REVIEW ARTICLE

Group interventions
Sinu Ezhumalai, Muralidhar D, Dhanasekarapandian R, Bala Shanti Nikketha
Department of Psychiatric Social Work, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru,
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo

Karnataka, India
4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

ABSTRACT

Over the past four decades, psychiatric social workers have been conducting group interventions for persons with
substance use disorders at NIMHANS. In this article, the authors highlight the brief history of group therapy, differences
between group therapy and group work, and purpose and indicators of group therapy. This article sheds light on
practical aspects of conducting group interventions for persons with substance use disorders and skills required by the
group therapist for conducting the same andbenefits of attending group interventions. Research studies carried out at
NIMHANS on group intervention for persons with substance use disorders, assessing group processes, dynamics and
outcome of group interventions have been highlighted as well.

Key words: Group work, Group therapy, substance use, alcohol

Perhaps the most important forces in each person’s field are other bring a change in them. It helps individuals to enhance their
persons social functioning through purposeful group experiences
and to cope more effectively with their personal, group or
– Kurt Lewin community problems.

INTRODUCTION Brief History of Group Therapy

Joseph Hersey Pratt is known as father of Group therapy.
Social work treatment is an integral component in the In 1905, he began his work with a group of eight patients
treatment of persons with substance use disorders. Social with pulmonary tuberculosis in Greater Boston. He was
workers play a prominent role in any given substance abuse holding general‑care instruction classes for recently
treatment centre, along with other multidisciplinary team discharged tuberculosis patients, for whom no place could
members. be found in the sanatoria. He noticed the impact of this
experience on their emotional states and allowed them
Group therapy is a form of treatment in which emotionally to discuss their common problems. Pratt reported very
disturbed persons are placed in a group, guided by one or positive results from this new type of treatment1. This is
more therapists for the purpose of helping individuals to known to be the first formally organized therapeutic group
in literature.
Address for correspondence: Muralidhar D, Professor,
Department of Psychiatric Social Work, National Institute of In 1936, application of group therapy was practiced among
Mental Health and Neurosciences (NIMHANS), Bengaluru,
prison inmates and discharged patients in psychiatric
Karnataka, India.
E-mail: [email protected]
This is an open access article distributed under the terms of the Creative
Access this article online Commons Attribution‑NonCommercial‑ShareAlike 3.0 License, which allows
Quick Response Code others to remix, tweak, and build upon the work non‑commercially, as long as the
Website: author is credited and the new creations are licensed under the identical terms.

www.indianjpsychiatry.org For reprints contact: [email protected]

DOI:
How to cite this article: Ezhumalai S, Muralidhar D,
Dhanasekarapandian R, Nikketha BS. Group interventions.
10.4103/psychiatry.IndianJPsychiatry_42_18
Indian J Psychiatry 2018;60:514-21.

S514 © 2018 Indian Journal of Psychiatry | Published by Wolters Kluwer - Medknow

 Ezhumalai, et al.: Group interventions

hospitals. This was pioneered by Paul Schilder and Louis • Recreational

Wender2. Later, it was extended to persons with neurosis, • Therapeutic
alcohol dependence and disturbed children. During World
War II, group therapy was applied to emotionally disturbed Contra‑indications for Group therapy
war victims. While a majority of persons seeking treatment for addictive
disorders could benefit from group interventions, the
Social Group Work Vs Group Therapy following members may not be suitable for group therapy:
Though group work and group therapy are used
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo

• Persons with acute psychotic symptoms

4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

interchangeably, there is a difference between both the • Those with active suicidal thoughts
terms. Group work as a primary method of social work • Organic disorders
is practiced with normal human beings and persons with • Physically unhealthy individuals
minor adjustment problems in non‑clinical settings. Group • Persons with significant Cognitive decline/deficits
work is considered when primary level of prevention is • Persons with severe Personality disorders
needed and not as a form of treatment. The group worker • Poorly motivated persons
acts as an enabler; s/he enables the group members to plan,
organize and execute the programme activities. Group work Group Formation
activities help its members for their personal growth and Certain broad principles underlying group interventions are
development. Social Group Work is practiced by a trained presented below.
social work professional who has had adequate field work • Selection of Individuals: Selection of individuals for
supervision. group therapy should be based on similarity of the
problems.
Group therapy is considered one of the promising • Number of members: Group therapy may be practised
psychosocial treatment modalities which is practiced in with more than two members and less than 15.
clinical settings for persons with emotional problems
Optimum number for group therapy is 8‑12 members.
or mental health issues by qualified mental health
• Seating arrangements: There should be enough chairs
professionals such as psychiatrists, clinical psychologists,
to accommodate the group members. Particular
psychiatric nurses, psychiatric social workers and
member chair should be left vacant if he/she is absent.
occupational therapists specialized in mental health. The group
Therapist and patients must have similar chairs.
therapist is as active participant of the group and helps its
• Frequency of group session: Group Therapy can be
members to understand their individual problems as well
conducted once in a week or 3‑4 times a day depends
as interpersonal problems. Group discussion is focused
upon the needs of the group members and clinical
on the current problems in relation to oneself and others.
settings. Groups that are conducted on a daily basis
Group therapy aims to bring about reduction in symptoms
such as negative symptoms, poor motivation, as well as may be of 45 minutes duration; group duration may be
improvement in social functioning, better adjustment and up to 90 minutes if it is once in a week.
improved interpersonal relationship skills. • Time Period: Length of the group therapy may be
extended for a maximum of 25 sessions or for a
Assumptions maximum period of six months.
There are certain universal assumptions that underlie group • Age range: Age range of the group members can be
therapy interventions. These include the following: relatively similar; ranging from 25 years to 55 years.
• Group Experience is Universal There should not be too much age disparity.
• Group  Therapy is used to bring about changes in
attitude and behaviour Phases of Group Development
• Groups produce change which is more permanent In closed groups, the following phases are described:
• Groups act as instruments for helping others • Forming
• Through Groups, people can grow together • Norming
• It is easy to change people in groups than at the • Storming
individual level • Performing
• Adjourning
Purpose of Group Therapy
Group therapies can serve a variety of functions. They can Forming
be: Members became oriented toward each other, work on
• Corrective being accepted, and learn more about the group. This stage
• Developmental is marked by a period of uncertainty in which members try
• Educative to determine their places in the group and learn the groups’
• Preventive rules and procedures.

Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018 S515

 Ezhumalai, et al.: Group interventions

Storming • Therapist needs to function as an Enabler and Leader

Conflicts begin to arise as member resist the influence of the • Therapist has a responsibility to share knowledge/
group and rebel against accomplishing their tasks. Members information
confront their various differences, and the management of • Helping to form, develop, participate in order to achieve
conflict often becomes the focus of attention. its objectives
• Ability to listen to members’ view
Norming • Efficient in handling agency schedule
The group establishes cohesiveness and commitment. In the
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo
4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

process, the members discover new ways to work together. Types of Group
Norms are also set for appropriate behaviour. Groups may be Closed or Open Groups depending on
whether the same group members continue in a session,
Performing or whether any member can join into the group. In
The group works as a unit to achieve group goals. Members addition, groups may be defined as homogenous (members
develop proficiency in achieving goals and become more with similar characteristics) or heterogeneous (variable
flexible in their patterns of working together. characteristics).

Adjourning Guidelines for Conducting Group Therapy[3]

The group disbands. The feelings that members experience Certain broad principles underlie the conduct of group
are similar to “Separation Stage”. therapy. These include:
• Planned Group Formation
Practical aspects of conducting groups • Specific Objectives
It is important that members of the group follow some • Purposeful Worker ‑ Group Relationship
ground rules with respect to group therapy participation. • Continuous Individualization
• Guided group Interaction
For the members • Democratic Group self‑determination
1. Members must be informed about the purpose of group: • Flexible Functional Organization
Purpose is to meet together to discuss their problems. • Progressive Programme Experiences
2. Discipline: Regularity, Punctuality, Confidentiality. • Resource Utilization
Members should agree to attend the group regularly as • Evaluation
per schedule. Group members are advised that issues
deliberated in the group not to be discussed after the Skills required for the Group Therapist[4]
group session or outside of the group. Every group therapist must have the skills to work as a part
of clinical setting. She/he must know the hospital needs and
For the therapist must possess a growing awareness of oneself as well as the
1. There must be two therapists. Participant recordings group. The group therapist skills are most evident while
can be done interchangeably for each session by the actively engaged in a helping capacity with the group. The
therapists. basic therapy skills required are summarised below:
2. The Group therapist should have individual session 1. Skill in establishing purposeful relationships
with each member before the therapy starts. A. The group therapist must be skilful in gaining the
3. The therapist should be aware of his/her own feelings acceptance of the group and in relating to the
towards the members of the group (the therapist’s group on a positive professional basis.
experience with other groups such as students, B. The group therapist must be skilful in helping
colleagues etc., may affect the interaction with the individuals in the group to accept one another and
group). to join with the group in common pursuits.

Therapist role 2. Skill in analysing the group situation

In a therapist facilitated group interventions, various A. The group therapist must be skilful in judging the
attributes of the therapist have been described; developmental level of the group to determine
• Directive approach: S/he has to enable the members to what the level is, what the group needs, and how
participate in the group intervention process. quickly the group can be expected to move. This
• Extensional: When a particular aspect comes up, the calls for skills in direct observation of groups as a
therapist has to extend the discussion if it is beneficial. basis for analysis and judgement.
• Interpretive: The therapist must be able to provide B. The group therapist must be skilful in helping the
insight that the members of the group have improved. group to express ideas, work out objectives, clarify
At the same time, premature interpretation must be immediate goals, and see both its potentialities
avoided and limitations as a group.

S516 Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018

 Ezhumalai, et al.: Group interventions

3. Skills in participating with the group feeling of belongingness, willingness to sacrifice personal
A. The group therapist must be skilful in determining, wishes. Members keep a focus on the main goal, which is
interpreting, assuming, and modifying his/her own to help each other to solve their problem and have warm
role with the group. feelings for each other. The group should not hinder the
B. The group therapist must be skilful in helping individual functioning outside. The group should become
group members to participate, to locate leadership an end in itself. This means that members should not feel
among themselves, and to take responsibility for that all the needs are met within group.
their own activities.
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo
4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

Content of the discussion: It is concerned with the current

4. Skill in dealing with group feeling interpersonal problems of daily life and not on the past. It
A. The group therapist must be skilful in controlling is focused on the current interaction between the members
his/her own feelings about the group and must and the therapist; ‘go‑ round’ technique is used to make
study each new situation with a high degree of everyone express as a particular matter/technique.
objectivity.
B. The group therapist must be skilful in helping the Modelling: Patient identifies with therapist and uses the
groups to release their own feelings, both positive therapist as a role model for more effective functioning.
and negative. The therapist must be skilful in Negative transference of the members is revealed through
helping groups to analyse situations as a part of the anger and negative response. Therapist in response has to
working – through of group or intergroup conflicts. be kind and calm. This will in turn be an example to the
participants to be calm and serene in similar situations.
5. Skills in programme development Retaliation is not good. Other members express the
A. The group therapist must be skilful in guiding feeling of acceptance. They realise that they alone
group thinking so that interests and needs will be don’t have the problems, but others also have similar
revealed and understood. problems. (universalization). There would be group pressure
B. The group therapist must be skilful in helping to alter the individual’s behaviour.
groups to develop programmes which they want as
a means through which their needs may be met. Cliques: Therapist must be aware of formation of group
cliques
6. Skill in using agency and community resources
A. The group therapist must be skilful in locating and Group bond: An important factor in group process is group
then acquainting the group with various helpful bond. It represents the feelings of cohesion that makes
resources which can be utilized by them for for a group. Group bond is exclusively defined as “sense
programme purposes. of belonging”. It can be measure a group’s effectiveness.
B. The group therapist must be skilful in helping However, group bond can also be destructive. Its strength
certain individual members to make use of might have been produced by threat or by serious
specialised services by means of referral when they dependence of the members on each other. Group bond,
have needs, which cannot be met within the group. therefore, may be a powerful aspect of the group process in
either a constructive or destructive sense.
7. Skill in Evaluation
A. The group therapist must have skill in recording Other Group dynamics to be considered: Sometimes an individual
the development processes that are going on while is in an even less favourable position than isolation. He is
working with the group. rejected by the group and exposed to open hostility. Again,
B. The group therapist must be skilful in using group one must search for the reasons before trying to change
therapy records and in helping the group to review them
its experiences as a means of improvement.
Therapeutic Factors in Group
Group Process/Group Dynamics A variety of therapeutic factors have been described in
In the beginning, members may be dependent on therapist group therapy processes. These include universality,
as an authoritative figure. They associate the therapist with altruism, cohesion, catharsis, imparting information,
magical powers and the ability to solve all their problems. imitation and modelling, instilling hope, developing social
skills, learning interpersonal skills and support[5,6]. The most
Various processes occur as the group sessions progress. favourable factor perceived by persons with SUD in group
These include: intervention is catharsis, followed by group cohesiveness
and interpersonal learning. Patients who received group
Cohesiveness: It is a key element of success to the group. intervention for 15 sessions or more had a significantly
There has to be feeling of identification with the group, more favourable outcome rate than those who received

Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018 S517

 Ezhumalai, et al.: Group interventions

other modes of treatment, in terms of lesser relapse rate[7]. Self‑Help group may be used as a viable option for effective
Apparently because of therapeutic techniques used in the after care intervention for persons with substance use
group such as feedback, reward, accepting them as they disorder who are discharged from the addiction treatment
are, joining, membership, confidentiality, support, and centres.
identification of their needs and problems has the capacity
to bond patients in overall treatment process[8]. Glimpses of Group Interventions at Centre for Addiction
Medicine
Assessing Group dynamics and Outcome of Group therapy Group interventions for substance use disorder at NIMHANS
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo
4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

There are a few tools available for analysing the group started in 1986. First, it was started for outpatients, later
therapy process, group dynamics and interaction among it was extended to in‑patients as well at psychiatry ward.
group members. Understanding behaviour of the individual The aim of group intervention was to encourage the group
in group therapy is essential. Some of the commonly members to open and share their experiences with other
used scales include the Group Climate Questionnaire, members and to learn skills to prevent relapse and maintain
Group Cohesiveness Scale and Group Work Engagement abstinence. Presently, in‑patient setting runs three group
Measure, the Therapeutic Factors Scale, Group Session interventions in different languages English, Kannada and
Rating Scale, Individual Group Member Interpersonal Process Tamil in parallel. Sometimes, depending upon the number
Scale, Interpersonal Relation Checklist, Group Emotionality of patients, group interventions would be conducted in
Rating System, The Hill Interaction Matrix, Member – Leader Telugu and Hindi as well.
scoring system, The Hostility/Support Scale and SYMLOG,
which is a measurement method for assessing norms, roles Kind and Form of group
and others dimensions of a group as a whole[9‑17]. Group is an open one. Members can join and leave the group
according to their admission and discharge timings. Groups
Research on Group Therapy at NIMHANS are educative in nature. Their opportunity to learn (gain
Process of Group therapy knowledge) is more as compared to their opportunity to
Advice giving, insight giving, support giving, self‑revealing, express[21].
symptom reporting, abreaction, imparting information were
frequently observed group process in a group therapy for Group structure
persons with alcohol dependence syndrome at NIMHANS, Often, groups are homogenous; each group contains 8‑16
Bengaluru[18] members (often‑speaking same language) each session lasts
for a duration of 45 minutes to an hour.
Effectiveness of Group therapy
Group therapy for persons with substance use disorder was Group format
significantly effective in reducing number days and quantity In a week, four group sessions were conducted in a week by
of substance use, lesser number of days of family role two psychiatric social workers and a M.Phil Psychiatric Social
dysfunction, financial problems, routine family activities, Work trainees posted in the centre would observe and on
occupational dysfunction. Medium to large effect size was few occasions they conducts some group sessions. A group
seen in improving all the domains of quality of life, coping session on recreational activities would be conducted
behaviour, self‑efficacy[19]. as well once in a week by psychiatric social workers and
occupational therapist.
Self‑Help Group (Alcohol Anonymous) Vs Group Therapy
Therapeutic elements such as remaining abstinent, A 12 cycle of sessions on group intervention focuses on
empathy, advice, using anti‑craving medicines were found
1. Introduction to Relapse prevention 7. Coping skill training
more useful in De‑addiction treatment group whereas in Group
Alcoholic anonymous group acceptance, self‑confidence, 2. Group Motivation 8. Anger management
spirituality, technique like ‘remain sober today’ were more 3. Assessing high risk situation 9. Money management
useful. Patients attending Alcoholic anonymous group had 4. Craving reduction techniques 10. Sleep hygiene techniques
longer periods of abstinence and lesser number of relapses 5. Handling peer pressure/Drug Refusal 11. Life Style modification
skills
due to euphoric mood and external factors than the alcohol 6. Problem Solving skill training 12. Increasing pleasant
dependents attended Group therapy at the De‑addiction activities
Centre, NIMHANS. AA group members were more satisfied
with their life in terms of neighbourhood and community Family Support Group
and financial well‑being [20]. These groups however are not Apart from the group intervention for persons with substance
strictly comparable, because addiction inpatient facilities use disorders, Group sessions were also conducted for their
get a heterogeneous group of patients at different stages family members once in a week since 2006. The focus is to
of motivation, whereas people likely to be regular at AA allow them to ventilate their feelings emotions. In addition,
meetings usually represent a group committed to change. psychiatric social workers educate them about to realize their

S518 Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018

 Ezhumalai, et al.: Group interventions

roles and involvement in recovery process. Family support participated in the group intervention are far better in terms
group would be in multi‑lingual as the people from varied of less relapse rate than those who are merely involved
culture seek treatment at centre for addiction medicine. in pharmacological and individual intervention. Group
intervention and pharmacological intervention are natural
Group Intervention for women allies for the treatment of SUD. One reason why group
Group intervention for women with substance use intervention is effective in treatment of SUD is that people
disorders commenced in the year 2016, after initiation often are more likely to remain abstinent and committed
of separate services for women. Presently, four to eight to recovery when treatment is provided in groups and the
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo
4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

women used to attend the relapse prevention group changes through the group are relatively stable[28].
interventions. Owing to culture sensitivity and varying
treatment needs for women with substance use disorder, Financial support and sponsorship
a separate relapse prevention group has been initiated. Nil.
Women recovery group had favourably more reductions
in average substance using days, and more satisfaction Conflicts of interest
than mixed gender group intervention. A women‑focused There are no conflicts of interest.
same‑gender group intervention may enhance longer‑term
clinical outcomes among women with substance use REFERENCES
disorders[22]. Affiliative statements such as supportive,
shared experiences, and strategy statements were more in 1. Editorial. Joseph Pratt: The Pioneer. New Engl J Medicine. 1955;
253:203‑204.
women‑focused group intervention than in mixed gender 2. Pinney EL Jr. Paul Schilder and group psychotherapy: the development
group intervention[23].  Women felt more safe, greater of psychoanalytic group psychotherapy. Psychiatr Q. 1978 Summer;
50 (2):133‑43.
acceptance of different aspects of their self, having their 3. Trecker, Harleigh Bradley. Social group work: principles and practices.
needs met, developing familiarity and confidence, empathy, New York: Woman’s Press, 1948.
4. Trecker, Harliegh Bradley. Social group work: principles and practices.
morality, group cohesion and perceived increased support Rev. and enl. New York: Whiteside, 1955.
in women‑focused group intervention on gender‑relevant 5. Yalom, I. D. (1985). The theory and practice of group psychotherapy (3rd ed.).
topics played an important role in supporting their New York, NY: Basic Books.
6. Brown S, Yalom ID. Interactional group therapy with alcoholics. Journal of
recovery[24‑25]. Women focused groups shown improved Studies on Alcohol. 1977;38 (3):426–456.
treatment satisfaction than mixed gender group treatment. 7. Sanaa et al. Therapeutic Factors in Group Psychotherapy: A Study of
Egyptian Drug Addicts. Journal of Groups in Addiction and Recovery,
However, both the groups did not differ significantly in terms 5:194–213, 2010.
of reduction in mean number of substance use days [26‑27]. 8. Treatment Improvement Protocol (TIP) Series, No. 41. Center for
Substance Abuse Treatment. Rockville (MD): Substance Abuse and
This research finding needs to be interpreted with caution. Mental Health Services Administration (US); 2005.
The fact that there is no difference in reduction in number 9. Corey Marianne Schneider, Corey Gerald and Cindy. Group Work
of substance using days does not warrant that women can Process and Practice. 9th edition. Cengage learning India Private Limited:
New Delhi; 2014.
be placed in mixed gender group intervention. 10. Garvin Charles D, Gutierrez Lorraine M.et, al. Handbook of Social Work
with Groups. India edition. Rawat Publications: Jaipur; 2004.
11. Edwards Suzette Glasner. The Addiction Recovery Skills Workbook.
Out‑Patient Recovery Support Group intervention 1st Edition. The Guilford Press: Oakland; 2010.
Recovery support group for recovering persons with 12. Hepworth Dean H, Rooney Ronald H. et, al. Theory and Skills in Social
substance use disorder have been in place since 2010. It Work. India edition.C engage learning India Private Limited: New Delhi;
2010.
occurs three days in a week during out‑patient consultation. 13. Nick Kansa. Process and Outcome in Therapy Groups for Substance
Persons who have maintained abstinence for a period of Abusers. International Journal of Group Psychotherapy. 1999: 49 (2).
14. Palmer Sharon Duca. Social Work in Mental Health and Substance Abuse.
one year have been felicitated during the recovery support 1st Edition. Apple Academic Press Inc: Oakville; 2011.
group intervention. In NIMHANS, Dr Murthy felt there is a 15. Paylor Ian, Meashan Fiona. et, al. Social Work and Drug Use.
1st India (reprint) edition. Rawat Publications: Jaipur; 2013.
need for such support group for recovering persons and this 16. Segal Elizabeth A, Gerdes Karen E.et al., Professional Social Work.
provides an opportunity for those not treated in an in‑patient 1st India (reprint) edition. Cengage learning India Private Limited:
setting. Recovery support group is usually facilitated by a New Delhi; 2010.
17. Sheafor Bradford W, Horejsi Charles J. Techniques and Guidelines for
person who has recovered from substance use disorder and Social Work Practice. 9th edition. PHI Learning Pvt Limited: New Delhi;
enabled by psychiatric social workers. Recovery support 2011.
18. Bhatti, R. S. (1982). Family Therapy in Alcoholism. Paper presented at
group enables people who abuse substances to witness the the International Consultation on Christian Response to Alcohol and Drug
recovery of others. It provides useful information to clients Addiction, held at ECC, Bangalore, India on November22‑27.
19. Bala Shanthi Nikketha, Muralidhar D, Benegal V. Effectiveness of
regarding new and alternate ways to recovery. Felicitation Group Work Intervention for persons with substance use disorder. PhD
of recovery provides positive peer reinforcement for Thesis, Department of Psychiatric Social work, NIMHANS, Bengaluru
recovering persons for sustenance. 2009.
20. Sujit, Bhatti RS. Effectiveness of Self‑help group for persons with alcohol
dependence. M.Phil Thesis. Department of Psychiatric social Work,
CONCLUSION NIMHANS, 2000.
21. Sinu E, Ushakiran, Bala SN. Social Group work practice in De‑addiction
centre: An Experience Sharing, Journal of School Social Work, 2005;
It was observed that patients who are actively involved and 2 (1):30‑32.

Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018 S519

 Ezhumalai, et al.: Group interventions

22. Greenfield  SF, Trucco  EM, McHugh  RK, Lincoln  M, Gallop  RJ. The 25. Greenfield SF et al. A qualitative analysis of women’s experiences in
Women’s Recovery Group Study: a Stage I trial of women‑focused single‑gender versus mixed‑gender substance abuse group therapy.
group therapy for substance use disorders versus mixed‑gender group Subst Use Misuse. 2013 Jun; 48 (9):750‑60.
drug counseling. Drug Alcohol Depend. 2007 Sep 6;90 (1):39‑47. Epub 26. Greenfield SF et al. Implementing substance abuse group therapy clinical
2007 Apr 18. trials in real‑world settings: challenges and strategies for participant
23. Sugarman DE et al. Measuring affiliation in group therapy for substance recruitment and therapist training in the Women’s Recovery Group Study.
use disorders in the Women’s Recovery Group study: Does it matter Am J Addict. 2014 May‑Jun; 23 (3):197‑204.
whether the group is all‑women or mixed‑gender? Am J Addict. 2016 Oct; 27. Greenfield SF et al. Group therapy for women with substance use
25 (7):573‑80. disorders: results from the Women’s Recovery Group Study. Drug Alcohol
24. Greenfield SF et al. Group Process in the single‑gender Women’s Depend. 2014 Sep 1;142:245‑53.
Recovery Group compared with mixed‑gender Group Drug Counseling. 28. Zastrow Charles H. Social Work with Groups. Indian edition. Cengage
Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo

J Groups Addict Recover. 2013;8 (4). learning India Private Limited: New Delhi; 2009.

4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

APPENDIX‑ I

GROUP THERAPY‑ RECORD SHEET

Name: P/No:

Medium of Intervention: Kannada/English/Tamil/others Duration:

D.O.A: D.O.D:

Sl No Group sessions Dates Present/Absent Remarks

Causes and consequences of substance abuse
Assessment of High‑Risk Situation
Coping with cravings
Thought management
Problem solving skill Training

Drink Refusal Skill Training

Planning Emergencies and Coping with lapse
Positive Addiction
Sleep Hygiene Techniques

Signature of the Group Therapist:

APPENDIX 2

SOCIOGRAM AND GROUP THERAPY RECORD

Socio‑ gram: (diagrammatic representation of group interactions)

------ = Passive

____ = Active

____ = Dominant

S520 Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018

 Ezhumalai, et al.: Group interventions

Issues brought up for the discussion by the members:

____________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_____________________________________

Suggestions given in the group:

Downloaded from https://journals.lww.com/indianjpsychiatry by BhDMf5ePHKav1zEoum1tQfN4a+kJLhEZgbsIHo
4XMi0hCywCX1AWnYQp/IlQrHD3i3D0OdRyi7TvSFl4Cf3VC4/OAVpDDa8K2+Ya6H515kE= on 09/12/2022

____________________________________________________________________________________________________
___________________________________________________________________________________________________
___________________________________________________________________________________________________
_____________________________________

Satisfaction in the group:

--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

1. Poor 2.Good 3.Very Good 4.Excellent

Group Processes Observed:

1 .Group Ventilation 8. Acquisition of Skills

2. Group Acceptance 9. Reality testing
3. Group Identification 10. Instillation of Hope
4. Group Clarification 11. Altruism
5. Catharsis 12. Mutual Support
6. Therapeutic Corrective Relationships 13. Universalization
7. Acquisition of Knowledge 14. Cohesiveness

Outcome of the Group Session:

1. Appropriate Expectation 5. Enhancement of Family Relationships

2. Acquisition of Knowledge and Skills (communication, relationships, 6. Self Esteem Enhancement
coping, etc)
3. Behaviour Change 7. Any Other
4. Attitudinal Change

Summary of the Group Process:

(The salient features, the phases and the direction in which the group progressed)

Signature of the Therapist

Indian Journal of Psychiatry Volume 60 (Supplement 4), February 2018 S521