Toxic Congregation or Group Psychotherapy with Addicted Populations

Toxic Congregation: How to Heal the Soul of Your Church

Author: G Lloyd Rediger

About the Author:
G. Lloyd Rediger, ordained in the Presbyterian Church (USA)

Book about: Instant Bean or Cooking with Crazy Charley IV

Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory

Author: Philip J Flores

Be more effective in group therapy with addicted clients

Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition is the newly revised edition of the classic text, that provides you with proven strategies for defeating alcohol and drug addiction through group psychotherapy. Philip J. Flores, a highly regarded expert in the treatment of alcoholism and in group psychotherapy brings together practical applications of 12-step programs and psychodynamic groups. This updated book explores the latest in constructive benefits of group therapy to chemically dependent individuals, providing opportunities to share and identify with others who are going through similar problems, to understand their own attitudes about addiction by confronting similar attitudes in others, and to learn to communicate their needs and feelings more directly.

Topics in Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition include:

• Alcoholism, addiction, and psychodynamic theories of addiction
• Alcoholics anonymous and group psychotherapy
• Use of confrontational techniques in the group
• Inpatient group psychotherapy
• Characteristics of the leader
• Transference in the group
• Resistance in groups
• Preparing the chemically dependent person for group
• The curative process in group therapy
• Integrating a modern analytic approach
• A discussion of object relations theory
• Group psychotherapy, AA, and twelve-step programs
• Diagnosis and addiction treatment
• Treatment issues at early, middle, and late stages of treatment
• A discussion of guidelines and priorities for group leaders
• Countertransference
• Special considerations of resistance to addiction
• Termination of treatment

Professionals working in group therapy and addictions will find Group Psychotherapy with Addicted Populations: An Integration of Twelve-Step and Psychodynamic Theory, Third Edition an invaluable resource emphasizing the positive and constructive opportunities group psychotherapy brings to the chemically dependent individual.

What People Are Saying

Edward J. Khantzian
SCHOLARLY YET IMMENSELY HELPFUL AND PRACTICAL BOOK . . . covers all the bases, integrating how group therapy and twelve step programs help to access and transform the core vulnerabilities of addicted individuals. . . . BRILLIANTLY FOCUSES on how the relational and self regulatory problems of addicted individuals can be addressed and modified by informed clinical approaches and twelve step programs. . . . ASTUTELY INSTRUCTS us how group and twelve step programs can serve as correctives by replacing addictive behaviors with meaningful and transforming relationships. (Edward J. Khantzian, MD, Clinical Professor of Psychiatry, Medical School at Tewksbury Hospital and the Cambridge Health Alliance)

Henry I. Spitz
Every so often a rare text comes along that possesses the qualities of being theoretically sound, clinically wise and easily readable. Philip Flores has written such a book. . . . A MAJOR CONTRIBUTION toward enriching our understanding of the interplay between psychological theory, neuroscience research and clinical group work with people struggling with problems of addiction. With his unique blend of scholarship and pragmatism, Dr. Flores provides the reader with A THOUGHTFUL AND WELL DOCUMENTED ROAD MAP for negotiating the notoriously challenging terrain of treating addicted individuals. This book is A 'MUST READ' for anyone seeking a comprehensive understanding of the use of group therapy for substance abuse treatment. (Henry I. Spitz MD, DFAGPA, Director Group Psychotherapy Training Program, Department of Psychiatry, Columbia University, College of Physicians & Surgeons, New York, & Distinguished Fellow, Americana Group Psychotherapy Association)

Molyn Leszcz
In this VERY CLEAR AND WELL-WRITTEN text book, DR. FLORES HAS SET THE STANDARD in his articulation of the way group therapy plays a pivotal role in the treatment of persons suffering from addictions. . . . Advances our understanding of the integration of addictions into mental health; psychology of the mind and biology of the brain; models of group therapy; 12-step approaches and leader led groups; scientific knowledge and clinical wisdom; and, the pivotal role that an understanding of attachment plays in effective group psychotherapy. . . . NEW CHAPTERS WRITTEN FOR THIS EDITION ARE OF GREAT VALUE: the first chapter on interpersonal neurobiology and addictions, is A MUST READ, not only for those who work in the area of addictions, but for psychotherapists in general, who are interested in understanding how the work that they do with their clients modifies their clients' brain as well as their clients' thinking. (Molyn Leszcz, MD, FRCPC, Psychiatrist-in-Chief, Mount Sinai Hospital, Professor and Head, Group Psychotherapy, Department of Psychiatry, University of Toronto)

Marilyn Freimuth
THIS BOOK KEEPS GETTING BETTER! Flores has interwoven his in depth explorations into attachment theory and addiction to create a text that is rare to find: a practical guide to treatment that is theoretically grounded. After reading this book, practitioners will be able to PROVIDE MORE EFFECTIVE TREATMENT TO ADDICTED POPULATIONS because they will know what to do and why to do it. This is really five books in one. . . . Provides comprehensive readable overviews of the nature of addictions, group therapy, 12-step work and psychodynamic theory. At the same time he interweaves these topics to create a theoretically grounded practical guide to more effective addiction treatment. (Marilyn Freimuth, PhD, Professor of Psychology, Fielding Graduate University and author of Hidden Addictions)

Table of Contents:

Foreword (Jeffrey D. Roth)
PART I: THEORETICAL MODELS
Chapter 1. Interpersonal Neurobiology and Addiction: An Attachment Theory Perspective
Interpersonal Neurobiology
The Neurophysiology of Attachment
Interdisciplinary Research and Attachment Theory: A Source for Informing Addiction Treatment
Contributions from Child Development Studies
Contributions from the Neurosciences
Reward Deficiency Syndrome
Attachment and Animal Research
Contributions of the Relational Perspective to Group Psychotherapy
Chapter 2. Attachment Theory As a Theoretical Basis for Understanding Addiction
Attachment Theory and Self-Psychology
Attachment Styles and Secure Attachment
Ainsworth and the Strange Situations
Implications for Treatment
Implications for Addiction Treatment
Summary of Treating Addiction As an Attachment Disorder
Chapter 3. The Disease Concept and Group Psychotherapy
Abstinence: Is It Necessary?
Paradigm Shift
Specific Implications of Group Therapy and the Disease Concept
Addiction, Abstinence, and the Disease Concept
Chapter 4. Psychodynamic Theory and the Relational Models
Character Pathology and Addiction
Contributions of Object-Relations Theory and Self-Psychology
Margaret Mahler's Theory of Normal Development
Ego Psychology and Object-Relations Theory
Mahler's Stages of Normal Development
Beyond the Ego: Kohut's Self-Psychology
Definition of Terms
The Self-Medication Hypothesis and Affect Regulation
Application for Therapy: Corrective Emotional Expression
Addiction As an Attempt at Self-Repair
Self-Esteem Vulnerabilities
The Reparative Approach
Chapter 5. Alcoholics Anonymous and Twelve-Step Programs
Misconceptions About Alcoholics Anonymous
Values, Science, and AA
Philosophy of Science and the Limits of Rationality
The Self-Help Movement
Alcoholics Anonymous: Its Historical Roots
AA—Why and How It Works: An Interpretation of AA
Pragmatism: Its Influence on AA
Existential View of AA
AA—How It Works: A Phenomenological Perspective
The Self-Attribution of Alcoholism
Honesty, Denial, and the Need for Others
AA: A Self-Psychology Perspective
AA: A Treatment for Shame and Narcissism
Higher Power As an Attachment Object
PART II: ADDICTION TREATMENT IN GROUP
Chapter 6. Different Models of Group Psychotherapy
Some Models of Group Psychotherapy
Psychological Levels of Intervention
Specific Applications for Addictions Treatment
Chapter 7. Preparing the Chemically Dependent Person for Group Therapy
Selection and Composition
Implications of Research Findings
Therapeutic Alliance and Cohesion in Group
Pre-Group Preparation: Increasing Treatment Retention and Reducing Dropouts
Recommendations for Entry into a Therapy Group
Present and Gain Acceptance of a Contract
Chapter 8. Interactional Group Psychotherapy
Yalom's Basic Tasks
The Model Setting Participant
Interpersonal Honesty and Spontaneity
Establishment of the Group Norms
The Norm of Self-Disclosure
Procedural Norms and Antitherapeutic Norms
Importance of Group
The Here-and-Now Activation and Process Illumination
Interpersonal Theory of Behavior
Sullivan's Interpersonal Theory of Psychiatry
Examples of Yalom's Here-and-Now Focus
Integration of Modern Analytic Approach
Conclusion
Chapter 9. Modifications of Yalom's Interactional Model
Treatment Considerations and Group Therapy
Recommendations for Group Therapy
Protocol
Early and Later Stage Treatment
Therapist Attributes and Special Considerations for Affect Attunement
Careseeking, Affect Attunement, and Psychotherapy
Group Therapy and ACOA
Addiction and the Family
Common Identified Characteristics of ACOA
ACOA and Shame
Alcoholics Anonymous and Group Psychotherapy
Chapter 10. Co-Occurring Disorders and Group Psychotherapy: An Attachment Theory Perspective
Addiction—The Cart or Horse of Mental Illness?
Cross-Addiction
The Relationship Between Mental Health and Addiction
Axis I Disorders
Axis II: Character Pathology and Addiction
Borderline Personality Organization and Pathological Narcissism
Kernberg's Borderline Pathology
Kernberg's Description of Supportive Psychotherapy
Narcissistic Personality Disorder
Dynamics of Multiple Addictions
Integration of Divergent Treatment Philosophies
The Relational Models: An Integration
Chapter 11. The Leader in Group Therapy
Values of the Group Leader
The Therapist As a Person
Qualities of the Group Leader
Guidelines and Priorities for the Group Leader
Roles of the Group Leader
Focus of the Group Leader
Characteristics of the Group Leader
The Therapeutic Process: Therapists' and Patients' Contributions
The Alliance and Addiction: Special Considerations
Group Leadership Functions
The Implications for Conducting a Successful Therapy Group
Alcoholism Treatment Outcome Studies
Patient Characteristics Related to Type of Therapy
Special Group Strategies and Requirements
Recommendations
Convergence of Therapist and Patient Characteristics
PART III: CLINICAL APPLICATIONS
Chapter 12. Diagnosis and Addiction Treatment
Avoidant Society: Cultural Roots of Impaired Attachment
Criterion Definitions of Addiction
Drug Groups
Drug Dependence and the Drug Groups
Neuropsychological Impairment
Stages of Change Model
Relapse Prevention
Interpersonal Neurobiology, Motivation, and Stages of Change Model and Brain Impairment
Chapter 13. Early Stage Group Treatment: Confrontation, Intervention, and Relapse
Special Problems of the Addicted Patient
The Use of Therapeutic Leverage
Confrontation
Intervention
Relapse and Recovery
Early Stage versus Later Stage Relapse
Therapist versus Patient's Contribution to Relapse
Later Stage Relapses
Relapse Prevention
Chapter 14. Inpatient Groups and Middle Stage Treatment
Yalom's Recommendations for Inpatient Groups
Composition of Inpatient Groups
Yalom's Strategies and Techniques of Leadership
Agenda Rounds
Difficulties with Agenda Rounds
The Special Circumstances of Inpatient Therapy Groups Within the Hospital
Leader's Transparency About Alcohol and Drug Use
The Group Contract
Simultaneous Membership in Other Groups
The Special Problems of Confidentiality on an Inpatient Unit
Active Outreach
Group Members Who Relapse and Come to Group
Attending Group Under the Influence
Summary Recommendations for Inpatient Group Therapy
Chapter 15. Late Stage Group Treatment: Conflict, Repair, and Reunion
Paradigm Shift
The Concurrent Treatment of Addiction and Character Pathology
Later Stage Treatment Strategies
Yalom's Model and Self-Psychology
Treatment of Internal Structure Deficits
Treatment of Introjections
Later Stage Treatment: Conflict, Repair, and Reunion
Attachment, Addiction, and the Working Alliance
Research and the Therapeutic Alliance
The Alliance: What Is it and Why Is it Important?
Attachment, the Alliance, and Negative Process
Chapter 16. Transference in Groups
Definition of Transference
Transference Possibilities in Group
Modifications of Transference Distortions in Groups
Types of Transference in Groups
Common Types of Acting Out Transference
Abuse of Transference
Countertransference
Projective Identification
Pathways for Psychological Change
Addiction and Countertransference
Chapter 17. Resistance in Group
Resistance: A Definition
Group Resistance and the Work of Wilfred Bion
The Leader's Influence on Basic Assumptions
Resistance to Intimacy in Groups
Resistance to Immediacy
Resistance to Feelings in Group
Special Considerations of Resistance to Addiction
The Group Leader's Effect on Group Resistance
Chapter 18. The Curative Process in Group Therapy
Yalom's Curative Factors
Curative Factors in Group
Existential Factors
Curative Factors in AA
Curative Factors Operating in Different Types of Therapy Groups
Mechanisms of Change and Cure in Group Therapy
The Curative Process
Working Through with the Addicted Patient
Stages of Cure in a Therapy Group
Addiction and Goals of Termination
Conclusion
References
Index