Discussion Topic
The group therapy model is used by most addiction treatment programs for a variety of reasons. There are different group models and strategies used to help members in the group develop relapse prevention skills. However, most models allow for clients to work on their goals at their own pace, so members enter and leave according to their individual treatment pace. This can create some interesting problems in the group (e.g., conflict). Further, there are some ethical issues that arise with having multiple members in the group. In this discussion, you will propose solutions to these challenges.
Use the scenario below to respond to the questions.
Scenario: Women’s Residential Treatment Group
Barbara has been working with a treatment group in a women’s residential facility for the past few months. Most of the members have been with the group for at least two weeks and are making progress towards their treatment goals. However, this morning a new member joined. Sheila introduced herself to the group by telling them that she was a polysubstance drug user and had been arrested for prostitution and possession of heroin. She said that she opted to attend residential to see if she could avoid jail time. Another group member, Lynda, commented sarcastically that this was not a women’s lock up facility and that she should go to jail. Sheila crossed her arms and sat back in her seat.
Barbara tried to focus the group by reminding them of their group agreement to maintain the confidentiality of the content of group. She gently reminded them of their agreement to treat each other with dignity and respect regardless of their opinions of each other. The members seemed to return to their normal group behavior and proceeded to work on the project. As they talked about their childhoods, Sheila did not participate. Barbara decided that was fine since it was her first day in group.
Later that afternoon, Lynda came to see Barbara in her office to tell her that she was very upset with Sheila. During lunch, Sheila told other clients about a story that Lynda shared with the group about being raped when she was a child. Sheila demanded that Barbara make Sheila apologize. Barbara knew that Lynda has been working on anger issues and was pleased that she had finally shared in group.  
1.   Explain at least one ethical issue that exists in this scenario. What are some steps that Barbara can take to help clients to maintain confidentiality of group content?
2.   With growing tensions between Lynda and Sheila, suggest some strategies that Barbara can use to build trust in the group. Propose a strategy for helping new clients join groups that have reached the middle phase of development.  
3. What strategy could Barbara use in this situation to help the group to welcome new members into the group?

Discussion 2
 Your post should be at least 300–350 words in length and should extend the discussion of the group supported by your course materials and/or other appropriate resources.

 
Discussion Topic
Substance Use Disorders (SUDs) affect not just the person with the disorder, but also close friends and family members. Besides traditional treatment settings, there are other, low-cost and free options available to assist addiction clients and their families. 12-Step programs such as Alcoholics Anonymous, Narcotics Anonymous, and Cocaine Anonymous were designed to help members suffering with substance use disorders.
Their main purpose is to help members feel part of a recovery community, offer peer mentorship, and provide education about addiction. Members can work through a system of 12 steps designed to help them build their self-awareness. Coupled with treatment, clients can do quite well participating in both. Family members can find guidance, support, and mentorship in a variety of settings: Al-Anon/Al-Ateen, family counseling or couple counseling. In this discussion, we explore how various methods of support can help clients and their families to build stronger and healthier relationships with themselves and with each other.  
After completing the assigned Reading, please discuss the following with your classmates:

Explain the advantages and potential disadvantages of participation in 12-Step programs.
Describe the kind of support families of addiction clients might require if the client is a teen or adult parent (you choose).
What services are offered by Al-Anon/Alateen for family members of addiction clients?

Answers should be at least 100-175 words and reflect critical thought. Whenever possible, please try to relate the course content to real-world applications from your work experience. Be sure to cite all sources as well. Provide citation and reference to the material(s) you discuss alongside the question.

1. How do you think it is best to handle a situation in which a client becomes upset or frustrated because the counselor’s paraphrase is not what the client was trying to communicate?

2. In your post, you stated, ” It is important when paraphrasing to end with” did I hear you correctly”? and the client will affirm to it or not.” This is a good point. When paraphrasing, we are making space to help ensure that we are understanding the client correctly and to get feedback from the client accordingly. You mentioned one way to give space to the client to confirm or correct our understanding by ending our paraphrase by asking if we hear them correctly. Can anyone think of some other ways that we can give the client space to affirm or correct our paraphrased understanding of the client?

3. Note taking is a very individualized therapeutic decision on the part of the clinician. I know many counselors who regularly take notes during session, and they find it to be a very useful way to stay connected to what the client is saying and provide clarity for therapy. Others, and I being among them, feel that taking notes prevents them from being able to attend to the client as closely as they want to. For me, I want to be able to constantly observe and interpret the client’s body language, facial expressions, and vocal tone. If I take notes, I am not able to do that as well as I would like. However, as I indicated above, it is something that is determined by the individual style and approach of the therapist. I like the plan you referenced in your post in which immediately following the session, therapists create a summary of the session with the follow up plan for the next session. Why do you think this is important to do immediately following the session versus at the end of the day?