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Abstract
Leader issues and countertransference dilemmas that emerge in psychotherapy groups for substance abusers will be examined along with strategies to extricate the therapist from the impasses that emerge. Specific issues include feelings of helplessness and inadequacy when a patient relapses and resumes substance use, countertransference reactions emanating from an overlapping personal or family history of substance abuse, countertransference helplessness when the therapist is more invested in the treatment than the patient, feelings of incompetence related to partial familiarity with 12-step culture and lingo, and countertransference devaluation fostered by systemic issues in substance abuse settings.