Group Therapy
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Overview: what is group therapy for addiction?
Group therapy for addiction is a structured psychological treatment used in substance use disorder care. Sessions typically involve 6–12 participants guided by one or two trained facilitators, allowing individuals with drug and alcohol addiction to engage in therapeutic work alongside others facing similar challenges.
In the UK, group therapy is provided across NHS, charity, and independent addiction services, usually organized around shared diagnoses or treatment goals, such as alcohol addiction, opioid use disorder, or relapse prevention. It offers a structured environment where group members learn, practice skills, and receive support within a clinical framework.
Group therapy complements other elements of substance abuse treatment, forming part of a broader plan that may include individual therapy, medication (e.g., methadone, buprenorphine, acamprosate), and social support. This approach aligns with National Institute for Health and Care Excellence (NICE) guidance recommending coordinated, multidisciplinary care.
Evidence supports group-based approaches in reducing substance use, enhancing coping strategies, and supporting long-term recovery. Cognitive behavioural groups and relapse prevention training have shown particular effectiveness. According to NHS Digital 2024 data, about 295,000 adults in England engage in substance misuse treatment, with group therapy as a key component.
How group therapy works in addiction treatment
In UK addiction services, group therapy sessions are typically scheduled once or twice weekly, with each session lasting 60–90 minutes. Programmes may be time-limited (for example, 8–12 weeks with a fixed curriculum) or run as rolling community groups where participants join at different stages.
A typical session follows a structured format. It usually begins with a brief check-in, where group members share how they have been since the previous meeting. The facilitator then sets the agenda, which might include a structured therapeutic exercise, such as CBT-based work on identifying triggers or skills practice for managing cravings. Guided group discussion follows, allowing participants to share experiences and offer feedback. Sessions often conclude with a short review and a take-home task to reinforce learning.
The facilitator—who may be a psychologist, counsellor, nurse, or specialist drug and alcohol worker—plays a central role in maintaining safety, confidentiality, and boundaries. Facilitators are expected to use trauma-informed and non-judgemental practice, creating a safe space where participants feel able to explore emotions and challenges without fear of criticism.
Groups are typically single-issue and purpose-led. A community alcohol service might run a weekly relapse-prevention group, while an NHS outpatient treatment programme could offer a CBT-focused programme for stimulant recovery. These aims align with NICE-recommended psychological approaches for substance misuse.
For example, a weekly NHS relapse-prevention group in a community drug and alcohol team might meet every Wednesday evening. Over 10 weeks, participants work through topics including understanding cravings, managing high-risk situations, and planning for alcohol-free social activities.
Clinical purposes and goals of group therapy
The clinical purposes of group therapy in addiction treatment extend beyond general peer support. The primary focus is typically on reducing harmful substance use, preventing relapse, improving coping with cravings, and addressing connections between substance use and mental health difficulties such as mood disorders, anxiety, trauma, or interpersonal problems.
These aims align with established frameworks. The Substance Abuse and Mental Health Services Administration (mental health services administration) Treatment Improvement Protocol 41 outlines how group therapy work addresses psychoeducational, skills development, cognitive-behavioural, and interpersonal process functions. In the UK, NICE guidance recommends specific psychological interventions—including CBT and relapse prevention—for alcohol-related problems and drug addiction.
The relapse prevention model, developed by Marlatt and Donovan, emphasises identifying high-risk situations, building self-efficacy, and distinguishing between a single lapse and full relapse. Many groups employ this framework to structure their content.
Goals written into an individual’s care plan are typically measurable and time-limited. Examples include:
Practising refusal and assertiveness skills in role-play exercises
Planning for high-risk situations such as weekends, paydays, or holidays
Managing withdrawal-related anxiety through distress tolerance techniques
Improving daily structure and routine to reduce opportunities for drug use
These goals are reviewed regularly with the facilitator or keyworker, often at midpoint and end-of-programme reviews. This allows adjustments based on progress and changing needs.
Types of therapeutic groups used for addiction
Different group models are used at different stages of the recovery journey and levels of complexity. Programmes often combine several types sequentially. Someone might begin with a psychoeducational group to build understanding, move to a skills development programme, and later engage with a support group or interpersonal process group.
It is important to distinguish professionally led therapy groups from peer led mutual aid such as Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or SMART Recovery. Both can be helpful, but they serve different functions. Therapy groups are facilitated by a trained therapist within clinical governance structures, with session notes and outcome monitoring. Mutual-aid groups are typically free, anonymous, and run by people in recovery themselves.
The following subsections describe five group models commonly used in UK addiction services.
Psychoeducational addiction groups
Psychoeducational groups are structured, curriculum-based therapy sessions focused on understanding addiction, withdrawal, medication, and physical and mental health risks. They are often the first point of contact with group treatment models for people new to services.
The typical format resembles a classroom-style approach: structured sessions with handouts or slides, followed by guided group discussion. Programmes usually run over a fixed number of weeks—for example, six to eight sessions covering alcohol and health.
The aims of psychoeducational groups include improving insight into how substances affect the brain and body, correcting myths about substance misuse (such as the idea that someone can be a “functioning alcoholic” without health consequences), and increasing motivation to engage with further treatment. This aligns with NICE guidance recommending education and information as part of addiction treatment.
Concrete session topics might include:
Cravings and the brain’s reward system (how repeated substance use alters dopamine pathways)
Sleep and substance use (the impact of alcohol on sleep architecture)
Interactions with prescribed medication (for example, how alcohol affects antidepressant efficacy)
Skills development and relapse-prevention groups
Skills development groups are practical, CBT-informed programmes teaching day-to-day coping skills needed to maintain abstinence and manage the recovery process. In NHS and third-sector services, these often run once or twice weekly over several weeks.
The content links directly to recognised relapse prevention models and NICE recommendations for coping-skills training. Marlatt and Gordon’s relapse prevention framework underpins much of this work, focusing on high-risk situations, self-efficacy, and practical strategies to interrupt the relapse chain.
Typical skills taught include:
Recognising high-risk situations (social events, emotional states, environmental cues)
Managing cravings through techniques such as urge surfing, delay, and distraction
Assertive communication for refusing substances without damaging relationships
Planning alcohol-free or drug-free leisure activities
Exercises might include role-plays of refusing substances at a party, creating detailed relapse prevention plans for challenging periods such as Christmas, or mapping out triggers and alternative responses over a week.
Group therapy sessions utilize socializing techniques to help clients develop new social skills and manage relational challenges.
A therapist’s important role in group therapy is to show participants the difference between healthy and unhealthy interpersonal skills. By encouraging discussions, receiving feedback, and promoting positive interaction, psychotherapists signal how participants must act in various situations.
Cognitive–behavioural therapy (CBT) groups
Cognitive behavioural groups are structured treatments focusing on the relationship between thoughts, feelings, physical sensations, and substance-use behaviour. They are among the most widely researched group formats for addiction.
Common elements include identifying unhelpful thinking patterns—such as “I’ve already had one drink so I might as well carry on”—and examining these through behavioural experiments. Between-session tasks, like monitoring triggers and emotional responses over a week, reinforce learning.
NICE recommends CBT for alcohol-related problems and drug misuse. Research, including the UKATT study, suggests that group CBT can be as effective as individual therapy when appropriately delivered and selected, with potential cost savings of up to 40% per patient.
A typical group exercise might involve members rewriting common “permission-giving” thoughts. For example, changing “I deserve a drink after a hard day” to “A hard day is a reason to use my stress management skills, not a reason to drink.”
In this group context, individuals can apply coping strategies and navigate real-life challenges by learning from both therapists and fellow group members.
Group therapy provides these individuals with a flexible yet structured guide to help them gradually get back into society. By providing a consistent safe space, and discussing real-life challenges along with practical coping strategies, it offers a supportive haven for those suffering.
Support and peer-based groups
Support groups are discussion-based groups focused on shared experiences of addiction and recovery. They tend to be less structured than CBT or skills groups, with more emphasis on active participation and mutual sharing.
It is important to differentiate between clinician-facilitated support groups within treatment services and independent mutual-aid groups such as AA, NA, Cocaine Anonymous (CA), or SMART Recovery. Professional support groups operate within clinical governance frameworks, while mutual-aid meetings are typically free, peer led, and anonymous.
Typical topics in professionally led support groups include:
Managing shame and self esteem issues related to addiction
Dealing with family reactions and rebuilding healthy relationships
Handling setbacks without catastrophising
Planning for life after formal treatment ends
Clinicians may encourage people to try different support options—some find the structured approach of SMART Recovery more helpful, while others prefer the community support of 12-step programmes. The right treatment varies between individuals.
Interpersonal process groups
Interpersonal process groups are longer-term relational groups that explore how people relate to others, using the group dynamics itself as a therapeutic tool. Unlike psychoeducational or skills-based formats, these groups focus on present-moment interactions between group members.
In addiction treatment, interpersonal process groups may be used for people with complex emotional or interpersonal difficulties, including trauma histories, attachment disruptions, or repeated relapses linked to relationship patterns. Sessions tend to be less structured, with emphasis on noticing feelings towards other group members and exploring patterns such as avoidance, anger, or dependence.
These groups require experienced facilitators, thorough screening, and careful risk management. They are not typically used as a first-line intervention during early detoxification or crisis stages. The group experience can be intense, and participants need sufficient stability to engage safely.
Specialised groups (trauma, gender, culture-specific)
Some services offer specialised groups tailored to particular needs. Examples include trauma-informed programmes, women-only or men-only groups, and culturally specific interventions for particular communities.
These groups may be clinically appropriate for several reasons. Research indicates that approximately 70% of people with substance use disorders have experienced significant trauma, and co-occurring PTSD is common. Women who have experienced gender-based violence may benefit from a safe space to address these issues without male presence. Culturally specific programmes can address barriers that prevent engagement with mainstream services.
UK examples include:
Trauma-informed groups using adapted DBT skills training to address emotion dysregulation
Women-only alcohol recovery groups addressing experiences of domestic abuse
Community-specific programmes developed in partnership with local faith or cultural organisations
Availability varies significantly between regions. Facilitators require additional training in evidence-informed frameworks such as trauma-focused CBT principles and culturally competent practice.
Evidence and effectiveness of group therapy for addiction
High-level evidence indicates that group-based psychological interventions can reduce substance use and improve engagement and retention in treatment. NICE guidance recommends group CBT for moderate to severe alcohol dependence and drug misuse, citing systematic reviews demonstrating effectiveness.
According to NICE Technology Appraisal 114, group therapy boosts treatment completion rates to approximately 60% compared with 40% for non-group interventions. The UKATT (UK Alcohol Treatment Trial) demonstrated equivalent efficacy between group and individual approaches, with group formats offering cost savings—NHS estimates suggest £200–£400 per patient for group work compared with £800 or more for individual therapy.
The benefits of group therapy appear strongest when combined with medications such as methadone, buprenorphine, or acamprosate for opioid or alcohol dependence. Relapse prevention training and CBT-based groups have the most robust evidence base.
Effectiveness depends on several factors:
Factor | Impact on outcomes |
|---|---|
Group composition | Matching severity levels and goals improves engagement |
Facilitator skill | Trained, experienced facilitators achieve better retention |
Attendance | Higher attendance correlates with improved outcomes |
Stage of change | Content must match participant readiness |
Evidence is stronger for some substances than others. Group approaches have been studied more extensively for alcohol addiction than for polydrug use. Some newer or highly specialised groups (such as mindfulness-based approaches for co-morbid depression) have emerging rather than definitive evidence.
Clinicians weigh these factors when recommending group therapy, considering both potential benefits and the risk that poorly matched groups may not help or could occasionally be counterproductive.
Who group therapy is suitable for (and who it may not suit)
Group therapy is typically suitable for people with harmful or dependent substance use who are medically stable, able to attend regularly, and willing to work in a group setting. Basic requirements include the ability to manage group norms—such as not attending intoxicated—tolerance of hearing other group members’ experiences, and capacity to keep information confidential.
Circumstances where group therapy may be less appropriate or require adaptation include:
Acute psychosis or severe mental health crisis
High suicide risk requiring intensive individual monitoring
Uncontrolled withdrawal requiring medical stabilisation
Severe cognitive impairment affecting ability to follow group content
Current domestic abuse involving another group member
Some individuals may find the group setting particularly challenging. Those with marked social anxiety, autism, or language barriers may struggle with the interpersonal demands. Services may adjust by offering smaller groups, more structured formats, or pre-group preparation sessions. For some, individual therapy may be the right treatment initially, with group work introduced later.
Assessment typically involves a clinical interview exploring substance use history, mental health, interpersonal skills, and preferences. Shared decision-making ensures the person understands what group therapy involves and can express concerns. This collaborative approach helps identify whether group work is appropriate, and if so, which type of group best matches their needs.
Benefits and potential drawbacks of group therapy in addiction
Experiences of group therapy vary considerably between individuals. Like any treatment, group therapy should be monitored and reviewed regularly, with permission to step back if it is not helpful or becomes distressing.
Potential benefits
Group therapy offers several concrete advantages within addiction treatment:
Increased access to evidence-based approaches: Group formats allow services to provide CBT, relapse prevention, and skills training to more people within limited NHS resources while maintaining clinical standards.
Shared learning from peers: Hearing how other group members manage cravings, navigate social situations, or rebuild life skills can provide valuable insights that complement professional input.
Reduced stigma and isolation: Meeting others with similar difficulties can normalise the recovery process. Research suggests over 90% of participants report decreased feelings of isolation.
Safe practice environment: Groups provide opportunities to test new coping skills—such as assertiveness or refusal techniques—through role-play before trying them in real-world situations.
Structured support: Regular weekly contact with a clinical team and consistent session times can help establish routine, which is often disrupted during active substance misuse.
Potential drawbacks and risks
Privacy concerns: In smaller communities, group members may know each other socially. Confidentiality has limits—safeguarding obligations under UK law mean facilitators must report certain disclosures.
Emotional impact: Hearing others’ stories can sometimes feel overwhelming. Some participants experience vicarious distress or feel pressured to share more than feels comfortable, particularly in early sessions.
Triggering content: Detailed discussions of past drug use can occasionally trigger urges. Facilitators actively manage this risk through session structure and ground rules, but the possibility remains.
Limited personalisation: Group therapy can feel less tailored than one-to-one sessions. Some people may disengage if content does not match their stage of recovery or personal goals.
Potential for negative influence: Although rare with skilled facilitation, there is a small risk of cross-addiction modelling or groupthink. Trained facilitators monitor group dynamics to mitigate these effects.
When concerns arise, facilitators work with participants to determine whether group therapy should continue, pause, or be replaced with alternative support.
What actually happens in an addiction group session?
Understanding what happens in group sessions can reduce uncertainty for someone considering referral.
Arrival and ground rules: Sessions typically begin with a reminder of group rules. Common expectations include:
Attending sober (not under the influence of substances)
Respecting time limits for sharing
Maintaining confidentiality about what other group members disclose
No sharing of substances or contact details for substance-related purposes
Handling disagreements respectfully
Check-in: Each group member briefly shares how they have been since the last session. This might include any challenges, achievements, or changes in their substance use.
Main content: The facilitator introduces the session’s topic or exercise. Over a typical 6–12 week programme, topics might include:
Understanding triggers and high-risk situations
Managing emotional responses without substances
Sleep hygiene and daily routine
Navigating social events
Planning for life after the group ends
Group discussion: Participants share experiences related to the topic. The facilitator guides conversation to ensure everyone has opportunities to contribute.
Closing: Sessions end with a brief review of key points and a take-home task—perhaps monitoring triggers during the week or practising a specific coping skill.
Active participation is encouraged but not forced. People can choose how much they share, particularly in early sessions. Any concerns can be discussed individually with the facilitator before or after the group.
How group therapy fits into a wider addiction treatment plan
In the NHS and UK voluntary sector, group therapy is usually one component within a broader care plan. This plan may include medical assessment, detoxification, opioid substitution therapy, blood-borne virus testing, mental health support, and social care.
Group treatment is often combined with individual keyworking or one-to-one therapy. This is particularly important during high-risk periods such as immediately after detox, during major life changes, or when complex issues arise that require individual attention.
NICE guidelines recommend coordinated, multidisciplinary care. Groups should be planned in conjunction with GPs, psychiatrists, addiction specialists, and social care where relevant. Communication between services ensures treatment components work together rather than in isolation.
Example pathway 1: A person with alcohol dependence might begin with a medical assessment and community detox. Once stable, they attend an 8-week psychoeducational programme, then progress to a 10-week CBT relapse-prevention group. Afterwards, they are encouraged to try SMART Recovery meetings for ongoing community support.
Example pathway 2: Someone with opioid use disorder on opioid substitution therapy attends weekly skills development groups alongside regular keyworker appointments. After completing the programme, they transition to a peer support group while continuing individual reviews every two weeks.
Accessing group therapy for addiction in the UK
Referral to group therapy typically occurs through one of several routes:
GP referral: A general practitioner can refer to local NHS drug and alcohol services
Self-referral: Many community drug and alcohol teams accept direct self-referral
Community mental health teams: For people with co-occurring mental health difficulties
Inpatient discharge planning: Group therapy may be arranged as part of aftercare following residential treatment
Availability, waiting times, and eligibility criteria vary between regions. Some groups may only be available in certain localities or for specific substances. Rural areas may have more limited access—Public Health England data suggests only 40% of services in some regions offer group provision.
Charities and community organisations sometimes run free or low-cost therapy groups. Independent providers may charge fees. When considering any service, check the facilitator’s professional registration (such as HCPC, BABCP, or BACP) and relevant training.
There are important differences between formal therapy groups and mutual-aid meetings:
Feature | Formal therapy groups | Mutual-aid meetings |
|---|---|---|
Facilitation | Trained therapist | Peer led |
Clinical governance | Yes (records, outcomes) | No |
Cost | Usually NHS-funded or fee-based | Typically free |
Structure | Time-limited programme | Ongoing, open access |
Urgent safety note: If you or someone you know has immediate concerns related to withdrawal symptoms, overdose, or self-harm, seek urgent help via NHS 111, your GP, or emergency services (999). Do not wait for a group therapy referral if safety is at risk.
Things to Take Care of in Group Therapy as a Therapist
A psychotherapist has the ability to speed the healing process or unintentionally hinder the journey. It is for this reason that a therapist must have distinct professional as well as personal qualities besides obtaining a practising licence.
At PCP, our experts are trained to take individual needs into account very seriously so they can devise treatment plans accordingly. To have psychotherapists provide safe and supportive group therapy sessions, our experts are taught to:
Maintain Trust and Confidentiality
Trust is a significant foundation of group therapy. It is a therapist’s role to foster an environment where participants feel secure to share their emotions. Therapists must assure individuals that what they are sharing remains safe with them. They must also tell the participants that no matter how vulnerable they become, they will never be judged.
Examining unconscious processes in group therapy allows members to gain clarity about themselves and facilitates personal change by tapping into the shared dynamics of the group.
Manage Conflicts Responsibly
Emotional tension is a mandatory part of group therapy. There can be instances when individuals might hold contradictory thoughts. A responsible psychotherapist must not stress in such situations. He must acknowledge individual differences and guide group members to communicate their viewpoints respectfully.
Managing conflicts responsibly can strengthen the group dynamic and enhance therapeutic outcomes by fostering an interactive environment among participants.
Encourage Open Communication
Participants, when joining group therapy, may at first feel hesitant in expressing how they feel. It is the therapist’s responsibility to make everyone who comes to the sessions feel at home. They must provide them a space that feels light so they can openly communicate their thoughts. Creating a supportive group environment is crucial for fostering open communication and emotional expression. Additionally, as a supervisor, he can also suggest healthy strategies to convey feelings.
Promote Active and Respectful Listening
In group therapy, every voice is heard. These sessions aren’t merely about voicing one’s feelings, but they also involve listening to what others are going through. Group members can model respectful listening by attentively listening to others and offering validating words. A psychotherapist here must ensure that the environment he provides is comfortable so everyone can freely speak up. He must attentively listen to others, maintain eye contact, and offer validating words so the participants can also model the same respectful listening.
Avoid Bias and Ensure Objectivity
A therapist must treat all the participants fairly and ensure that their personal opinions do not influence the treatment plan. People with diverse backgrounds are enrolled in group therapy. It is a therapist’s responsibility to take these differences with a neutral perspective. He must not support favouritism or personal bias in any way.
Understanding the significance of the individual’s primary family group in shaping their interpersonal relationships is crucial. Group therapy can replicate family dynamics, where members unconsciously project past family roles onto each other, allowing for new relational patterns to be explored and dysfunctional behaviors to be addressed within a supportive group environment.
Rehab Today: A Great Choice for Effective Group Therapy
Group therapy can be an invaluable tool in the healing process. These sessions provide individuals with a supportive environment to express themselves without being judged. However, the rule is that it must be guided by a credible experienced and well-trained psychotherapist.
At Rehab Today by PCP, we acknowledge the importance of professional help when recovering from addiction. Our team provides a wide range of programs ranging from inpatient and outpatient rehab plans to group as well as individual therapies. With us, recovery is not only possible but is just a few steps away!
Contact our experts today and start your healing journey now.