What Topics Are Allowed in Group Therapy?

Group therapy is an integral part of treatment for most individuals with substance use disorder (SUD). Peer support and positive social interactions help people develop important skills and process underlying issues related to substance abuse and recovery. As stated in the publication titled Substance Abuse Treatment: Group Therapy by the Substance Abuse and Mental Health Services Administration (SAMHSA), "One reason for this efficacy is that groups intrinsically have many rewarding benefits—such as reducing isolation and enabling members to witness the recovery of others—and these qualities draw clients into a culture of recovery." Some clients may wonder what topics are allowed during group therapy sessions. West Coast Recovery Centers encourages honesty, transparency, and compassion. Clinicians help clients work through many complex and personal topics during group therapy. 

The Value of Group Therapy and Peer Engagement

Group therapy and positive peer interactions increase self-confidence, self-esteem, and self-worth. However, some people may struggle to discuss topics that make them feel vulnerable. Opening up to strangers may feel frightening or overwhelming at first. In addition, some people may worry about what topics are taboo or off-limits in group settings. 

Some of the topics some people may hesitate to discuss include: 

• Illegal activities, including illicit substance abuse
• Domestic violence 
• Sexual, physical, emotional, or verbal abuse 
• Child abuse 
• Family dysfunction
• Suicidal thoughts or behaviors 
• Self-harming thoughts or behaviors
• Substance abuse while pregnant 

Clients in treatment might worry about peers or the group therapist reporting any potentially dangerous or illegal activities to the police, making them hesitant to talk about topics impacting their mental health and quality of life. Therapists are mandatory reporters. However, group and individual therapy sessions are a safe space where people should feel comfortable discussing topics related to their mental health and recovery. Therapists must legally inform clients of mandatory reporting criteria and exclusions to ensure everyone understands their rights, including what topics may prompt mandatory reporting and which do not. 

Encouraging Empathy, Compassion, and Honesty

Substance abuse treatment programs work with clients to ensure they receive the support they need in all areas of their recovery. Group therapy encourages empathy, compassion, and honesty between peers. Clinicians help clients navigate delicate topics of conversation while allowing everyone to have a voice and work through underlying issues. Group therapy sessions are a nonjudgmental space where people voice their doubts, fears, beliefs, and thoughts about a wide range of topics. 

What Common Topics Are Allowed

Some group sessions follow a curriculum with predetermined topics, including relapse prevention and coping skills. Other groups are less formal and focus on everyday client concerns or questions related to recovery and mental health. According to the Journal of Groups in Addiction and Recovery, "Group therapy may include psychoeducational presentations, recovery skills training, interpersonal process groups, 'check in' groups, motivational groups, and specialty topic groups."

Some common topics discussed during group therapy sessions include: 

• The impact of substance abuse on relationships 
• Triggers, intrusive thoughts, and other symptoms of SUD 
• Personal struggles caused by SUD or co-occurring mental health disorders 
• How to manage symptoms 
• Relapse prevention strategies
• The importance of mindfulness and how to incorporate it into everyday routines 
• Trauma and other underlying issues related to mental health or substance abuse
• Healthy coping skills 
• Stress management 
• Maladaptive thoughts, beliefs, and behaviors 
• What to expect from long-term recovery 

Some topics are "big picture" and look at how different aspects of treatment affect a person's quality of life. Other topics may be specific to the individual and something they experienced that day. For example, someone may want to discuss how SUD impacted a relationship with their loved one. 

What Taboo Topics Are Allowed During Therapy Sessions?

In addition to typical topics, including relapse prevention or mental health symptoms, group sessions also cover what many people consider taboo topics, including: 

• Sexual interactions, abuse, or indiscretion 
• Socially unacceptable thoughts, beliefs, or behaviors 
• Violence, aggression, and anger issues
• Sexual or physical trauma 
• Childhood abuse
• Human trafficking or loss of autonomy
• Loss and grief

Moreover, the publication titled Group Therapy by authors Malhotra and Baker explains that during group therapy, some people "may feel uneasy sharing certain details for fear of who may repeat them, which can cause harm to patients' mental wellbeing as they struggle to contribute while maintaining their confidentiality." Clinicians reduce feelings of unease by adopting "a set of confidentiality/sharing guidelines that the group agrees to and discuss with members the limitations of confidentiality before the first session." By setting boundaries and expectations, therapists provide clients with guidelines for appropriate topics and responses during group sessions. 

Empowering Recovery Through Group Sharing

Sharing experiences with peers in a group setting empowers people and builds self-confidence. Listening to others talk about their experiences helps people feel less isolated during treatment and long-term recovery. Feeling worried over what topics are allowed may stop people from opening up. Clinicians help people overcome these barriers by reassuring clients of their freedom to discuss taboo or complex topics in group therapy.

Clients uplift and support one another by being open, honest, and compassionate. Some topics may feel off-limits. However, often, more than one person in the group has often experienced similar issues, and sharing can help people learn from one another. Group sharing is an important part of building social bonds during recovery from substance abuse. West Coast Recovery Centers encourages clients to use group therapy as a safe space for exploring thoughts, feelings, and beliefs related to recovery.

Group therapy may feel intimidating for some people. Individuals recovering from substance abuse often have underlying trauma and other issues affecting their mental health. Discussing these topics with peers who share similar life experiences can uplift and empower people in recovery. However, many individuals hesitate to take advantage of group therapy because they are uncertain about what topics are allowed. Clinicians at West Coast Recovery Centers facilitate deep discussions on issues impacting client health and recovery. Clients also have the opportunity to discuss potentially taboo topics in individual therapy first to determine how appropriate it is for group sessions. To learn more about our services and programs, call us today at (760) 492-6509.