Didactic therapy is generally performed in group sessions, although it can be performed in individual therapy sessions. This article will concentrate on didactic group therapy as it is far more common; however, the principles that generally apply to didactic therapy groups also apply to didactic individual therapy sessions.
In general, there are five different types of groups used in the treatment of substance use disorders. The five different types of groups include:
- Cognitive-behavioral groups or other treatment groups that are focused on gaining insight to personal issues and on solving problems
- Groups devoted to the development of specific skills
- Interpersonal process groups that work on relationships, communication skills, etc.
- Support groups that are not technically therapy groups but offer numerous benefits (e.g., Alcoholics Anonymous, Narcotics Anonymous, etc.)
- Didactic therapy groups, often referred to as psychoeducation groups
Didactic therapy groups do not actually perform specific therapeutic interventions, but instead use classroom-type techniques to help individuals learn information about substance use disorders. This information can range from understanding basic neurobiological associations with substance abuse, the signs and symptoms of substance abuse, issues regarding relapse prevention, or basic learning about specific interventions, such as meditation, anger management, nutrition, relaxation, etc. Didactic therapy is a form of instruction or psychoeducation.
The Purpose of Didactic Therapy
Didactic therapy groups are designed for the purpose of educating group members about issues related to substance abuse, behaviors associated with substance abuse, and the consequences of substance abuse. These groups are very structured, concentrate on specific content, and may use lectures, videos, or audio recordings.
Most often, there will be a group leader who will provide specific material, discuss the material, and offer instruction. The instruction is designed to be directly applicable to the lives of the individuals in the group and to:
- Suggest evidence for growth and change
- Help develop greater self-awareness about one’s substance abuse
- Identify community resources to assist clients
- Understand the process of recovery
These groups do not actually perform therapy, although the process of education is believed to be one mode of the therapeutic experience. Their major purpose is to expand the awareness of clients about the consequences of substance abuse and to motivate clients to participate more fully in their recovery. The information from these groups helps clients establish, maintain, and guide their recovery by fostering abstinence and positive choices as a result of the learning experience.
In addition, didactic therapy groups can be very useful in helping members of the individual’s family to understand issues regarding substance abuse and treatment, and to learn about resources that are available for family members of those in recovery.
Characteristics of Didactic Therapy
Many of the current models of didactic therapy are considered to be useful and even necessary components of treatment, but are not sufficient components of treatment. Often, didactic therapy is designed to address individuals at their level of need, such as individuals who may not recognize the signs of substance abuse or who may understand how relapse occurs and why it occurs so frequently. The leader of these groups typically attempts to focus the psychoeducational component at the level of the clients in the group.
As clients become more knowledgeable about issues surrounding substance abuse, they can learn new ways to address their issues and ways to increase their self-esteem. Thus, didactic therapy groups should have established clear guidelines about who the particular clients in the group are, when the members of the group are ready for a specific type of instruction, and how well the information from the sessions is being assimilated by members of the group.
Leaders of didactic therapy groups can also actively encourage discussions about the material, getting group members to reflect on the material presented and apply it to their own personal experience. This allows the leader to have group members engage in multiple group processes to facilitate learning.
Psychoeducational groups are generally fairly structured, follow a preplanned itinerary, and have limited time periods. Accommodations will often need to be made for certain populations, such as individuals with disabilities or those who need special considerations. These groups should meet in a relatively quiet and private environment in order to be effective in the same way that other forms of group therapy should be organized.
The Therapist’s Role
The therapist in didactic therapy sessions most often assumes the roles of educator and group facilitator. Members of the group typically look to the therapist as a sort of teacher or instructor. Other core characteristics of a successful group therapist should also be present, such as positive regard for others, warmth, sincerity, and empathy. The therapist should understand group processes, including:
- How people interact in groups
- Group dynamics and how groups influence an individual’s behavior
- Basic approaches to teaching material, organizing material, making material presentable, etc.
- How the group leader affects the functioning of the group
To facilitate the process, the group leader should also have a firm grasp on therapy skills, such as being an active listener, understanding how the material should meet the needs of clients, and being able to think “outside the box” at times in order to make material clearer.
Some Techniques in Didactic Therapy
Again, it should be stressed that these groups are not formal therapy groups but instead designed to transmit information that can be useful in recovery. The techniques of didactic therapy should be focused on:
- How to effectively present information
- How to assist group participants in incorporating information so it leads to improvements in recovery
- How to make the information relevant to each client in the group
In order to do this, the therapist should attempt to create an environment that supports active participation and discourages individuals simply taking notes and listening. The actual lecture should be of limited duration and the therapist should then focus on developing a group discussion of the material. The therapist should encourage the members of the group to take responsibility for their learning rather than sitting and passively listening. The therapist should develop activities, such as problem-solving exercises, role-playing, and other structured exercises that foster active learning.
Lectures should be presented with a variety of mediums, including visual presentations, auditory material, and exercises that use touch and movement. This facilitates the learning experience and makes it more relevant to participants. In addition, presenting material across a wide range of sensory mediums can help individuals who may still be dealing with cognitive issues as a result of being in the early stages of recovery. The therapist needs to be sensitive to these issues as well as other issues that individuals in recovery often bring with them, such as issues with rejection, anxiety, failure, low self-esteem, etc. The goal is to make the sessions as informative, fun, and engaging as possible.
The level of the participation of the therapist should be extremely high, and the therapist should be actively involved at all levels of the group unlike some other interventions where the therapist often takes a backseat and lets clients experience things. The sessions should be designed to last long enough for the material to be effectively transmitted; lectures can be anywhere from 15 minutes to an hour, and sessions can be anywhere from 40 minutes to 90 minutes in total length to facilitate discussion. Sessions should remain focused on very specific topics and have specific goals in mind. Therapists should outline the goals prior to teaching the material, and then summarize the material as it relates to the goals that were initially presented for the session.