54 Substance Abuse Group Therapy Activities to Do With Your Clients

In my work with clients navigating substance use disorders, I’ve come to see treatment less as a single intervention and more as a combination of supports working together — medication-assisted treatment, group therapy, individual therapy, life skills groups, psychoeducation groups, and peer support all playing their own role in someone’s recovery.

Group therapy is often the piece clients feel most hesitant about. I’ve sat with plenty of clients who were open to individual sessions but visibly tensed up at the idea of sharing in front of others — and that reaction makes sense. Individual therapy offers one-on-one time with a trained counselor, which can feel far less overwhelming and more personal than a room full of people who are, at least at first, strangers. When a client shares that hesitation with you, it’s worth slowing down and talking through it, because there are real, well-supported benefits to group therapy that are easy to miss when you’re anxious about walking in the door. In this post, I highlight 54 substance abuse group therapy activities for recovery that you can use with your clients.

How Does Group Therapy Help with Substance Abuse?

Group therapy is a common approach used in the treatment of substance use disorders, with a substantial body of research supporting its effectiveness (Substance Abuse and Mental Health Services Administration, 2020). Counselors can use this format effectively within an addiction treatment program to support their clients.

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

Group sessions can also help members work through challenging emotions like shame and guilt. Listening to what other members share often provides a sense of validation and normalcy for members who may have believed they were alone, or wrong for feeling the way they do.

Group sessions give members an opportunity to practice life skills, including communication and boundary setting. Effective group leaders can help create an environment where members challenge each other productively while practicing these 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 benefits not just the client sharing, but the other members who can learn from their experience — including how to cope with uncomfortable emotions and situations. This can also promote a culture where members feel comfortable asking for help when they’re struggling. For members newer to recovery, group sessions provide valuable education about addiction and the recovery process.

Being part of a group also establishes a source of accountability. Members are expected to show up and stay engaged, which gives them a consistent, protected time in their routine to focus on recovery.

The specific activities used in a substance abuse group will shape the benefits your clients actually experience from it.

Considerations Before Facilitating a Substance Abuse Group

Substance abuse group therapy can foster genuinely powerful discussion and connection. It also involves a population with a specific set of clinical and safety considerations worth keeping in mind.

Clinical Consideration	What Counselors Should Consider
Screen for Co-Occurring Suicide Risk Before High-Intensity Exercises	Substance use disorders carry an elevated risk of suicidal ideation, and some activities in this list — such as writing one’s own obituary or discussing relapse consequences — are emotionally intensive. Assess each client’s current risk level before introducing higher-intensity existential or reflective exercises.
Stay Within Scope of Practice on Medication	Counselors can provide general psychoeducation about medications used in addiction treatment, such as buprenorphine, naltrexone, and methadone, but should refer clients to a prescribing provider for individualized medical guidance rather than making specific recommendations.
Address Overdose Risk Directly, Especially After Periods of Abstinence	Tolerance drops quickly after a period of abstinence, which significantly increases overdose risk if a relapse occurs. This should be addressed directly and without judgment, particularly for clients with a history of opioid use.
Recognize High Rates of Co-Occurring Disorders	Substance use disorders frequently co-occur with depression, anxiety, trauma, and other mental health conditions. Facilitators should be prepared to address these overlapping presentations rather than treating substance use in isolation.
Be Mindful of Shame as a Relapse Driver	Shame is both extremely common in this population and a well-documented relapse risk factor. Facilitators should approach relapse, setbacks, and disclosures with curiosity and compassion rather than judgment, which shapes whether clients feel safe being honest in group.
Maintain Clear Confidentiality and Group Norms	Given the legal, relational, and professional stakes many clients carry, clearly established and consistently reinforced confidentiality expectations are essential to building the trust this work depends on.
Understand Where Group Fits in the Broader Treatment Picture	Group therapy is a valuable component of SUD treatment, but clients with significant physical dependence may need medical detox or a higher level of care before group-based work is appropriate or safe.

Clinical Note: Substance abuse group therapy activities should be facilitated by qualified mental health professionals within an appropriate treatment framework. Interventions should be individualized based on each client’s substance use history, risk factors, co-occurring conditions, and treatment goals.

List of Group Therapy Activities for Substance Abuse

Substance abuse group therapy can facilitate healthy discussion about relatable topics in recovery. Activities can relate to a variety of themes, including education, shame, guilt, triggers, cravings, boundaries, health, mental health, and sober support. You can also adapt many of these for substance abuse group therapy with teens if you’re working with a younger population. This gives you, as the group leader, the flexibility to tailor activities to your members’ current concerns.

Here’s a list of 54 substance abuse group therapy activities to use in your sessions:

1. Building a Relapse Prevention Plan

If there’s one activity in this entire list I’d consider foundational, it’s this one — relapse prevention planning is one of the most well-supported interventions in addiction treatment (Marlatt & Gordon, 1985).

What It Is: This activity guides clients through building a personalized relapse prevention plan, including high-risk situations, early warning signs, coping strategies, and people to contact if they’re struggling.
How It Helps Clients: A plan built in advance, while a client is stable, is far more usable in a moment of genuine risk than trying to think clearly in the middle of a craving or crisis.
How To Do It: Provide a relapse prevention planning worksheet covering high-risk situations, warning signs, coping strategies, and supports. Review each client’s plan individually and encourage them to keep a copy somewhere accessible.

2. Overdose Safety and Naloxone Education

This is a conversation that can genuinely save a life, and it deserves direct, non-judgmental attention in group.

What It Is: This activity provides education on overdose risk factors — including the sharp rise in overdose risk after a period of abstinence — along with information on naloxone as an opioid overdose reversal medication (Substance Abuse and Mental Health Services Administration, 2024).
How It Helps Clients: Understanding overdose risk factors and how naloxone works can be genuinely life-saving information, both for clients and for the people around them.
How To Do It: Provide education on overdose risk, including how quickly tolerance drops after abstinence. Discuss what naloxone is, how it’s used, and how members or their support people can access it in your area.

3. Understanding Post-Acute Withdrawal Syndrome (PAWS)

Many clients new to recovery don’t realize that withdrawal symptoms can linger, in a milder form, for weeks or months after acute detox — and misunderstanding this is a common driver of early relapse.

What It Is: This psychoeducational activity introduces Post-Acute Withdrawal Syndrome, including common symptoms like mood swings, sleep disturbance, and cravings that can persist well past initial detox.
How It Helps Clients: Understanding that these lingering symptoms are a recognized, temporary part of recovery — not a sign that something is wrong or that they’re failing — can prevent discouragement from turning into relapse.
How To Do It: Provide education on PAWS and its common symptoms. Ask members if they’ve noticed any of these patterns in their own recovery, and discuss coping strategies for managing symptoms as they occur.

4. HALT: Hungry, Angry, Lonely, Tired

HALT is one of the simplest, most widely used relapse-prevention tools in recovery, precisely because it’s so easy to remember in a vulnerable moment.

What It Is: This activity introduces the HALT framework — checking in on whether a craving or difficult moment is connected to being hungry, angry, lonely, or tired.
How It Helps Clients: A short, memorable checklist gives clients something concrete to run through before reacting to a craving or urge, often revealing an underlying need that’s easier to address directly.
How To Do It: Introduce the HALT framework and what each letter represents. Ask members to reflect on which of the four tends to affect them most, and discuss a plan for addressing each one proactively.

5. Urge Surfing: Managing Cravings

Cravings feel urgent and permanent in the moment, but they actually follow a predictable rise-and-fall pattern — and clients can learn to ride that wave instead of acting on it (Bowen, Chawla, & Marlatt, 2010).

What It Is: This activity introduces urge surfing, a mindfulness-based technique for observing a craving without acting on it, recognizing that cravings typically peak and subside within a limited window of time.
How It Helps Clients: Learning that a craving will pass, whether or not it’s acted on, gives clients a genuine alternative to either giving in or white-knuckling through it.
How To Do It: Explain the urge surfing concept and the natural rise-and-fall pattern of cravings. Guide the group through a brief mindfulness exercise imagining a current craving as a wave to observe rather than act on, and discuss the experience afterward.

6. Challenging Addictive Thinking

Addiction often comes with a specific set of permission-giving thoughts — “I deserve this,” “just once won’t hurt” — that are worth naming and directly challenging (Beck, Wright, Newman, & Liese, 1993).

What It Is: This activity helps clients identify common addictive or permission-giving thoughts and practice challenging them using evidence and more balanced alternatives.
How It Helps Clients: Naming these thoughts as a recognizable pattern — rather than a spontaneous, isolated decision — helps clients catch them earlier and respond with a plan rather than automatically acting on them.
How To Do It: Provide examples of common addictive thoughts. Ask members to identify ones they recognize in themselves, and walk through challenging one together, examining the evidence and generating a more balanced alternative thought.

7. Decisional Balance: Pros and Cons of Use vs. Recovery

Ambivalence about change is normal, and naming it directly — rather than avoiding it — tends to move clients further than pretending it isn’t there (Miller & Rollnick, 2013).

What It Is: This activity walks clients through a structured decisional balance exercise, weighing the perceived benefits and costs of both continued use and recovery.
How It Helps Clients: Making ambivalence explicit, rather than avoiding it, often strengthens a client’s own motivation for change more effectively than being told what to do.
How To Do It: Provide a four-quadrant worksheet: pros of use, cons of use, pros of recovery, cons of recovery. Ask members to fill it out individually, then discuss patterns and insights as a group.

8. Stages of Change Ruler

Recovery readiness isn’t all-or-nothing, and naming where a client currently stands can reduce pressure while still supporting forward movement (Prochaska & DiClemente, 1983).

What It Is: This activity uses a visual ruler based on the Stages of Change Model, asking members to identify where they currently fall in terms of their readiness for recovery.
How It Helps Clients: Recognizing readiness as a spectrum, rather than a fixed state, reduces shame for clients who aren’t yet at “action” and gives the group language for talking about ambivalence honestly.
How To Do It: Create a visual ruler representing the stages of change. Ask each member to identify where they currently fall, and facilitate a discussion about what might help them move toward the next stage.

9. Levels of Addiction Treatment

Clients benefit from understanding the full continuum of care, both for their own planning and to reduce anxiety about what different levels of treatment actually involve.

What It Is: This psychoeducational activity reviews different levels of addiction treatment and when each is generally appropriate.
How It Helps Clients: Understanding the full continuum of care helps clients see their current level of treatment as one step in a larger process, not a permanent placement.
How To Do It: Provide education on the levels of addiction treatment, from outpatient to residential and detox. Discuss what determines the appropriate level of care and answer questions about the broader treatment landscape.

10. Local Support Group Options

Support groups outside of formal treatment are often a critical part of long-term recovery, and clients benefit from an honest conversation about the options.

What It Is: This activity discusses local support group options such as AA or NA, along with their pros, cons, and common barriers or concerns.
How It Helps Clients: An honest, judgment-free conversation about barriers — discomfort with the format, transportation, scheduling — helps clients problem-solve around obstacles rather than quietly avoiding support groups altogether.
How To Do It: Discuss local support group options available to your group members. Talk openly about the pros, cons, and common barriers or concerns members have, and problem-solve around specific obstacles as a group.

11. Medication-Assisted Treatment Psychoeducation

Stigma around medications like buprenorphine and methadone can prevent clients from considering an evidence-based option that genuinely helps many people in recovery.

What It Is: This activity provides general education about medications used to support recovery, including buprenorphine, naltrexone, and methadone.
How It Helps Clients: Reducing stigma around medication-assisted treatment can open the door for clients to have an informed conversation with a prescribing provider about whether it’s a fit for them.
How To Do It: Provide general education on medications used in addiction treatment and how they work. Offer appropriate referrals for clients interested in exploring these options, without making specific medication recommendations.

12. Group Rules and Norms

Establishing group expectations up front does more than just organize logistics — it builds the sense of safety and accountability the rest of the group depends on.

What It Is: This activity involves the group collaboratively establishing group rules and norms, including expected behaviors and consequences if rules are broken.
How It Helps Clients: Participating in creating group expectations, rather than having them handed down, helps members feel ownership over the group’s culture and their own accountability within it.
How To Do It: Facilitate a discussion establishing group rules and norms. Identify expected behaviors and appropriate consequences together, and revisit these norms periodically as the group evolves.

13. Identifying Triggers and Coping Responses

Naming a specific trigger is only half the work — pairing it with a concrete coping response is what actually makes the awareness useful.

What It Is: This activity has members work in pairs or small groups to identify their personal triggers, then reconvene as a full group to build a shared list of coping skills for managing them.
How It Helps Clients: Mapping specific triggers to specific coping responses, developed collaboratively with peers, gives clients a more concrete plan than a general list of coping skills alone.
How To Do It: Have members work in pairs or small groups to identify their triggers. Bring the group back together to build a shared list of coping skills or healthy behaviors for managing the different triggers identified.

14. Coping Skills Inventory

Building a shared, tested list of coping skills gives clients a resource grounded in real, lived recovery experience.

What It Is: This activity has members identify healthy coping skills they currently use, in pairs or small groups, then commit to trying two new ones from the shared list before the next session.
How It Helps Clients: Hearing what has genuinely worked for other group members in recovery expands each client’s coping toolkit beyond what they’d generate alone.
How To Do It: Have members work in pairs or small groups to identify coping skills they currently use. Compile a shared list, and ask each member to commit to trying two new skills before the next session, following up on what worked and what didn’t.

15. Physical Environment and Triggers

The specific spaces where a client used to use can carry a surprising amount of trigger power, even after the substance itself is no longer present.

What It Is: This activity explores how a client’s physical environment — a particular room, chair, or routine — may act as a trigger, and problem-solves ways to change that space.
How It Helps Clients: Making a concrete environmental change removes a passive, ongoing trigger without requiring the client to rely on willpower alone every time they encounter it.
How To Do It: Ask members if there’s a specific space in their home associated with using or drinking. Discuss concrete changes they could make to that space to reduce its power as a trigger, such as rearranging furniture or changing their routine in that room.

16. Consequences of Relapse

Naming the real stakes clearly, without shame, can strengthen a client’s motivation heading into a vulnerable moment.

What It Is: This activity discusses the potential consequences a client would experience if they relapsed, including impacts on relationships, physical and mental health, employment, and legal standing.
How It Helps Clients: Clearly naming what’s actually at stake — rather than leaving it vague — can serve as a grounding reminder during a moment of craving or temptation.
How To Do It: Facilitate a discussion on the consequences of relapse. Cover the range of potential impacts, including relational, physical, mental health, occupational, and legal consequences, and keep the tone factual and non-shaming.

17. What’s Holding You Back?

Naming a specific barrier is the first step toward actually working through it, rather than continuing to feel stuck without knowing why.

What It Is: This activity asks members to identify something currently holding them back in their recovery, such as fear, guilt, their environment, or lack of support or motivation.
How It Helps Clients: A specific, named barrier is something a client and their treatment team can actually problem-solve. A vague sense of being “stuck” is much harder to address directly.
How To Do It: Ask each member to identify something holding them back in their recovery. Discuss healthy ways they can begin working through the specific barrier they’ve named.

18. Bad Habits and Their Triggers

Habits outside of substance use often share the same underlying triggers — boredom, discomfort, stress — worth examining together.

What It Is: This activity asks members to identify a personal bad habit and explore what triggers it, such as boredom or uncomfortable emotions.
How It Helps Clients: Recognizing shared triggers across different habits helps clients build coping strategies that generalize beyond substance use alone.
How To Do It: Ask members to identify a bad habit and its common triggers. Discuss alternative coping responses they could try the next time that trigger shows up.

19. Anger as an Iceberg

Anger is often the most visible tip of a much larger emotional experience happening underneath.

What It Is: This activity uses the metaphor of an iceberg to explore how anger frequently masks other, less comfortable emotions underneath, such as fear, hurt, or shame.
How It Helps Clients: Learning to look beneath anger for the emotion actually driving it helps clients respond to what they’re really feeling, rather than reacting to anger alone.
How To Do It: Introduce the iceberg metaphor for anger. Ask members to think of a recent moment of anger and explore what other emotions might have been underneath it.

20. Exploring Shame

Shame is one of the most common — and most corrosive — emotional experiences in active addiction, and it deserves direct, careful attention.

What It Is: This activity creates space to explore the role shame has played in a client’s active addiction, followed by discussion of how members can begin coping with the shame they’re carrying.
How It Helps Clients: Naming shame directly, in a supportive group setting, can begin to loosen its grip — shame tends to grow in isolation and secrecy, and shrink with honest disclosure.
How To Do It: Facilitate a discussion on the role shame has played in members’ addiction. Explore healthy ways members can begin to cope with and process the shame they’re carrying.

21. Letter to Addiction

Externalizing addiction as something separate from the self can shift how a client relates to it.

What It Is: This narrative activity asks members to write a letter to their addiction and share it with the group.
How It Helps Clients: Externalizing addiction — treating it as separate from a client’s identity — can help clients process complicated feelings of anger, grief, and even attachment toward the substance.
How To Do It: Have members write a letter to their addiction. Allow those who are comfortable to share with the group, and process the emotions and reactions that come up together.

22. Letter Never Sent

Writing without the pressure of the recipient ever reading it can unlock honesty that a real conversation might not.

What It Is: This activity asks members to write a letter they never intend to send, to anyone they feel unresolved emotions toward.
How It Helps Clients: Removing the stakes of an actual conversation gives clients permission to write with full honesty, which often opens the door to a broader conversation about forgiveness.
How To Do It: Have members write a letter they never intend to send. Allow those comfortable sharing to do so, and use the activity as a springboard for discussing forgiveness of both themselves and others.

23. Letter to Younger Self

Writing to a younger version of themselves can help clients access compassion they don’t typically extend to their present-day struggles.

What It Is: This activity asks members to write a letter to their younger self.
How It Helps Clients: Compassion often flows more easily toward a younger, more vulnerable version of ourselves — this activity uses that natural tendency to build broader self-compassion.
How To Do It: Provide time for members to write their letters individually. Allow sharing for those who are comfortable, and process the emotions and reactions that come up.

24. Forgiveness Discussion

Unresolved resentment, toward others or oneself, can quietly fuel continued use.

What It Is: This activity leads a group discussion on forgiveness, asking members if there’s anyone they’d like to forgive and what they might want to say to that person.
How It Helps Clients: Exploring forgiveness directly, including how they imagine feeling afterward, can help clients begin releasing resentment that’s been weighing on them.
How To Do It: Facilitate a discussion on forgiveness. Ask members if there’s someone they’d like to forgive, what they might want to share with that person, and how they imagine feeling after forgiving them.

25. Self-Kindness Note

A small, concrete act of self-kindness is more achievable than an abstract intention to “be nicer to myself.”

What It Is: This activity asks members to write down something they can do to show themselves kindness, placing it in a bowl for the group to review together.
How It Helps Clients: Reading through the group’s collective ideas often surfaces options a client wouldn’t have generated on their own, and reinforces self-compassion as a shared value in the room.
How To Do It: Have members write a self-kindness idea and place it in a bowl. Review the ideas together as a group, and use the activity to open a discussion on self-compassion and patience.

26. Grief and Addiction

Unprocessed grief is a common, and often overlooked, contributor to substance use.

What It Is: This psychoeducational activity introduces grief and invites members to share whether, and how, grief has impacted their addiction.
How It Helps Clients: Naming grief as a specific contributing factor — rather than a vague sense of sadness — helps clients see a clearer connection between their loss and their use.
How To Do It: Provide psychoeducation on grief. Ask members to share, if comfortable, whether and how grief has played a role in their substance use.

27. Depression Psychoeducation

Depression and substance use disorders frequently co-occur, and understanding the overlap helps clients make sense of their full experience.

What It Is: This activity provides psychoeducation on depression and invites members to share their experience and what has helped them.
How It Helps Clients: Understanding depression as a distinct, treatable condition — separate from but connected to their substance use — helps clients see the full picture of what they’re working through.
How To Do It: Provide education on depression. Ask members who are comfortable to share their experience and discuss what has helped them manage depressive symptoms.

28. Anxiety Psychoeducation

Anxiety is another common co-occurring condition, and many clients have used substances specifically to manage it.

What It Is: This activity provides psychoeducation on anxiety and invites members to share their experience and what has helped them.
How It Helps Clients: Understanding anxiety as a distinct, treatable condition helps clients build healthier coping strategies to replace substance use as an anxiety-management tool.
How To Do It: Provide education on anxiety. Ask members who are comfortable to share their experience and discuss what has helped them manage anxiety symptoms.

29. Dual Diagnosis Discussion

Naming the reality of co-occurring conditions directly helps clients understand why their treatment plan may need to address more than substance use alone.

What It Is: This activity facilitates a broader discussion on common dual diagnosis concerns seen alongside addiction, inviting members to share their own experiences.
How It Helps Clients: Understanding that co-occurring mental health conditions are common, not the exception, reduces shame and reinforces the importance of integrated treatment.
How To Do It: Facilitate a discussion on common dual diagnosis concerns. Ask members to share their own experiences with co-occurring mental health conditions and what has helped them when struggling.

30. Mindfulness and Breathing

Mindfulness and breathing skills give clients an in-the-moment tool for managing cravings, stress, and difficult emotions without needing anything but themselves.

What It Is: This activity provides psychoeducation on mindfulness, followed by a guided meditation and practice of a specific breathing technique, such as box breathing.
How It Helps Clients: Practicing these skills in a calm group setting builds the familiarity needed to access them effectively during a genuinely difficult moment.
How To Do It: Provide psychoeducation on mindfulness, then lead the group through a guided meditation and a breathing exercise like box breathing. Process members’ experiences and discuss where they might apply these practices in daily life.

31. Fear in a Bowl

Hearing how many others share the same specific fear can be a powerful, immediate antidote to isolation.

What It Is: This activity has members anonymously write down a fear and place it in a bowl. The counselor reads each fear aloud, and members share if or how they relate.
How It Helps Clients: Seeing how many members relate to each fear reinforces that they’re far less alone in their specific anxieties than they may have assumed.
How To Do It: Have members write a fear and place it in a bowl. Read each note aloud and ask members to share if they relate, which can help validate and normalize members’ fears.

32. Drawing Coping Skills for Difficult Emotions

Visual, creative engagement can help clients connect with coping skills in a way that feels more personal than a written list.

What It Is: This activity provides a worksheet listing emotions that can be difficult to cope with, and asks members to draw a coping skill they could use for each one.
How It Helps Clients: Creating a visual, personalized reference for specific emotions makes coping strategies easier to recall than a generic list.
How To Do It: Provide a worksheet listing challenging emotions along with paper and drawing materials. Ask members to draw a coping skill for each emotion, and allow time to share and discuss as a group.

33. Recovery Cheat Sheet Card

A physical, portable reminder is more likely to actually get used in a real moment of crisis than a mental list.

What It Is: This activity has clients create a small card listing helpful phone numbers or coping skills that fits in a wallet.
How It Helps Clients: Having a tangible, always-accessible reference reduces the mental effort required to recall a coping strategy or support contact while already struggling.
How To Do It: Provide small cards or index cards. Ask members to write down helpful phone numbers and coping skills, and encourage them to keep the card somewhere accessible, such as their wallet.

34. Life Timeline

Mapping out important life experiences can help clients notice patterns between their history and their relationship with substances.

What It Is: This activity asks members to draw a timeline of important experiences in their life and share it with the group.
How It Helps Clients: Seeing their experiences laid out visually can help clients recognize connections between specific life events and the development of their substance use that weren’t obvious before.
How To Do It: Provide materials for members to create a personal timeline. Allow time to share and explore connections between the events shown and their substance use history.

35. Beautiful From Pieces Collage

A tactile, creative metaphor can land in a way that a verbal reassurance sometimes can’t.

What It Is: This activity has members create a collage from cut-up colored paper, building something they find beautiful out of individual pieces.
How It Helps Clients: The activity offers a concrete metaphor: even when life feels like it’s in pieces right now, with time and patience, recovery can become something beautiful too.
How To Do It: Provide colored cut-up paper, a larger base sheet, and a glue stick. Ask members to create something they find beautiful, and discuss the metaphor of building something whole from pieces.

36. Write Your Own Obituary

This is one of the more emotionally intensive activities in this list, and it deserves the screening described in the considerations section above before being used.

What It Is: This activity asks members to write their own obituary, then reflect on the experience.
How It Helps Clients: Confronting mortality directly, in a supported setting, can create genuine clarity about what a client wants their life and legacy to actually look like going forward.
How To Do It: After appropriate risk screening, ask members to write their own obituary. Process what the experience was like, and ask whether it brought up any changes they’d like to make in their life.

37. Two Truths and a Lie

A lighter icebreaker can help members build genuine connection with each other outside of heavier clinical content.

What It Is: This classic icebreaker asks members to share two true statements and one false one, inviting the group to guess which is the lie.
How It Helps Clients: Building genuine personal connection with peers strengthens the group’s overall sense of trust and cohesion.
How To Do It: Ask each member to share two truths and a lie about themselves. Have the group guess which statement is false, and allow members to share more about their answers afterward.

38. Unlimited Money for a Day

A playful hypothetical can reveal genuine values in a lower-stakes, more approachable way than a direct question.

What It Is: This icebreaker asks members how they’d spend an unlimited supply of money for a single day.
How It Helps Clients: Responses often reveal what members genuinely value, offering a lighter entry point into a more meaningful conversation about priorities.
How To Do It: Ask each member how they’d spend unlimited money for a day. Allow time for sharing, and explore any values or priorities that surface in members’ answers.

39. Self-Description vs. Others’ Description

Comparing how we see ourselves to how others might see us can surface real insight about identity and self-perception.

What It Is: This activity asks members to describe themselves, then reflect on how they believe others would describe them.
How It Helps Clients: Noticing gaps or overlaps between self-perception and perceived outside perception can open a conversation about which behaviors a client might want to change.
How To Do It: Ask members to describe themselves, then describe how they think others see them. Explore any changes they’d like to make to their behaviors based on what surfaces.

40. Values and Recovery

Recovery tends to be more sustainable when it’s clearly connected to what a client actually values.

What It Is: This activity explores members’ personal values and discusses the role those values play, or could play, in their recovery.
How It Helps Clients: Clients are often more motivated to sustain recovery when they understand how it protects something meaningful to them, such as family, rather than treating sobriety as an isolated goal.
How To Do It: Ask members to identify two or three core values. Discuss whether and how those values connect to their recovery, and explore ways they can lean on those values as motivation.

41. Internal vs. External Motivation

Understanding the source of a client’s motivation can help them and their treatment team anticipate where extra support might be needed.

What It Is: This activity discusses the difference between internal and external motivation, and explores both as they relate to each member’s recovery.
How It Helps Clients: Recognizing which type of motivation is currently driving their recovery helps clients and counselors identify where additional internal motivation might need to be cultivated over time.
How To Do It: Discuss the difference between internal and external motivation. Ask members to identify what’s motivating their own recovery and whether it feels more internally or externally driven.

42. Five Strengths

Clients in early recovery often struggle to identify their own strengths without prompting.

What It Is: This activity asks members to identify five personal strengths or positive traits, and discusses how these can support their recovery.
How It Helps Clients: Having a structured prompt makes it easier for clients to identify strengths than being asked to generate them from scratch, especially early in recovery when self-esteem is often low.
How To Do It: Ask each member to identify five strengths or positive traits. Discuss how these specific qualities can play a positive role in supporting their recovery.

43. Healthy Communication and “I” Statements

Clear, non-blaming communication is a skill many clients need to rebuild alongside their recovery.

What It Is: This activity provides psychoeducation on healthy communication, including the use of “I” statements, followed by role-play practice.
How It Helps Clients: “I” statements reduce defensiveness in the other person and help clients communicate their needs clearly without escalating conflict, a skill often eroded during active addiction.
How To Do It: Provide psychoeducation on healthy communication and “I” statements. Allow time for members to practice through role-play in pairs, and debrief the experience together.

44. Charades: Body Language

A playful format can make an abstract concept like body language feel concrete and memorable.

What It Is: This activity uses a game of charades to demonstrate the importance of body language, followed by a discussion of members’ own body language during group.
How It Helps Clients: Increasing awareness of their own body language — for example, closed posture that may make others less likely to open up — gives clients another concrete lever for improving communication.
How To Do It: Play a round of charades as a group. Use the activity to discuss the role body language plays in communication, including how members’ own posture might affect others in the group.

45. Healthy Support Identification

Naming specific traits of supportive people gives clients a clearer standard for who to invest more time in during recovery.

What It Is: This activity asks members to identify healthy supports in their life and discuss what specific characteristics make those people feel supportive and helpful.
How It Helps Clients: A concrete list of supportive traits helps clients recognize — and seek out — similar qualities in other relationships going forward.
How To Do It: Ask members to identify healthy supports in their life. Discuss what characteristics make those people feel supportive and helpful.

46. Isolation and Social Connection

Isolation and substance use frequently reinforce each other, making this one of the more urgent patterns to address directly.

What It Is: This activity discusses the concerns that can arise from isolation, such as depressive symptoms and lack of social support, and has the group generate ideas for avoiding it.
How It Helps Clients: A shared, group-generated list of concrete ways to avoid isolation gives clients more options than they’d likely generate alone.
How To Do It: Discuss the concerns that can come from isolation. Have the group brainstorm a shared list of things they can do to stay connected and avoid isolating.

47. Alcohol-Related Health Consequences

Concrete medical information can motivate change in a way that a general “it’s bad for you” message often doesn’t.

What It Is: This activity discusses specific health consequences associated with alcohol use, such as fatty liver, alcoholic hepatitis, cirrhosis, and high blood pressure.
How It Helps Clients: Specific, concrete medical information tends to land differently than a vague warning, and can motivate follow-up with a medical provider.
How To Do It: Provide education on the health consequences of alcohol use. Encourage members to discuss any medical follow-up they may need and answer questions as they come up.

48. Drug-Related Health Consequences

Different substances carry different medical risks, and clients benefit from accurate, substance-specific information.

What It Is: This activity discusses health consequences associated with drug use, such as lung damage, transmitted infections, poor nutrition, and skin health concerns.
How It Helps Clients: Accurate, substance-specific information helps clients understand their own individual risk profile rather than a generic warning about “drugs” as a whole.
How To Do It: Provide education on the health consequences associated with drug use. Encourage members to discuss any medical follow-up they may need.

49. Nutrition and Exercise Goals

Physical health often takes a back seat during active addiction, and rebuilding it can be a meaningful, tangible part of recovery.

What It Is: This activity discusses the importance of nutrition and exercise, and asks members to identify realistic goals in each area.
How It Helps Clients: Realistic, specific goals are more achievable than a vague intention to “get healthier,” and physical health improvements can reinforce a client’s broader sense of progress.
How To Do It: Discuss the role of nutrition and exercise in recovery. Ask members to identify realistic goals and what changes to their current routine could support them.

50. Self-Care Discussion

Self-care is easy to deprioritize during recovery, even though it plays a real role in sustaining it.

What It Is: This activity discusses the importance of self-care and asks members to reflect on their current practices and any benefits they’ve noticed.
How It Helps Clients: For members with little or no current self-care practice, exploring potential benefits — rather than assuming they already see the value — can be the more effective starting point.
How To Do It: Discuss the importance of self-care. Ask members about their current practices and benefits they’ve noticed, or, for those without a current practice, what benefits they might expect from starting one.

51. Documentary or Media Discussion

Watching addiction portrayed on screen can open a conversation clients might not otherwise start themselves.

What It Is: This activity involves watching a documentary or other media related to addiction, followed by group processing.
How It Helps Clients: Discussing a portrayal at a slight remove — rather than their own experience directly — can make it easier for some clients to open up about what feels relatable in their own recovery.
How To Do It: Select a documentary or media clip related to addiction. Process the group’s reactions, what felt relatable, and any takeaways afterward.

52. Song Sharing

Music can offer clients a non-verbal outlet for emotions that are difficult to put into words.

What It Is: This activity asks members to pick a song they enjoy, listen to it together as a group, and discuss what they connect with in it.
How It Helps Clients: Music can access and express emotion in a way that talking sometimes can’t, giving clients an easy-to-access coping tool for daily life.
How To Do It: Ask each member to pick a song they enjoy. Listen together as a group, and allow the member to share what they connect with in the music.

53. Celebrating Special Occasions Without Substances

Holidays and celebrations are common high-risk times in early recovery, and planning ahead makes a real difference.

What It Is: This activity has the group discuss positive, substance-free ways to celebrate happy occasions, holidays, or special events.
How It Helps Clients: Proactively planning for a known high-risk occasion — rather than hoping it goes fine — significantly increases a client’s chances of navigating it successfully.
How To Do It: Facilitate a discussion on substance-free ways to celebrate special occasions. This is especially useful timed around the holiday season or when a member has a known upcoming event.

54. Addiction Psychoeducation Jeopardy

Reinforcing psychoeducation through a game format helps concepts stick better than a straight lecture-style review.

What It Is: This activity uses a jeopardy-style game to review addiction-related topics, such as triggers, coping skills, and healthy behaviors.
How It Helps Clients: Gamified review increases engagement and gives the facilitator a low-pressure way to assess how well concepts have been retained across the group.
How To Do It: Develop a jeopardy-style board covering topics relevant to your group. Play as a group, and use incorrect or uncertain answers as an opportunity to briefly reinforce the underlying concept.

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

Group therapy activities for substance abuse can be a genuinely helpful tool for creating a safe, healthy group environment. Activities can encourage discussion when members are reluctant or unsure how to contribute. They also give group leaders an interactive way to deliver psychoeducation that members actually respond to.

If you prefer to run your sessions with structured handouts, TherapyByPro’s Substance Abuse Worksheets can guide discussion on the concerns most relevant to your group members.

Resources

• Substance Abuse and Mental Health Services Administration. (2020). Substance use disorder treatment: Group therapy. SAMHSA Treatment Improvement Protocol (TIP) Series 41. Resource
• Substance Abuse and Mental Health Services Administration. (2024). Opioid overdose reversal medications (OORM). Resource
• Marlatt, G. A., & Gordon, J. R. (1985). Relapse prevention: Maintenance strategies in the treatment of addictive behaviors. Guilford Press.
• Bowen, S., Chawla, N., & Marlatt, G. A. (2010). Mindfulness-based relapse prevention for addictive behaviors: A clinician’s guide. Guilford Press.
• Miller, W. R., & Rollnick, S. (2013). Motivational interviewing: Helping people change (3rd ed.). Guilford Press.
• Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395. Resource
• Beck, A. T., Wright, F. D., Newman, C. F., & Liese, B. S. (1993). Cognitive therapy of substance abuse. Guilford Press.