Applying Stage-Wise Treatment to a Mixed-Stage Co-occurring Disorders Group

Abstract

The authors present a case study in which Stages of Change (SOC), Motivational Interviewing (MI), Cognitive Behavioral Therapy (CBT), and illness management concepts are applied to a mixed-stage co-occurring disorders group. The authors explore the difficulties of applying stage-wise treatment to a mixed-stage group and discuss the benefits and disadvantages of two approaches. The authors observed that applying stage-appropriate interventions individually to members in a mixed-stage group (the tailored interventions approach) seemed to better address the immediate needs individuals were facing in their day-to-day recovery by allowing members to take the lead in the group process and responding to that lead. In the workbook approach, we offered the same exercise to each group member regardless of the stage of change or recovery need each member was facing. We propose that the tailored interventions approach provided more relevant and engaging treatment to group members, increased group cohesiveness and better enabled lower functioning members to tolerate the group. It also helped members in earlier stages move to the action stage of treatment. A suggested method and format for using this approach is also offered.

Keywords:

• Addiction
• Co-occuring disorder
• Day treatment
• Dual diagnosis
• Group
• Mixed stage
• Motivational interviewing
• Partial care
• Stages of change