspects you can bring to this group?
8. Do you have any questions for the facilitator regarding the
group?
Group Plan, Timeline and schedule
The group anxiety on substance abuse will meet every other at
least on Wednesday evenings for for 6 10 weeks from the time
5:30pm-830pm. During the time of meeting clients will first
sign a sign in sheet for attendance, then will do introduction,
the facilitator will have a warmup to ensure some comfortability
within the clients. Cclients will also break into small groups to
complete activities and group work. During sessions there will
be a break for participants to utilize the bathroom, stretch, and

fresh air. Each week will discuss different topics and complete
do different activities. Clients are expected to attend each
session and after three tardy and three missed groups clients
will be asked to give up their spot to someone that is on the
waiting list. Clients will receive warning on the second missed
day.
Outline for group topics
Thise group will be based on the asessemnt to ensure that each
client is successfully getting the information needed while in
the group. The different assessment will help clients to also
have a better understanding what this group is about and the
primary focus of the group. Facilitators will encourage powerful
motivation ted talks to help boost client’s self-esteem and shift
their thoughts towards more positive thinking, considered this is
an anxiety group on substance abuse. Anxiety can very much
alter one thought and create false scenarios that can linger in
one’s mind for a long time. We will also discuss and find
resources on samhsa.gov. and The Center for Mental Health
Services (CMHS) “Strengthens the Nation's mental health
system by helping states improve and increase the quality and
range of their treatment, rehabilitation, and support makes it
easier for people to access mental health programs Encourages a
range of programs such as systems of care to respond to the
increasing number of mental, emotional, and behavioral
problems among America's children Supports outreach and case
management programs. for
Tthe thousands of Americans who are homeless and the
improvement of these services ensures that scientifically-
establishedscientifically established findings and practice-based
knowledge are applied in preventing and treating mental
disorders” (SMHA, 2021). Clients will also be task to complete
a chart for anxiety. Another tool that can be used during session
is the GAD-7. “This questionnaire called the GAD-7 screening

tool can help you find out if you might have an anxiety disorder
that needs treatment. It calculates how many common symptoms
you have and based on your answers suggests where you might
be on a scale, from mild to severe anxiety” (Spfizer,2021).
Group stages, and plan
“When opening start with a long opening statement about the
group and its purpose; then conduct an introduction exercise.
This type of opening is often used for education or task groups,
although some leaders use a long opening statement for therapy
and growth groups as well. The leader will spend the first 3 to 5
minutes describing the purpose and format of the group in a
pleasant, energetic manner, and then he will present an
overview of the planned content for another couple of minutes.
During this opening, the leader will usually give some
background information about himself and his experience in
leading groups. A practical reason for using a long opening is to
capture the interest of the members who are present when other
members have not yet arrived” (Jacobs, et al.,2016, p96).
During the stageworking stage group is well known for client
and facilitator to get to know each other more and build a strong
relationship. During this stage client will be able to develop
trust and comfort level around the instructor which inI result
will enable them to share more. When rules are place rules
although some participants will not agree it will be beneficial to
themto them and show clients that the group information will
not be shared elsewhere. Considering in counseling ROI have to
be in place along with info meaning clients in session
everything share in counseling is confidential. It will also
implement others to respect each h otherseach other’s opinion
during group even though they may not agree. “All groups go
through three stages, regardless of the type of group or style of
leadership: the beginning stage; the middle, or working, stage;

and the ending, closing, stage. Whether a group meets for one
session or fifteen sessions, it will go through these stages; it is
important that the leader attend to each” (Jacobs, 2015). (P36).
“The beginning stage refers to the time period used for
introductions and for discussion of such topics as the purpose of
the group, what to expect, fears, group rules, comfort levels,
and the content of the group. In this stage, members are
checking out other members and their own level of comfort with
sharing in the group” (Jacobs,2016). (P36). Comment by
Perjessy, Caroline: What stage
It is also important to provide clients to have time to talk
among each other when in small groups which will enhance
comfortability and allow them to share personal experiences
that they wouldn’t normally sharemore. “It is beneficial to have
them get acquainted soon after the session begins. Members
tend to feel more at ease after learning each other’s names and
spending some time getting to know each other” (Jacobs, et
al.,2016, p100).
Cooccurring mental Health issues are likely to happen to those
with history of substance use. As we get further into anxiety
amongst those with substance use, many
Deal with several issues are that they are not able to utilize a
coping skill for. In this group we will help each participant by
giving them the opportunity to talk about some. oOf the
challenging things they encounter for them when it comes to
anxiety. Listed below are some
Of the topics we will Cover by a case by case in order to
accommodate each client. Each client may have ethical issues
they are dealing with and facilitators will ensure of that prior to
the session during their interview to ensure clients are
accommodated appropriately. For some the ending will be an
emotional experience, whereas for others the closing will
simply mean that the group has done what it was supposed to
do. The length of the closing stage will mostly depend on the
type of group. Most groups need only one session for this stage.
· Death of a loved one.

Can be challenging and something that can lead one to use. We
will be task to help each client who deal with this topic by
providing Indian them with resources and effective Coping
skills.
· Marriage problems.
All though marriage can be a beautiful thing while others may
have issues with coexistence with their partner .and Iin this
group we will go over the importance of being heard while in
their marriage and applying some techniques on how to deal
with anxiety that can lead to substance use when not dealing
with unexpected life stressors that may occur. applying
effective coping skills.
· Family problems.
· Rather it’s issues with siblings or immediate family problems
scan before something one can go through that cause anxiety
and eventually substance use. Family relationship when not
resolve. Family issues depending into je amount of time can
take a toll one one and even make them feel lonely, outcast and
several other emotions.
· Loss of a job.-job. - depending on Tthe economy and the way
the lostloss of job is was can be something that can lead a client
to use. Lack of funds ind can have someone feel
unaccomplished and lead them to steal, or feel humiliated dified
especially if they are not comfortable with of asking for help
from others .others.
Social anxiety i.is something that can many challengechallenge
those with especially in the cBrockton ommunitiescommunity.
where I’m from. Due to lack of diversity many are afraid to
approach others. Depending on the clientsclient’s environment
or the waythe way they were brought up can also be an issue.
For Example, fear, consciousness, embarrassment and bullying.
All These topics will be discussed and will also accompany
different pamphlets that go along with them for those who are
visual learners. Although this is an anxiety group among
substance use individuals’, different topics like these are

important because those who are currently dealing with anxiety
could be dealing with these as an underlining issue as discussed
prior. Each topic will be discussed thoroughly and during
sessions the facilitator will engage participant and create group
wok to discuss further. “One of the most important
considerations for the first session is how to begin the group.
How the leader opens the session will have a bearing on the
tone of the group and the comfort level of the members. The
leader should convey warmth, trust, helpfulness, understanding,
and positive regard. This is the time when members form their
impressions of the leader and assess whether or not they think
the group is going to be helpful to them” (Jacobs, et al.,2016,
p95). As many are getting to know each other in the group it’s
expected there will be small groups, and some will get along
with others and some will not. To avoid some attrition and
issues as a facilitator we will go over rules every day and even
have participants state the rules as well to ensure that they
comprehend. We will also emphasize things like bullying, name
callings and all other negative behaviors are forbidden in Order
for each person to leave the session with a successful outcome.
· “The middle, or working, stage is the stage of the group when
the members focus on the purpose. In this stage, the members
learn new material, thoroughly discuss various topics, complete
tasks, or engage in personal sharing and therapeutic work. This
stage is the time when members benefit from being in a group.
During this stage, many different dynamics can occur because
the members are interacting in several different ways. The
leader must pay particular attention to the interaction patterns
and attitudes of the members toward each other and the leader”
(Jacobs, 2016) (P37).
“11. Explaining group rules, 12. Explaining any special terms
that will be used , 13. Assessing members’ interaction styles,
14. Being sensitive to multicultural and diversity issues and any
dynamics that may be present, 15. Focusing on the content 16.
Cuttingcontent, Cutting off members, 17. Addressing questions,
18. Getting members to look at other members, 19. Closing the

first session” (Jacobs, et al.,2016, p 95).
“In certain kinds of groups, particularly task groups, there are
times when storming is a desired or necessary stage, especially
when there are powerful personalities and some disagreement as
to how things should be done. Great skill is required to guide
the unpredictable interactions among members through the
storming period so that members can work together” (Jacobs, et
al.,2016, p 39). Although clients are task to attend all group
sessions it’s expected that some clients can end treatment prior
to completing it. What can be done is the facilitator can have a
one to one to address some issues that are causing the behavior.
Also, facilitator should also get to the root of the issue. The
Facilitator will also need to improve groups by changing the
topics ,getting feedback from the participants on how to-
improve the group, find ways to individualize care, complete
follow up calls and check ins. lastly, setting expectations can
also refrain from attrition along with being open by answering
questions that participants may have.
“There are a number of skills, techniques, and exercises that are
useful during closing. Rounds are very helpful because they
tend to get everyone to speak, and it is important to hear
reactions from the quieter members. Writing as a part of closing
has proved to be quite valuable for many different kinds of
groups. Cut- ting off is essential because members tend to tell
stories or bring up new topics” (Jacobs, et al.,2016, p 403).
Concluding the group on a positive note is important for a many
cleintsclients especially those going home to environment that
are challenging. As facilitators end group itsit’s also important
to end with a positive note and haveing each menebermember go
around the room and state e what they lraenedlearned from the
group .group. It’s its also important because those who came
late can take notes on what was missed prior to their arrival.
“For some groups, the ending will be an emotional experience,
whereas for others the closing will simply mean that the group
has done what it was supposed to do. The length of the closing
stage will mostly depend on the type of group. Most groups

need only one session for this stage” (Jacob, 2016). (P37).
It’s essential to be aware that some clients in group can be
emotional while may not be. Facilitators should take
consideration of those who are to allow a space for them to be
venerable and be able to release their emotions. Some clients
also may be dealing with attachment issues and are not able to
cope when things end.
Group curriculum and plan
Week 1- Introductions and warm up
Facilitator will go over rules and have clients pass around the
room to ensure its clear
Clients will get to know each other and facilitator by
completing a ice breaker and go around the room. Clients will
first state their name, their diagnosed, and three things that they
believe that the group should know about them. Each client will
receive an index card where they can put this information as
well and facilitator will collect it to retain confidentiality.
During the first group the facilitator will discuss further the
tools needed in order to have a successful outcome.
Week 2- Dealing with Anxiety
Group will continue to pick up from last session by going over
the last session which is helpful for those who were not in
attendance. Next, facilitator will have clients go around and
complete a warmup but different task. Clients will watch a ted
talk regarding the topic then write down what stood out to them.
Facilitator will allow others to chime in to also recite how they
can relate to the video if they feel led to speak and provide
feedback according to what they wrote. Lastly, Facilitator wi ll
provide brief info on what will talk about the next session for
overview.

Week 3 substance use triggers-
After reviewing last session and asking who attendance the
facilitator was will ask a client to revise what was talked about
in last session for everyone in the group. Facilitator will
provide worksheet relating to substance sue triggers, drug
dependence, and moral weakness. After each client complete
each worksheet they will pair up and discussed with others in
the group. Facilitator will then go over the importance of
working in group and the benefits of it for those who didn’t
participate. Clients will not be giving any homework but instead
will be task to think about the worksheet and provide more
feedback to others in the group.
Week 4 -Overcoming negative behaviors
During this session clients will go over briefly the last session
and homework
Clients will take a moment to listen to relaxation music
Client will talk about some of the behaviors they encountered
Clients will talk about some illnesses they faced with substance
use
Week 5- symptoms of anxiety
Clients will start with going over what was talked. Out last
class then break for 30 minutes.
Upon return clients will discuss some symptoms they faced with
anxiety substance use
Clients will share their thoughts with the peers
Clients will watch each a video on symptoms
Clients will share in writing their symptoms and if they
overcome and how
Week 6 Relapse prevention
Clients will review last class homework
Clients will discuss with facilitator the purpose of this group
Facilitator will take the lead and explain briefly the rules of the
group and importance of the group
Clients will learn about relapse prevention by working on a
worksheet

Clients will talk about during rounds what they about relapse
prevention
Closing each client will mention how it made them feel talking
about this topic.
Clients will complete and assessment
Counselor will review the importance or carrying a Narcan and
proper usage
Clients will meet individually with facilitator to discuss final
thoughts
Each client will go around group and state a positive
affirmation about someone
Session will end with lite refreshments and interacting with one
and other.
Reference
Adrian, M., Zeman, J., Erdley, C., Lisa, L., & Sim, L. (2011).
Emotional dysregulation and interpersonal difficulties as risk
factors for nonsuicidal self-injury in adolescent girls. Journal of
Abnormal Child Psychology, 39, 389–400. doi:10.1007/ s10802-
010-9465-3.
A. Allgaier, K. Pietsch, B. Frühe, J. Sigl-Glöckner, G. Schulte-
Körne
Screening for depression in adolescents: validity of the patient
health questionnaire in pediatric care Depress.
Anxiety, 29 (10) (2012), pp. 906-913, 10.1002/da.21971
J. Bose, S.L. Hedden, R.N. Lipari, E. Park-Lee Key Substance

use and Mental Health Indicators in the United States: Results
from the 2015 National Survey on Drug Use and Health
Substance Abuse and Mental Health Services
Administration, Rockville, MD (2016)
Expósito-Álvarez, C., Lila, M., Gracia, E., & Martín-
Fernández, M. (2021). Risk factors and treatment needs of
batterer intervention program participants with substance abuse
problems. The European Journal of Psychology Applied to
Legal Context, 13(2), 87-97.
https://doi.org/10.5093/ejpalc2021a9
Orhurhu VJ, Pittelkow TP, Hooten WM. Prevalence of smoking
in adults with chronic pain. Tob Induc Dis. 2015; 13:17.
Kato, T. (2015). Frequently used coping scales: A meta-
analysis. Stress and Health: Journal of the International Society
for the Investigation of Stress, 31, 315–323
Johnson SB, Blum RW, Giedd JN. Adolescent maturity and the
brain: the promise and pitfalls of neuroscience research in
adolescent health policy. J Adolesc Health. 2009;45(3):216–21.
https://doi.org/10.1016/j.jadohealth.200 9. 05.016.
Key Substance Use and Mental Health Indicators in the United
States: Results From the 2017 National Survey on Drug Use and
Health. Rockville, MD, Substance Abuse and Mental Health
Services Administration, 2009

Beck et al., 1988 A.T. Beck, G. Brown, N. Epstein, R.A. Steer
An inventory for measuring clinical anxiety: psychometric
propertiesJ. Consult. Clin. Psychol., 56 (1988), pp. 893-897
Güleç Öyekçin D, Aldemir E, Altıntoprak AE Dalbudak E,
Deveci A, Güleç G, et al.; Opioid Kullanım Bozukluğunda Tanı
ve Tedavi Kılavuzu Çalışma Grubu. Opioid Kullanım
Bozukluğunda Tanı ve Tedavi Kılavuzu. Evren C, editör.
İstanbul: Yerküre; 2017.
Group objectives, planning, and screening (1 page; draft due
week 4)
Outline at least 3, but no more than 5 group objectives related
to your chosen group counseling topic. What will group
members ultimately get out of or take away from having
participated in this group? Be sure to outline objectives that are
specific and measurable.
Discuss any practical or logistical considerations around
forming and facilitating this group. Group composition. How

will group members be recruited for the group? What population
do you hope to work with? How will group member screening
be conducted? What is the process for informing potential group
members whether or not they have been accepted to participate
in the group process? How will you serve those who have not
been admitted into the group (referral, suggestions for other
resources/groups, individual counseling)?
Discuss specific screening tools or assessments you may use.
How will you incorporate informed consent into the group
planning process? How will you record member progress and
how will those notes be kept?
Group Plan, Timeline, and Schedule (1-2 pages; draft due week
4)
Outline various elements of the groups structure including the
timeline.
Frequency and duration of group sessions: How long will each
session be? How frequently will you meet and where? How
many group sessions will there be? How will you address
possible group member attrition after the first few sessions?
Create a general overview of the topics you intend to anchor
your group sessions around each week (this does not have to be
complete, but you should include general topics).
Group Stages and Plan (1-2 pages; draft due week 6)
This section will build on the work completed in week 4 and
will include additional information for each weekly session,
including general guidelines for when various stages of the
group can be anticipated. Include the following:
· Discuss the various stages of group and how the dynamics may
shift.
· Explore how these stages of group might impact the group
process and dynamics given your chosen topic.

· Identify strategies for addressing any challenges that may
arise during specific stages of the group.
Curriculum Overview/Plan (1-3 pages; draft due week 6)
Provide an overview of each week (max. one paragraph per
week) of your group curriculum using the following format:
Topic:
Important information/logistics: (logistics, ex. Establishment of
group norms in week 1):
Assessments: (if applicable, ex. pre- and post- evaluations):
Relevant techniques and interventions (ex. Exercises and rounds
in week 1):
Example: (this example is for a parenting group)
Topic: Parenting and Self Care
Important information/logistics: Session 8 of 10, begin
preparing group members for group ending
Assessment: Send home parenting skills inventory to be
returned before week 10
Relevant techniques and interventions: Self care drawing
exercise; cutting off/drawing out, rounds to process exercise
Group Evaluation/Assessment (due week 9 with final
submission):
Discuss plan for the group’s timeline and any indicators of
progress. How will notes be kept? Evaluate group progress
through the use of pre and post evaluations. What plans will be
made to address the needs of any group members who have not

progressed or who may need additional support once the group
has terminated?

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