Thursday, December 3, 2009

The Magic Group

“Do Not Disturb. Magic Group in Session.”

There’s no such sign outside the door at the end of the second floor hallway, but if there were, that’s what it might say. It’s an exclusive club, invitation only. They meet here three days a week, from 9 AM to noon. And there’s a positive energy in the air; so much so, that walking in on a session feels like you’re interrupting something very important. Some have taken to calling it the Magic Group.

Whatever they call it, the group of 17 people at the Brandywine Counseling Lancaster Center is hard at work on their recovery. Sean, 28, who’s been attending for four weeks, describes what goes on. “It is at times really good, because we get a lot of people in here that are eager. We’ve got a good mix of people, different cultures, different people at different stages. [Some are just] starting to learn about their addiction; other people have been through programs like this before, and those people are willing to help other people.”

Sean is part of the IOP, or Intensive Outpatient Program. Run by counselor Janine Rinderle, the IOP consists of 3 hours of group counseling, 3 days a week, as well as individual counseling. It’s a higher level of care designed to help participants set and work toward their goals for recovery.

Brandywine introduced the service in 2009 at Lancaster and two other locations, realizing that traditional monthly counseling wasn’t enough for some patients. Unable to remain abstinent, they were at risk of discharge from the methadone program, which often leads to relapse. This was despite having consistent attendance and making a good effort in treatment. Patients who fit this profile and meet other medical criteria and agency requirements, are now recruited by staff for the IOP.

Sean was one of those on the verge of discharge. Traditional treatment had worked for him at first, but only for so long. “I just hit a crossroads after awhile, a couple months in. Once I got clean, I guess I needed something a little more than once a month. My counselor approached me to say they might recommend me for the IOP. I didn’t get too much information before I got in, because it was a new program.”

It was a similar situation for “Charles,” 38, who has been in the IOP for two months. “Recovery is hard for me. I was clean for five years straight. One day I relapsed, and since that time, I’ve been trying to pick myself up again. I thought I could do it by myself, but you can’t. When you’re an addict, you need help. You need the support.”

Joining the IOP is a big commitment. Participants not only have to be willing to do the work, they have to make time for the three hour sessions. “When I heard about the IOP, I was a little skeptical,” says Sean. “Coming here, it’s gonna cut into my time.” But his commitment brought unexpected benefits. “I’m a little more active. I wake up [and] get my day started a little earlier. And you meet more people here.” He’d never socialized much with other people on the clinic, but that has started to change.

Charles also came in with doubts. “In the beginning, I was a little nervous talking [in group], like everybody. But it’s coming along. I’m glad I’m in here. In group, we all get along. In the beginning, everybody was quiet, but we all give feedback now. I’ve got people to help me, and that’s what I like. Now I’ve got my support.”

Janine uses a wide variety of activities to help keep group members engaged, including psychoeducational components, art therapy, and goal setting. At times, she lets group members dictate where the topic goes. She has them practice relaxation techniques, and teaches skills to reduce anxiety. This is particularly useful in slowing down a craving when it occurs.

“Far too often, a craving occurs and is immediately acted upon,” she explains. “But if clients give themselves the chance to work through some of the thoughts associated with the craving, they may avoid following through with the urge to use.”

The most important technique she tries to use in group is a client-centered approach. “I want to create an environment where group members feel ownership of the group, where they feel safe and not judged. Giving members unconditional positive regard allows them to try new behaviors and ways of thinking within the context of the group. The group is a time where they can really work on things with the help and support of myself, but also the other group members who have been through similar trials and struggles.”

Charles has been able to take what he’s learned and make changes in his life. “The therapy she’s giving us, it’s good, believe me! I’m using the tools right now with this person in my life, a drug dealer. I’ve changed my ways with my behavior. All the feedback I’ve taken, it’s working for me.”

Sean has also gained insight from the group. “Being in a group helped a lot, seeing everyone else struggling, it wasn’t just me. I think it’s the more time in here, the more time we spend with the people, and the counselor. Three days a week and three hours long, that’s what’s really helping us.”

“The biggest progress I see in clients is a change in their motivation,” says Janine. “Many of them enter the IOP angry, frustrated, and hesitant; however, after a few weeks, I begin to see big changes in how they relate to one another, how much they open up in group, and the newfound motivation to become engaged and to take more of a proactive role in their recovery.

“I think the magic is that group members have become very close with one another. They meet three days a week and while some were hesitant at first to open up, it wasn't long before they were all sharing personal experiences. The closeness that has formed between them is, I think, what helps them feel supported and understood.”

The first seven members of IOP are about to successfully complete the program, many of them long-time drug users who have provided their first ever negative drug screen. There is a waiting list to get in. Many clients hear about the program by word of mouth, or when they see fellow clients like Sean sticking with treatment and doing better. “I think people are starting to hear more about it,” he says. “It’s starting to get a little buzz out there, as more people learn about it.”

Or they hear it from Charles, who would be back on the street right now if not for the program. They hear how the IOP turned his frustration into motivation. “I brought myself in here. If I’m doing it without missing days, that means I care. I want change. I take it one day at a time.

“The thing is good! I like it!”

Now that is magic.

Brandywine Counseling services are funded by and is part of the system of public services offered by Delaware Health and Social Services, Division of Substance Abuse and Mental Health. For more information, please call 302-656-2348.

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