How Do I Choose: Individual or Group Sessions for Addiction Treatment?

 A. Tom Horvath, Ph.D., ABPP

Are you searching for the “right” treatment center for you or a loved one?  This article is written to suggest that pre-established “programs” (individual or group sessions for addiction treatment) of treatment are not the best approach.  Rather, there are as many roads to recovery as there are individuals.  Treatment centers need to support you on your own path to recovery, not push you into a generalized recovery path that may be slightly helpful to many people, but not exactly helpful to anyone.

If you were looking for the “right” center, there are many factors you would need to consider.  Are all of the substances that you use included?  A program just for drinkers may not be suitable if you also have concerns about other substances.  Do you have relatedaddictive behaviors, like gambling, overeating or an eating disorder?  Are your related issues included?  For instance, are anxiety, depression, trauma, panic, bipolar disorder or mood swings, attention-deficit disorder or other concerns, if relevant to you, going to be addressed? Can your health problems be identified and treated?  If you need to develop better health habits (e.g., around sleep, exercise, food, hygiene, etc.), will these concerns be addressed?  Will there be opportunity to include family members or other significant people in your life?  On the other hand, will you be required to include people who, for various good reasons, it might be better not to include for now?

There are additional factors to consider as well.  Are you a member of a group that is often misunderstood?  Are you disabled in some way, a minority group member, of an uncommon ethnic or nationality background, or have a particular spiritual or religious orientation?  Do you have responsibilities at work or home that others might not easily understand?  Will your upbringing and the influence of your family of origin be included in understanding how you developed your problems and how you need to overcome them?  Do your own difficult experiences in trying to be understood by others suggest that it will require others with similar experiences or backgrounds (or professionals dedicated to working with you) in order to be understood?  Will a treatment center have enough of these individuals available to you?

The above questions are intended to help you realize how many different factors might need to be considered in establishing a practical and personal approach to recovery.  Almost everyone entering addiction treatment already understands what needs to be done:  Stop drinking!  Stop drugging!  Stop the activity addiction (e.g., gambling, video games)!  The issue for almost everyone is not what to do, but how to do it.  “So, I need to quit drinking, but then what?  How do I cope with ____?”

Would it make sense to enter a “program” that is 1) almost entirely based on attending group sessions (with few or no individual sessions), and 2) based on following a prescribed sequence of topics or curriculum (“in your first week we look at how your life has become unmanageable, in the second week…”)?  How could such a program address all the issues that are relevant to finding and following your own path to recovery?  If you have no choice but to enter a program based on group sessions, then of course get the best match you can find.  However, a treatment center that offers primarily individual sessions, with group sessions available, will offer the best opportunity for addressing your unique concerns, and developing your unique path to recovery.