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

518 V. TREATMENTS FOR ADDICTIONSeral months. These “senior patients” monitored the progress of patients in theorientation group and were supervised by the primary therapists, who attendedthe orientation for part of each session, participating in a limited fashion only.A patient in crisis might be invited to return to the orientation group, if thisinvitation was seen as helpful.GROUP THERAPYWeekly group meetings were oriented toward practical life issues among controls,but insight was encouraged; progress toward abstinence was a majortheme. The two primary therapists served as facilitators for the group, usingtheir own empathic manner to encourage mutual acceptance and support.When confrontation was necessary, the therapists undertook it in a forthrightbut supportive manner. In the self-help program, groups met with the same frequency,but senior patients assumed the leadership role. Primary therapistsattended part of each session and participated intermittently; they served, however,primarily in a coordinating capacity for these groups and supervised thesenior patients. Patients were encouraged to deal with unusual problems byrecourse to their peers in the program, either in their therapy group or throughsenior patients.PEER THERAPYSelf-help program patients were made aware that the primary source of supportin the clinic was the peer group. New patients were encouraged to seek outpeers and senior patients who would be available to assist them through theprogram. Senior patients were supervised in assisting with crises when this assistancewas judged clinically appropriate by the primary therapists. The seniorpatient program was operated in the self-help modality. Potential seniorpatients were screened for sobriety and social stability, and assisted in patientmanagement of the program for a time-limited period. Those who served asgroup leaders met weekly as a group with the primary therapists, focusing ontheir therapeutic functions in the unit. Under supervision of the therapists,they directed orientation, therapy, and activity groups. Their interventions inmore difficult patients’ problems were reviewed with the primary therapists, andthey referred self-help patients to their respective primary therapists for moretroublesome problems. Other senior patients had administrative functions inthe program.Meetings of the full patient complement also took place in the self-helpprogram. A monthly evening meeting open to all patients served as a focus forgroup spirit and as a context for organizing recreational activities. The meetingswere run collaboratively by staff and senior patients, with programwide activitiesand patients’ progress as the focus. Socialization at the time of these meetingsfocused on the status of patients’ recovery.