Clinical Textbook of Addictive Disorders 3rd ed - R. Frances, S. Miller, A. Mack (Guilford, 2005) WW

CHAPTER 23Group Therapy, Self-Help Groups,and Network TherapyMARC GALANTERFRANCIS HAYDENRICARDO CASTAÑEDAHUGO FRANCOTreatment modalities that employ social networks, such as group therapy, selfhelpprograms, and adaptations of individual office-based psychotherapy (suchas network therapy, described below), are of particular importance in treatingalcoholism and drug abuse. Family therapy is described elsewhere in this volume(Chapter 24). One reason is that the addictions are characterized by massivedenial of illness, and rehabilitation must begin with a frank acknowledgmentof the nature of the patient’s addictive process. The consensual validationand influence necessary to achieve such pronounced attitude change are mosteffectively gained through group influence. Indeed, for this purpose, a fellowaddict carries the greatest amount of credibility. Another reason for employingsocial networks is that they provide an avenue for maintaining ties to thepatient beyond the traditional therapeutic relationship. Furthermore, therapistsare not in the position to confront, cajole, support, and express feeling in amanner that can influence the abuser to return to abstinence; a group of fellowaddicts or members of the patient’s family can do so quite directly.This chapter explores the impact of group treatment in a number of disparatesettings. We look at therapy groups directed specifically at the treatment ofaddiction, at 12-step programs such as Alcoholics Anonymous (AA), and NarcoticsAnonymous (NA), and at institution-based self-help for substance abusers.The role of the clinician varies considerably in relation to each of these502