Group Therapy for Substance Use Disorders: What Do We Know?

Abstract

Although group therapy is the most prevalent treatment modality for substance use disorders, an up-to-date review of treatment outcome literature does not exist. A search of the literature yielded 24 treatment outcome studies comparing group therapy to other treatment conditions. These studies fell into one of six research design categories: (1) group therapy versus no group therapy; (2) group therapy versus individual therapy; (3) group therapy plus individual therapy versus group therapy alone; (4) group therapy plus individual therapy versus individual therapy alone; (5) group therapy versus another group therapy with different content or theoretical orientation; and (6) more group therapy versus less group therapy. In general, treatment outcome studies did not demonstrate differences between group and individual modalities, and no single type of group therapy reliably demonstrated greater efficacy than others. Unique methodological and logistical hurdles encountered in research on group therapy for substance use disorders, as well as considerations for future research, are also discussed.

Consequences of misspecifying the number of latent treatment attendance classes in modeling group membership turnover within ecologically valid behavioral treatment trials

“…Data generated from open enrollment groups, on the other hand, have historically been difficult to analyze (at least in a statistically defensible manner) because membership turnover gradually changes the group composition over time; in fact, complete turnover in membership in open enrollment groups (nay times over for groups that run for extended periods of time) is the norm rather than the exception. Many treatment researchers who have proposed open enrollment group studies have faced significant criticisms in grant and/or manuscript review in part because of analytic (Morgan-Lopez & Fals-Stewart, 2006a) and logistical difficulties (Weiss et al, 2004) in executing open enrollment treatment trials. In the absence of resolutions to either set of these challenges, substance abuse treatment researchers have largely eschewed group therapy research to sidestep these issues (Morgan-Lopez & FalsStewart, 2006a.…”

“…As a result, there have been more research studies funded that have focused on group therapy for substance abuse, yet many well-founded concerns remain about the ecological validity (i.e., the match between treatment research designs and treatment-inpractice) of many currently-funded group-based trials (Morgan-Lopez & Fals-Stewart, 2007Weiss et al, 2004).…”

“…In spite of the widespread use of therapy groups in substance abuse and alcoholism treatment, there has been a relative dearth of rigorous empirical research of group therapy for substance abuse (Weiss, Jaffe, de Menil & Cogley, 2004). Indeed, standing in stark contrast to the way treatment is delivered in community practice (see Klostermann, Fals-Stewart, & Morgan-Lopez, 2008), the portfolio of federallyfunded research on psychosocial interventions for substance abuse has been dominated by studies of interventions delivered in a one-on-one counseling format (NIDA, 2003).…”

Psychotherapy through the phases of bipolar disorder: Evidence for general efficacy and differential effects

“…In contrast, integrated group therapy, a cognitive-behavioral approach specifically designed for patients with bipolar and substance-use disorders, resulted in longer times of sobriety (Weiss, Jaffee, de Menil, & Cogley, 2004).…”

“…Although there is no consistent evidence that one form of psychotherapy is more efficacious than another for bipolar disorder (Weiss, Jaffee, et al, 2004), group therapy may be more effective than individual therapy (for comorbid substance abuse) (Schmitz et al, 2002). PE combined with pharmacotherapy is to date the best balance of cost effectiveness and positive outcome for the treatment of substance-abuse patients with bipolar disorder.…”