MAC Group Therapy 5 — Questions and Answers
Question 1: Which group format is MOST appropriate for clients who are in the contemplation stage of change regarding their substance use?
- Relapse prevention skills group
- Motivational enhancement or pre-treatment group (Correct answer)
- 12-step facilitation group
- Aftercare maintenance group
Correct answer: Motivational enhancement or pre-treatment group
Clients in contemplation are ambivalent about change and benefit most from groups that explore ambivalence and build intrinsic motivation rather than assuming readiness.
Question 2: A member expresses anger directly at the group leader during a session. The MOST therapeutically productive response is to:
- Defend your clinical decisions to the group
- Acknowledge the feeling and explore what it may represent for the member (Correct answer)
- Redirect the anger toward another group member for processing
- End the session early and address the issue in a private meeting
Correct answer: Acknowledge the feeling and explore what it may represent for the member
Acknowledging and exploring the member's anger within the group allows for genuine therapeutic work on authority and trust issues common in addiction recovery.
Question 3: Which of the following BEST describes the concept of 'group cohesion' in addiction counseling?
- All members agreeing on the same treatment goals
- The sense of belonging, trust, and mutual commitment members feel toward the group (Correct answer)
- The absence of conflict among group members
- Members following every guideline established by the group leader
Correct answer: The sense of belonging, trust, and mutual commitment members feel toward the group
Group cohesion — the sense of togetherness and belonging — is a foundational curative factor that predicts positive treatment outcomes in addiction group therapy.
Question 4: When facilitating a trauma-informed addiction group, the leader should AVOID:
- Establishing clear group agreements at the start
- Requiring members to share detailed trauma narratives early in the group (Correct answer)
- Providing psychoeducation about trauma and addiction connections
- Offering choices to members about level of participation
Correct answer: Requiring members to share detailed trauma narratives early in the group
Pushing early trauma disclosure before trust and safety are established can re-traumatize members and undermine the therapeutic container.
Question 5: A mandatory drug court participant reluctantly attends an addiction group and states, 'I don't need to be here.' The leader's MOST effective MI-consistent response is:
- Remind the member that attendance is legally required
- Explore what the member sees as positive about their current substance use (Correct answer)
- Ask the group to encourage the reluctant member to commit to treatment
- Confront the member's denial directly in front of the group
Correct answer: Explore what the member sees as positive about their current substance use
Exploring the positive aspects of use (decisional balance) is an MI-consistent strategy that engages ambivalence without triggering reactance.
Question 6: The MAIN advantage of homogeneous addiction groups (e.g., all opioid use disorder) over heterogeneous groups is:
- They are easier for counselors to facilitate with less training
- Members experience greater universality and targeted skill application (Correct answer)
- They eliminate the risk of cross-addiction triggering
- They are required by most state licensing regulations
Correct answer: Members experience greater universality and targeted skill application
Homogeneous groups allow for more targeted interventions and deeper universality because members share similar experiences, challenges, and recovery pathways.
Question 7: According to SAMHSA best practices, the recommended maximum group size for an effective outpatient addiction therapy group is:
- 4-5 members
- 6-8 members (Correct answer)
- 12-15 members
- 20-25 members
Correct answer: 6-8 members
Groups of 6-8 members allow adequate airtime for each person while maintaining the interpersonal richness needed for group dynamics and therapeutic work.
MAC Group Therapy 5
Which group format is MOST appropriate for clients who are in the contemplation stage of change regarding their substance use?