This document discusses developing a treatment group for individuals who have recently lost a loved one to addiction. Key points: - The group will be led by two licensed professionals and meet weekly for 12 weeks to provide support, counseling, and teach coping skills. - The group will have 7-10 members who are newly bereaved within the last year and at least 3 months from the loss. Members must be over 18 and bereaved due to addiction. - Preliminary interviews will be conducted to orient members and assess fit for the group. Meetings will follow a structured format with time for checking in, content presentation/discussion, problem solving, and evaluation. - Initial meetings will focus on establishing group guidelines

1. Group Project
TREATMENT GROUPS

2. Note
• All information used in this powerpoint was taken directly from the textbook:
Zastrow, C. H., & Hessenauer, S. L. (2019). Social work with groups: Comprehensive practice
and self-care (10th edition). Cengage Learning.
Unless specifically cited otherwise.

3. Developing Treatment Groups
• Identify the need for the
group
• Establish the group
purpose
• Decide on leadership
• Determine group
composition
• Choose an open or
closed group
• Determine group size and
location
• Set the frequency and
duration of meetings
• Conduct preliminary
interviews
• Determine the group
structure
• Formulate preliminary group
guidelines

4. Need
• Death from substance abuse leaves surviving family and friends at a greater risk of developing a
mental illness due to the lack of support they receive. These individuals often struggle with feelings
of shame, stigma, and subsequent isolation which prevents them from seeking support.
• Studies have shown that addiction bereaved individuals find the most success in support groups
that allow them to positively memorialize their loved one with other people who share a similar
experience and who are not uncomfortable discussion addiction related deaths.
• Studies also show that people bereaved from either suicide or drug death, showing that those
who openly disclosed the cause of their loved one's death had significantly fewer grief difficulties
and viewed their mental health more positively, compared with bereaved others who concealed
the death cause ([ 6])(Fiegelmen, 2018).

5. Purpose
• Led by licensed professionals/social workers/counselors
• To provide support, counseling, and to teach coping skills and ways
to focus on honoring a lost loved one to individuals suffering from the
recent loss of a loved one due to addiction.
• Many drug-death-bereaved people experience
disenfranchised grief, which is when society does not acknowledge
and support a mourner's grief, thereby worsening the grieving
experience (Doka, 2001)

6. Group Population
• Newly Bereaved within the last year
• At least 3 months from the loss (read widow to widow slide)
• Over 18
• Bereaved due to addiction

7. Leadership
• According to our textbook- Two facilitators can provide additional eyes and ears for the group, with
one facilitator specifically attending to content and the other taking note of the process and meta-
messages (underlying messages) by group members. Co-leaders can bring different perspectives,
backgrounds, and personalities to the group process, which can appeal to a wider array of
members than a single facilitator might. They can also use their interactions to model effective
communication and problem solving. In addition, two facilitators have greater capacity for observing
communications and formulating responses and can support and strategize with each other (Luke &
Hackney, 2007; Yalom & Leszcz, 2020).
• Sometimes co-leadership is necessary for practical reasons. With two facilitators, one can check on
a member who is missing or has left the room, while the other continues working with the group.
Co-leadership can provide continuity if vacations, illness, or another emergency on the part of one
facilitator might otherwise result in cancellation of a session. With some populations, two facilitators
may help send a message of authority in an otherwise disruptive group; they may also provide a
sense of physical safety and protection from harm by their very presence (Carrell, 2000).

8. Group Composition
• Newly Bereaved (Within the last year)
• Over 18 (adults only)
• Loss of a loved one due to addiction
• Individuals seeking group/mutual support

9. Open or Closed Group
• Closed group: Only individuals suffering from a loss from
addiction within the last year. Short term support groups that
provide counseling education, coping strategies, and looking for
ways to honor loved ones (such as advocacy) over a set
amount of time. (12 weeks ) Allowing new members could
disrupt the healing process for current members. After
completing preliminary interview, new members can join at the
start of the next 12 week group.
•

10. Treatment Group Theories
• Page 470 in the Social Work with Groups Textbook
• Rational therapy
• Behavior therapy
• Reality therapy,
• Dialectical behavior therapy

11. Size & Duration
• Seven to ten members is usually an optimal number for a group with an
emphasis on close relationships (Stewart et al., 2009). The group must be small
enough that members feel safe and comfortable sharing confidential information
but large enough that group members receive adequate support and relevant
feedback.
• closed groups benefit from having a termination date at the outset, which
encourages focused work. Regarding the possible life span of a group, Corey
and Corey (2006) note: “The duration varies from group to group, depending on
the type of group and the population. The group should be long enough to allow
for cohesion and productive work yet not so long that the group seems to drag on
interminably” (p. 92).
• In general, short-term groups vary between one and 12 sessions, with the
shorter-duration groups being targeted at crisis situations, anxiety alleviation, and
educational programs (Northen & Kurland, 2001).

12. Preliminary Interviews
• Before convening a treatment group, social workers often meet
individually with potential group members to provide
information, establish rapport, explore concerns, and clarify
limits, mandates, and options for involuntary members.
Interviews are helpful for optimizing group composition; they
help ensure that the members are selected according to
predetermined criteria and are likely to make effective use of
the group experience. These meetings can:

13. Preliminary Interview Cont.
Orient potential members to proposed goals and purposes of the group, its content and structure, the facilitator’s philosophy and style in managing group processes, and the roles
of the facilitator and group members. This is also a good time to identify expectations, such as attendance, confidentiality, and to focus and gauge the client’s corresponding
reactions and suggestions (Yalom & Leszcz, 2020; Singh & Salazar, 2014). With involuntary groups, you must distinguish between non-negotiable rules and policies, such as
attendance expectations and general themes to be discussed, and negotiable norms and procedures, such as arrangements for breaks, food, and selection of topics and their
order.
Elicit information on the individual’s prior group experiences, including their style of relating in the previous groups and the goals that they accomplished. With people who may be
uncomfortable or unfamiliar with group services, a pregroup orientation can answer questions, help them understand what to expect, reduce apprehension, and offer coaching on
how best to participate (Chen et al., 2008).
Elicit, explore, and clarify the clients’ needs, and identify those that fit with the proposed group. In some instances, either because people are reluctant to participate in the group
or because their issues appear to be more appropriately handled through other settings or modalities, you may refer them to resources other than the group.
Explore clients’ hopes, expectations, and goals regarding the proposed group (e.g., “What would you like to be different in your life as a result of your attending this group?”). This
conversation may influence decisions in the construction of the group or may indicate that the proposed group is not the best fit for the client’s interests.
Mutually develop a profile of the client’s strengths and attributes and determine the ways they can contribute to the group and capacities that the client might like to enhance
through work in the group. Preliminary interviews enable social workers to enter the initial group sessions with a previously established relationship with each member—a distinct
advantage given that facilitators must attend to multiple communication processes at both individual and group levels.
Identify and explore potential obstacles or reservations about participating in the group, including shyness or privacy concerns, opposition from significant others about entering
the group, a heavy schedule that might preclude attending all group meetings, or needs for transportation or child care.
Ensure that screening for the group is a two-way process. Potential members should have the opportunity to interview the social worker and determine whether the group meets
their interests and whether the relationship with the facilitator will likely lead to a successful outcome. Further, establishing rapport with the facilitator is beneficial for members in
that it enables them to feel more at ease and to open up more readily in the first meeting.

14. Structure of Meetings
• Define group and individual goals in behavioral terms and rank them according to priority.
• Develop an overall plan that organizes the work to be done within the number of sessions allocated
by the group to achieve its goals. The facilitator or co-facilitators should have done preliminary work
on this plan while designing the group.
• Specify behavioral tasks (homework) to be accomplished outside the group each week that will
assist individuals to make and sustain the desired changes.
• Achieve agreement among members concerning the weekly format and agenda—that is, how time
is allocated each week to achieve the group’s goals. For instance, a group might allocate its weekly
1.5 hours to the format shown in Table 11-3.

15. Structure Example
• Example of Format for a Ninety-Minute Group
• 15 Minutes –
Checking in
Reviewing and monitoring Tasks
• 1 Hour -
Focusing on Relevant content (presentation and discussion)
Mutual Problem Solving
Formulating Tasks
Plan for the week
• 15 Minutes -
Summarizing plan for the week
Evaluating group session

16. Group Guidelines
• Developing consensus about group guidelines (e.g., staying on task, adhering to confidentiality) is a vital aspect of contracting in the initial
phase of the group. In formulating guidelines with the group, the social worker takes the first step in shaping the group’s evolving
processes to create a working group capable of achieving specific objectives. We offer the following suggestions to assist you in this
aspect of group process:
• If there are nonnegotiable expectations (e.g., confidentiality, no smoking policies, or rules about contact between members outside
sessions), you should present them, explain their rationale, and encourage group discussion (Corey et al., 2013).
• Introduce the group to the concept of decision by consensus on all negotiable items, and solicit agreement concerning adoption of this
method for making decisions prior to formulating group guidelines.
• Ask group members to share their vision for the group by responding to the following statement: “I would like this group to be a place
where I could .…” Reach for responses from all members. Once this has been achieved, summarize the collective thinking of the group.
Offer your own views of supportive group structure that assists members to work on individual problems or to achieve group objectives.
Acknowledge that these initial wishes and agreements may be revisited as the group evolves.
• Ask members to identify guidelines for behavior in the group that can assist them to achieve the kind of group structure and atmosphere
they desire. You may wish to brainstorm possible guidelines at this point, adding your suggestions. Then, through group consensus,
choose those that seem most appropriate

17. The following 10 items identify pertinent topics for treatment group guidelines, although each
guideline’s applicability depends on the specific focus of the group.
• Help-Giving/Help-Seeking Roles
• Groups can benefit from clarification of the help-giving and help-seeking roles that members play. The help-seeking role incorporates such
behaviors as making direct requests for input or advice, authentically sharing one’s feelings, being open to feedback, and demonstrating
willingness to test new approaches to problems. The help-giving role involves such behaviors as listening attentively, refraining from
criticism, clarifying perceptions, summarizing, maintaining focus on the problem, and pinpointing strengths and incremental growth. This
guideline helps the group avoid moving prematurely to giving advice and offering evaluative suggestions about what a member ought or
ought not to do. The facilitator can further help the group appropriately adopt the two roles by highlighting instances in which members
have performed well in either of these helping roles.
• New Members
• Procedures for adding and orienting new members may need to be established. In some cases, the group facilitator may reserve the
prerogative of selecting members. In other instances, the group chooses new members based on certain criteria and consensus
regarding the selections. In either case, procedures for adding new members and the importance of the group’s role in orienting those
entrants should be clarified.
• Individual Contacts with the Social Worker
• Whether you encourage or discourage individual contacts with members outside the group depends on the purpose of the group and the
anticipated consequences or benefits of such contacts. In some cases, individual contacts serve to promote group objectives. For
example, planned meetings with an adolescent between sessions may provide opportunities to focus on behaviors in the group, support
strengths, and develop an individual contract with the youth. When the outside contact is not planned or routine, it may derail issues that
should be brought to the group rather than addressed one on one, and it may alienate other group members who do not have access to
the facilitator.
• Member Contacts Outside the Group
• Contacts by members outside the group can be constructive or harmful to individuals and the group’s purpose, and thus, the practice
literature contains differing views on this topic. Group sessions are but one activity in peoples’ lives; and it is, therefore, unreasonable to
expect members to follow rules that extend outside the temporal and special boundaries of the group. The nature and the benefit of
collaborative support is limited if members are forbidden to make contact outside of session (Shulman, 2009).

18. Cont.
• Use of Recording Devices and Phones
• Given the subtlety of current recording technology and the risks posed by inappropriate video or audio recording, this is an important topic for members and facilitators alike. Members should be
reminded of confidentiality rules, and recording should be prohibited as part of their ground rules. If there is a therapeutic or professional purpose for recording the group, the social worker should
always ask for the group’s permission before doing so (NASW, 2021). Before asking for such a decision, the social worker should provide information concerning how the recording may be used
outside the session, how it will be kept, and when it will be destroyed. Members’ reservations regarding recording the session should be thoroughly aired, and the group’s wishes should be respected.
• Eating and Drinking
• Opinions vary among group facilitators concerning these activities in groups. Some groups and facilitators believe that they distract from group process; others regard them as comforting and thus
beneficial to group operation. Some groups may intentionally provide meals as an incentive to encourage group attendance (Wood, 2007). You may wish to elicit members’ views about these activities
and develop guidelines with the group that meet member needs, conform to organization or building policies, and facilitate group progress. A related conversation involves the configuration and care of
the room where the group meets. Making group decisions regarding care of the physical space (e.g., food, furniture, trash) fosters shared responsibility for the group meeting area.
• Profanity
• A related issue is the use of profanity in the group. Some social workers believe that group members should be allowed to use whatever language they choose in expressing themselves (Howes,
2012). However, swearing may be offensive to some participants, and the group may wish to develop guidelines concerning this matter, particularly if slurs have religious, racial, or gendered
connotations.
• Attendance
• Discussing the importance of regular attendance and soliciting commitments from members can solidify membership and prevent the challenges that arise from attrition or absences. Involuntary
groups often have attendance policies that permit a limited number of absences and late arrivals. Late arrivals and early departures by group members can typically be minimized if the group develops
norms about this behavior in advance and if the facilitator starts and ends meetings promptly. Exceptions may be needed, of course, to accommodate crises affecting the schedules of members or to
extend the session to complete an urgent item of business if the group concurs. However, individual and group exceptions to time norms should be rare.
• Touching
• The sensitive nature of some group topics may lead to expressions of emotion, such as crying or angry outbursts. It is important to have group guidelines that provide physical safety for members,
such as no hitting. It is also important to set a climate of emotional safety to sanction the appropriate expression of feelings. Some group guidelines prohibit members from touching one another with
hugs or other signs of physical comfort. Sometimes these rules are included to protect members from unwanted or uncomfortable advances. Other groups maintain that touch is a feeling stopper when
one is tearful and insist that group members can display their empathy in other ways—through words or through eye contact and attention to the other, for example. Whatever the group’s policy, it is
important to explain the expectation and the rationale and to address member concerns rather than impose the guideline unilaterally.

19. Widow to Widow (Just an interesting article I read on the Institute of
Medicine, about when the bereaved should seek support)
“It also became apparent that the bereavement process was not over in a few weeks or months but that it extended over a period of years; that guilt and
anger were not identified by widows as the critical issues needing attention, although these were the common therapeutic foci; and that bereavement was
best thought of not as a "crisis" but as a "transition." The death of a spouse initiated a critical life transition, marked by a sudden change in social status
(from wife to widow) and requiring major changes in self-concept, roles, and tasks. With these observations in mind, Silverman considered how best to
assist people in this transition and when to intervene. 43,44
Because it is not always possible to identify in advance which individuals are at risk and because people seemed reluctant to ask for help, it was decided
that the intervention should be based on a public health approach rather than a clinical model. Thus, the program was designed for the entire population at
risk and used an outreach rather than a selfreferral approach. 46
The next question had to do with the timing of intervention. Immediately following bereavement widows are likely to be numb and to act reflexively.
Clergy, funeral directors, family, and friends are there to help with the specific tasks of the funeral and mourning rituals. Only somewhat later, during the
phase Silverman 43 calls "recoil," does the meaning of the loss begin to become real. But by then family and friends have often gone home, expecting that
the widow is over the worst and can manage on her own.
This period of recoil seemed the ideal time to offer help to widows with practical problems, management of extreme and profound feelings, and a general
reordering of their lives. Thus, it was decided: (1) that help should not be offered until at least three to six weeks after the bereavement; (2) that in order to
be accepted by the entire population at risk, it should be offered by another widow in the neighborhood who could serve as a role model during this critical
transition; and (3) that help should be offered initially on a one-to-one basis because the recently bereaved were not often ready for group interactions for
several months. Mutual support groups were useful later.
The goals of the program centered around change, not around "recovery." It was discovered in talking to widows that they never "recovered" in the sense of
returning to all prebereavement baselines, but that a successful outcome depended on their ability to adapt and alter their images and roles to fit their new
status. Although emotional support from a person who has also been through the experience was considered important, the women's more fundamental need
was to learn how to change. Thus, in addition to emotional support, the intervention provided specific information about various practical concerns and
about bereavement, as well as helping the widows develop alternate coping strategies (Institute of Medicine, 1984). 44

20. References
Feigelman, W., Feigelman, B., & Range, L. M. (2020). Grief and Healing Trajectories of Drug-Death-Bereaved
Parents. OMEGA - Journal of Death and Dying, 80(4), 629–647. https://doi.org/10.1177/0030222818754669
Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement; Osterweis M, Solomon F, Green M, editors. Bereavement:
Reactions, Consequences, and Care. Washington (DC): National Academies Press (US); 1984. CHAPTER 10, Bereavement Intervention Programs. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK217843/
Zastrow, C. H., & Hessenauer, S. L. (2019). Social work with groups: Comprehensive practice
and self-care (10th edition). Cengage Learning.