Saturday, April 3, 2021

“Must Haves” – Identifying and Discussing Basic Needs for Self-Improvement


Opening Exercise: “Gotta Have It: The small things in life”

Directions: As a group go through the following list one by one. With each item on the list, group members are encouraged to share their opinion using one of these choices:

*   “Gotta have it” - (This is something very important to you)


*   “Could live without it” – (You either are not interested at all or you could give it up or live without this if you had too)


Gotta Have It” List:


ü Morning coffee


ü Sunday football


ü A dog


ü Gym membership


ü Owning a car with driver’s license


ü 12 Step Meetings/Self Help Groups


ü Streaming video entertainment (Netflix, Hulu, etc.)


ü A relationship partner (as compared with being single)


ü Sweets


ü Newer more modern smart phone


ü Music on in the background at home when doing chores


ü A best friend


ü Regular, quality, professionally done hair cut/style


ü A book you are reading


ü A hobby


ü Continue with your own ideas: Now the group should follow this same process with everyone in the group coming up with at least one thing in life that you “Gotta have” then sharing that with the group to discuss in the same manner as the above examples




Part 2 – “Must Haves” for Progress and Goals

Directions: For this part of the exercise, the group will try to focus on more important things that are important in life as they are basic needs for goals. As a group go through each topic and group members should try to share “must haves” or basic needs that are personally important for making progress in each area. These things should be non-negotiable things you would not be willing to compromise. Discuss each one by one with everyone in the group encouraged to share at least one thought per topic if possible


Friendship – For someone to be your friend, what is one non-negotiable requirement? – Some examples provided to get the group started:

Ø  “For someone to be my friend, they have to be honest, I can’t stand liars”

Ø “To be my friend you have to be loyal and not talk behind my back or gossip about me”

Ø “I can only be friends with people who love animals

...Now as a group discuss people’s thoughts on Friendship then continue with the rest of the list:


Love (Romantic) – “For me to love someone they must….”


Serenity – “I need ____ in my life to experience inner peace”


Weekends – “On my weekends, I need to have….”


Entertainment – “What forms of entertainment are most important to you? (Reading, going outdoor, sports, binge watching, social media, music, etc.…)


Balance – “To achieve balance in life I need…”


Health – “To feel healthy in life I need…”


Safety – “To feel a sense of security in life I need” … (A guard dog, alarm system, self-defense skills, safe car in good condition, stay out of crime areas, etc.…)


Recovery (Substance related) – “To successfully manage substance use issues I need…”


Good Mental Health – “For me to be calm, stabile and regulated mentally I need…”


Happiness – “I need ___ in my life in order to be truly happy”

OTHER? – If the group is up for it and there is time, discuss other life areas in the same way



Closing Questions


Ø How do you make sure that you get your basic needs met?



1.  What specifically do you do?



2.  What skills or do you still need?



3.  Who or what can help you?



Ø What are you doing now to make sure you have your needs met?



Ø How can you improve for the future so that you have more of what you need?



Ø To close out the group, everyone should try to answer the following: “Three things that I will specifically start doing to make sure that my basic needs are met so I can achieve my goals are:










Wednesday, March 24, 2021

Icebreakers for Break Time

– Often substance use and co-occurring groups can be longer in length, especially in Intensive Outpatient Program and Partial Care and in some residential programs. In longer group sessions there is often time set aside for breaks. Quite often, depending on the rules of the program or the facility, some group members may use that time to smoke cigarettes or vape use other nicotine products. Rather than just standing around killing time smoking or vaping, the activities listed here can be given out as group assignments so that group members can use break time more productively. These break time assignments can then be later discussed and processed in the group therapy setting once group reconvenes.

Group Challenges:

Nicotine Free Challenge - Try not to smoke, vape or use any habit-forming product during the break. When you get back to group try to be ready to share what coping skills you used and what worked the best for you


No Complaint Break – Try to go the entire break only talking about positive things without complaining about anything going on in your life. Be prepared what it was like individually to go without complaining and how did this challenge affect the group as a whole while on break


Silent Break – Take a break where the entire group stays quiet and uses the time for quiet relaxation and self-reflection rather than talking. When back in the group be prepared to discuss if the group was able to do this successfully. If not, what went wrong and what was difficult. If you were successful, what was it like?


Share the Positivity – Everyone’s assignment is to spend break time being encouraging with one another. Everyone should try to focus their break time conversation on being supportive and upbuilding to other group members by letting others know what you believe they are doing well with.


Restricted Topics – The group should take break and agree not to discuss anything at all related to mental health or substances and just keep it to discussing personal interests and topics outside of the treatment goals of the program.


Individual Group Assignments:

Interview – During break time each member should spend a few minutes with another group member and do a brief interview session. When group reconvenes, everyone should discuss what they learned about someone else in the group


Interesting Discussion Ideas – Everyone in the group has the individual assignment to think of an interesting topic to discuss for the next part of group therapy after the break. When group reconvenes for therapy, there are two choices for follow up:


Ø  As a group vote on one topic that someone came up with and then discuss that topic for the next segment of group therapy time


Ø  Or rather than vote on one topic, divide up the remaining group therapy time and allow each person to discuss their topic for a few minutes (For example, each group members topic gets 5 minutes for discussion)


My Favorite – This should be an easy one. Everyone in the group should spend some time thinking about something that is their favorite (Favorite food, sports team, musical performer, etc.) Everyone should share what favorite they thought about while on break


Three Things Going Right in My Life – Everyone should come up with three things (no matter how small) that are going well in life at this time and then discuss them with the group when group returns for therapy


“I’ve Never Shared About…” – During break each person should come up with something that they have never shared in group before, but they are now ready to talk about. Discuss these when group therapy resumes


Unique – Every group member should try to come up with one or two things about themselves that they believe makes them unique from the rest of the group. Discuss when group reconvenes


I Never – Try to think of something that many people have done but you have never done that you are willing to share about when group continues


“You’re Not Going to Believe This…” – Try to think of something unbelievable that you have experienced or witnessed or know about and then discuss these as a group after break


I Don’t Know (But I Want To) – Everyone in the group should try to think about something that they are willing to admit that they don’t know or understand and then discuss these together as a group after break


Come up with an Example – Before group breaks, the group leader should come up with a topic or a descriptive word and then everyone in the group should come up with an example that they can discuss later after the break. (Some ideas – Come up with something: Weird, Funny, Puzzling, Inspiring, Fascinating, etc.)


You Lead for Five – When the group gets back together, everyone in the group will get five minutes to lead the group. Come up with an interesting way to use your five minutes where you oversee the group activity.


Cooperative Group Assignments – 

(Things the group should try to work on together during break)

Take a Vote – As a group come up with an interesting topic to vote on and then take an unsupervised vote on the topic and then discuss the outcome when group therapy resumes


Organize – This is an advanced challenge that is very wide open for a creative group. See if the group can organize by coming up with a shared idea everyone agrees with. This could involve the group coming up with any one idea (preferably something positive) that can be discussed when the group gets back together (Some examples “Lets make Taco Tuesdays where we all pool our money together and order Mexican food” or “Lets organize a talent show”)


Story Telling Idea – As a group come up with an interesting topic that everyone should be prepared to tell a story about when the group reconvenes. (For example, “Tell a story from your childhood about a time when….”)


Group Rule – As a group, come up with a group rule that will apply for the rest of the group when everyone gets back for therapy. It can be a serious rule or perhaps something amusing or anything in between as long as they group agrees on it and it is appropriate and reasonable


Commonalities – See if the group can have a discussion and make a list of things that everyone in the group has in common. Discuss the list when group resumes


Group Name – Work together as a group to come up with an interesting name for the group and then discuss this idea when group is back together


We Agree! – As a group come up with something interesting that everyone agrees on. Be prepared to discuss why you chose this answer and what it means to the group as a whole


Wednesday, March 17, 2021

Nicole Tierney on Forgiveness...

In my first blog, I remarked how much advice I received from so many well-meaning people early in my journey.  One of the most consistent and popular messages was to forgive myself. 

Let the past go.  Focus on the future.  All I wanted to do was change and find peace and so I set out to follow this advice of self-forgiveness.  Moreover, honestly it made sense.  It would also be a relief. 

I hated myself.  I had done horrible, unspeakable, things which hurt the people I loved so very much.  While I fully understand that substance use disorder is a disease which has drastic effects on one’s brain and judgment, I could not reconcile even that acknowledgement with an abdication of the things I had done to hurt others. 

So I set out to master the task of self-forgiveness, acceptance, and love.  But like chasing a butterfly, the more diligently I pursued self-forgiveness,
 the more elusive it seemed.  

Because my default cognitive response is rumination, I became obsessed with self-forgiveness.  I attended meetings, read dozens of books, completed steps, made apologies, changed, followed any and all advice about forgiving myself and letting go.  None of it worked.  Not even remotely.  In fact, in some ways, the inability to forgive myself increased my self-hatred.  

Here I was being told they key to recovery is forgiving oneself and I cannot even do that.  I felt doomed to fail and was losing hope.  I read books about forgiveness and acceptance and even decided to read the Bible cover to cover because I thought where better to lean about forgiveness.  None of this searching shed light on how I could let go of my past.  How could I ever forgive myself for hurting and disappointment so many people I loved and who loved me? 

It was a dark night, I still was not allowed to see or speak to my children and my parents, with whom I lived at the time did their best not to show their disappointment and pain, but I could sense it.  I felt so lonely.  So afraid. I felt as though I would never again feel the love and respect of my family again, and frankly, I did not feel like I “deserved” it.  I remember hating myself and realizing that if something did not change, I would likely repeat behaviors of my past.  I did not think I could take another day trying to achieve the unachievable.  I wept.  I wept for the pain I had caused my children.  I cried for the hurt my family endured.  And for the first time, I cried tears for myself too.  While the pain I caused others was atrocious, I destroyed myself during those years too.  The proverbial scars from some things that happened to me during that period, some of the things I did, are still evident today.  I could not stop crying.  That night, ever so slightly I realized that my past was a part of me and always would be.  There would be no magic wand of forgiveness and healing.  There would be no successful blocking it out and focusing on the bright horizon.  I had to learn to let the present, my past, and my hopes for the future occupy my brain and my heart compatibly.  I still hated every single thing I did but I learned to appreciate all the results of my actions and not only focus on the bad that came from my past.  Likely you just had to reread that’s sentence.  I know it sounds counterintuitive, but in fact, out of the most horrible actions, came the most necessary, painful, yet beautiful growth.  

There was no way to not acknowledge that who I was today was based on who I was yesterday.  Balancing has never been (and likely will never be) a strong suit of mine.  But I had to learn how to have who I was, who I am, and who I want to be peacefully coexists with all parts be accepted.  There were days when too much of my brain and heart were filled with the negative parts of the past, and that was where the work needed to be completed.  

I needed to not to forgive myself for my past, but learn lessons, and use my past as motivation and a reality check at times.  I needed to thank my past too.  This realization about not having to forgive myself provided me so much peace, so much contentment.  It has taken years, but I realized so slowly that self-love has to be unconditional and genuine.  So while I do not love what I did (in fact I still hate it) I love myself.  All of myself and that includes the past.  

This is how I have reconciled hanging on an letting go.  Learning and living.  And most of all, continuing, always to grow.  

Follow up questions for groups:

What can you identify with from this reading?

If you are willing to share, what are some things you are working on when it comes to forgiving yourself?

What can you personally do today to work on self-forgiveness, letting go and increasing your ability to forgive and love yourself and who you are today?


Friday, March 12, 2021

Low Hanging Fruit

 Why not start with the easy stuff?

Intro – The focus of this activity is for people who are just getting started making changes toward substance use and mental health treatment goals. Start by discussing the following points about low hanging fruit

Low hanging fruit is a common metaphor that refers to doing the simplest or easiest work first. Just like the phrase sounds, fruit that hangs low on a tree is the easiest to grab with the least effort.


Especially with more difficult tasks or dealing with a long-term process, it makes sense to start going after low hanging fruit first. Why not try to go after and get what is within reach early on?


Successfully going after low hanging fruit can bring some quick results that can fuel motivation to keep going

Discuss and make personal application: In your personal situation, how can going after low hanging fruit help you personally to start to achieve all of these things?

Kickstarting motivation

Build up and increase early momentum

Fuels and stimulates important feelings of encouragement and inspiration

Empowering (Yes - I can do it!)

Decreases discouragement (Helps avoid the feeling of wanting to give up)

Identifying Low Hanging Fruit for Your Goals

Directions: Start by identifying two or three (or more) areas where you have goals for positive change (Substance Use, Mental Health, Relationship, Social, Employment/Education, Financial, Family, Health, Other)

Under each life area are some examples of low hanging fruit: (Things you can reach for early in the change process to start making progress). Discuss any that you may have already achieved and then choose a few more that you can strive for soon, from the examples provided or come up with your own ideas.

Substance Use 

  • Clear home of booze/drugs/paraphernalia
  • Delete dealers contact info from phone
  • Sober support- Try to go to a meeting or schedule time with someone who is doing well
  • Find and try a sober hobby
  • Medication Assisted Treatment (Suboxone, Methadone, Vivitrol etc.)
  • Other?

Mental Health

  • See a counselor for individual therapy
  • See a prescriber (APN/psychiatrist)
  • Practice a basic coping skill every day – Relaxation skills – Self-care – Stress management
  • Other?

Close Relationships

  • Basic conflict resolution skills
  • Assertiveness/boundaries (learn to say no)
  • Couples/family counseling
  • Other?

Social Functioning

  • Therapy to learn about self, manage anxiety, increase self esteem
  • Prescriber – medicine for social anxiety?
  • Learn and start to practice basic social skills


  • Schedule family therapy session
  • Increase daily effort to openly communicate your feelings with family peacefully
  • Other?


  • Go online and look at application process for school or training program
  • Research a course of study that interests you
  • Other? 


  • Work on a budget
  • Other? 


  • Start a job search
  • Fill out some applications
  • Other? 


  • Exercise
  • Join a gym
  • Research and start a healthy hobby
  • Plan a diet
  • Other? 

Basic life improvement – Other easy life improvement ideas?

  • Organize daily structure – Use a daily planner
  • Organize home environment and chore schedule
  • Other? 

Closing Discussion – Summarize your goals and go for it

Evaluate your successes: What are some examples of low hanging fruit that you are already doing well with?


Overcome obstacles: Be honest: What are some examples of low hanging fruit that you know that you really should be going after but for some reason you are not?


Consider and discuss some possible causes of not going after low hanging fruit. Do any of these apply in your situation?


Procrastination- (I’ll do it tomorrow)

Just not ready (hesitant, anxious or afraid of change?)

Headstrong/Unmotivated (I just don’t want to)

Denial/Lack of insight (Deep down I still don’t believe that I need to change)


Go for it: What are one or two (or three?) low hanging fruit goals that were discussed in this group you can commit to trying to start today?