When we look at treatment programs that are designed to help individuals who are struggling with a substance abuse disorder, we often see that treatment facilities utilize a combination of different approaches. This can include medication-assisted treatment, group therapy, individual therapy, life skills groups, psychoeducation groups, and support groups. Some clients may present with reluctance to participate in the different forms of group therapy during their treatment program. Individual therapy provides clients with one-on-one time with a trained Counselor which can feel less overwhelming and more personal than a group setting. When a client shares their hesitations with you about group therapy, there are numerous benefits that you can discuss with them. In this post, I highlight 50 Substance Abuse Group Therapy Activities for Recovery that you can use with your clients.

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How Does Group Therapy Help with Substance Abuse?

Group therapy is a common approach used in the treatment of substance use disorders. With a plethora of research supporting its effectiveness, Counselors can effectively use this form of treatment within an addiction treatment program to support their clients.  

There are many benefits that can occur within a group setting which includes reducing isolation. Active addiction can cause clients to distance themselves from their loved ones and friends which can make recovery feel lonely. Group therapy can give them a chance to feel connected to others, and witness others in their own recovery.

Group sessions can allow members to work through challenging emotions such as shame and guilt. Listening to what other members share can provide a sense of validation and normalcy for members who may have thought that they were alone, or wrong for feeling as they do.

Group sessions provide group members with an opportunity to practice life skills including communication and establishing boundaries. Effective group leaders can help create an environment where members can challenge each other in a productive manner while practicing these life skills.

Group therapy can be used to explore and process a member’s triumphs, challenges, and relapses. Talking about these experiences in a group setting will not only benefit the client experiencing them, but also other members of the group who can learn from their experience. This can include learning to cope with uncomfortable emotions and situations. Additionally, this can promote an environment where group members feel comfortable asking for help when they find themselves struggling. For group members who are new to recovery, group sessions can provide valuable education about addiction and recovery.

Being a part of a group can help establish a source of accountability for group members. They are expected to be present and engaged in the group sessions. Group sessions provide them with a set time within their routine to focus on their recovery.

The ideas and activities for substance abuse group therapy that are used will have an impact on the benefits that our clients have. 

List of Group Therapy Activities for Substance Abuse

Substance abuse group therapy can facilitate healthy discussions about relatable topics in recovery. Group therapy activities for substance abuse can be related to a variety of topics including education, shame, guilt, triggers, cravings, boundaries, health, mental health, and sober support. Additionally, you can use substance abuse group therapy activities for teens if you are working with a younger population. This gives the Counselor leading the group an opportunity to tailor the group activities to the current concerns of the group members.

Here is a list of 50 Substance Abuse Group Therapy Activities to use in your sessions:

1. Have the group members write a letter to their addiction and share the letter with the group. Spend time processing emotions and reactions that they experience during the activity.
2. Have group members write a letter they never intend to send, and share it with the group. They can write to whomever they feel they have unresolved emotions for. This can lead to a discussion about forgiving themselves and others.
3. Establishing group rules and norms. This allows the group to identify behaviors and actions that are expected while in the group session, as well as identifying consequences if the rules and norms are broken. This can help develop a sense of accountability. 
4. Provide psychoeducation about mindfulness before practicing guided meditation. Process the group member’s experience from the meditation and discuss the benefits of practicing on their own. Ask members where they can apply mindfulness practices to their life. 
5. Provide psychoeducation about healthy communication followed by roleplaying of what was discussed. As an example, you can discuss the use of “I Statements”. This can help members learn about healthy and effective communication styles.
6. View a documentary or other media form that relates to addiction and process with a group.
7. Have group members write down fear, and place their notes in a bowl. The Counselor takes each note out and asks group members to share if or how they can relate. This can help validate group members’ fears and normalize their experience.
8. Have your group work in pairs or smaller groups to identify healthy coping skills they use when they struggle. When pairs are finished, have the group as a whole share what coping skills they have identified.
9. Have your group work in pairs or smaller groups to identify their triggers. Bring the group back together to develop a list of coping skills or healthy behaviors they can do to manage the different triggers.
10. Provide the group with a list of healthy coping skills and ask them to use two skills before their next group session. Process their experience by talking about what worked and what wasn’t as helpful in the next session as a follow up.
11. Play Jeopardy with addiction-related topics such as triggers, coping skills, and healthy behaviors. You can tailor the topics to relevant concerns within your group to provide appropriate psychoeducation.
12. Ask group members to write a letter to their younger self. If they are comfortable sharing with the group they can, or you can spend time processing the emotions and reactions that come up for them.
13. Have group members write down something they can do to show themselves kindness and place the note in a bowl to review as a whole. Follow up with discussing self-compassion and patience.
14. Have the group discuss positive ways they can celebrate happy times/holidays/special occasions. This can be used during the holiday season or when group members knowingly have a special occasion approaching.
15. Provide psychoeducation about grief, and ask members to share if or how grief impacted their addiction.
16. Discuss the difference between internal and external motivation, explore both for group members’ motivation for recovery.
17. Provide a psychoeducational group about different levels of addiction therapy and when they would be appropriate.
18. Discuss the different local support group options such as AA or NA with pros, cons, barriers, and concerns within the group. 
19. Spend time exploring (if) the role that shame has played in their active addiction. You can then talk about how members can cope with shame they are carrying.
20. Provide psychoeducation about depression, ask if group members are comfortable sharing their experience and talking about what has helped them.
21. Provide psychoeducation about anxiety, ask if group members are comfortable sharing their experiences and talk about what has helped them.
22. Discuss the consequences members would experience if they relapsed. This can include hurt relationships, health concerns, mental health concerns, loss of employment, legal repercussions, etc.
23. Have group members identify healthy support and talk about what characteristics make them feel supportive and helpful. 
24. Spend time discussing health concerns that can arise from use of alcohol such as a fatty liver, alcoholic hepatitis, cirrhosis, and high blood pressure.
25. Spend time discussing health concerns that can come from using drugs such as lung damage, transmitted infections, poor nutrition, and poor skin health.
26. Play two truths and a lie, this can help group members learn more about each other.
27. Spend time exploring members’ values and discuss (if) the role their values have in their recovery. For example, family values could act as a source of external motivation.
28. If you had an unlimited supply of money for a day, how would you use it?
29. Ask group members to write their own obituary. Process what this was like and ask if it makes them consider changes to their life.
30. Discuss concerns that can arise with isolation, such as depressive symptoms and having no social support. Have the group come up with a list of things they can do to avoid isolation.
31. Ask group members to draw a timeline of their life and share with the group.
32. Provide group members with a worksheet that lists emotions that can be uncomfortable or challenging to cope with. Ask group members to draw a coping skill they can use for each emotion.
33. Provide the group with pieces of colored cut-up paper. On a larger piece of paper and using a glue stick, ask them to create something they find beautiful. You can talk about how they may feel as though their life is in pieces at the moment, but with time and patience, their recovery can be beautiful too.
34. Ask the group to identify something that has been holding them back in their recovery. This can produce a range of responses including fear, guilt, their environment, lack of support, and lacking sufficient motivation. Talk about how they can work through these barriers in a healthy manner.
35. Develop a recovery “cheat sheet card” with helpful phone numbers or coping skills that fit into a wallet for members to carry around when they need it.
36. Lead a discussion about how anger can often mask other emotions that we are uncomfortable with. Similar to an iceberg, we may feel anger, but when we take a moment to think about what we are feeling there may be other emotions underneath that we can be missing.
37. Provide education about medications that can be used to help individuals in recovery. This can include Suboxone, Naltrexone, and Methadone.
38. Talk about the role that our physical environment can have on recovery. If group members have something in their home, or a room in their home that they associate with using or drinking, what can they do to change that space to decrease the chances of it acting as a trigger? As an example, if they sat in a particular spot watching television while drinking, can they rearrange the room so that spot is not there?
39. Ask group members to identify 5 strengths or positive traits that they have. Talk about how these can have a positive impact on their recovery.
40. Create a ruler using the Stages of Change Model and ask group members to identify where they fall in regards to their readiness for recovery.
41. Utilize worksheets, such as the Substance Abuse Worksheets available at TherapyByPro to guide discussion on concerns relevant to your group members.
42. Ask members to describe themselves, followed by how they believe others would describe them. Follow this by asking if there are any changes that they would like to make to their behaviors.
43. Facilitate a game of charades to demonstrate the importance of body language. You can then talk about group members body language during group sessions and how it makes others feel. As an example, if you have members with a closed posture, group members may be less willing to open up and share in the session. 
44. Talk about the importance of nutrition and exercise and ask what realistic fitness or nutrition goals the group members have. Ask them what changes can be made to their current routine that would work towards their identified goals.
45. Talk about the importance of self-care and ask group members to discuss their current self-care practices and the benefits they have seen. If they have limited or no self-care practices, can they see any benefits from beginning to engage in self-care? 
46. Lead a discussion about forgiveness. If there is anyone that they would like to forgive, and if so, is there anything they would like to share with that person? How do they think they would feel after forgiving this person? 
47. Are there any bad habits that the group member has? For those who do, are there any triggers for these habits such as boredom or uncomfortable emotions? If so, what can they try to cope with the trigger instead of engaging in their bad habit?
48. Ask each group member to pick a song they enjoy. Allow time for the group to listen to the song and then ask the group member to discuss what it is about the music they enjoy.
49. Facilitate a group on mindfulness and introduce Box Breathing. Discussing situations where Box Breathing can be helpful, and practice it.
50. Facilitate a group discussing common dual diagnosis concerns seen among individuals living with an addiction. Ask the group members to share their experience with mental health concerns and what has helped them when they are struggling

Final Thoughts on Selecting Group Therapy Activities for Your Clients with Substance Abuse

The use of group therapy activities for substance abuse can be a helpful tool in creating a safe and healthy group environment. Activities can encourage discussion when members may be reluctant or unsure of how to contribute to the conversation. Lastly, substance abuse group activities can provide group leaders with an opportunity to provide psychoeducation in an interactive way that members respond to. 

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Author: Kayla Loibl, MA, LMHC

Kayla is a Mental Health Counselor who earned her degree from Niagara University in Lewiston, New York. She has provided psychotherapy in a residential treatment program and an outpatient addiction treatment facility in New York as well as an inpatient addiction rehab in Ontario, Canada. She has experience working with individuals living with a variety of mental health concerns including depression, anxiety, bipolar disorder, borderline personality disorder, and trauma.