This is a recommended list of “must-read” books for therapists and other mental health professionals.
The first section includes recommendations for both professionals and consumers. The next section includes suggested workbooks for therapy and/or self-help. The “Textbooks” section is comprised of required reading that I found valuable as a counseling grad student. In the “PracticePlanners Series” section, I included the planners I’ve relied on the most. The last section includes additional reads that have been helpful to me in both my professional and personal life.
Initially, the idea of group therapy terrified me. What if I couldn’t “control” the group? What if a client challenged me? What if I couldn’t think of anything to say? What if everyone got up and walked out? – which actually happened, once, by the way.
What made group counseling especially intimidating was that if I “messed up,” an entire group of people [as opposed to one person] would witness my failure.
Group facilitation wasn’t always comfortable and I made many (many!) mistakes, but I grew. I realized it’s okay to be counselor and human; at times, humans say dumb stuff, hurt each other’s feelings, and don’t know the answer.
By letting go of the need to be perfect, I became more effective. Group facilitation is now one of my favorite parts of the job.
This resource guide provides practical information and tools for group therapy for mental health practitioners.
Group therapy is an evidence-based treatment for substance use and mental disorders. An effective group calls for a skilled clinician to meet treatment standards. Professional associations, such as the American Group Psychotherapy Association, develop best practice guidelines based on scientific data and clinical research.
Want to learn more about current best practice in group work?
Additionally, SAMHSA promotes research-based protocols and has published several group therapy guides for best practice, including TIP 41: Substance Abuse Treatment: Group Therapy, Substance Abuse Treatment: Group Therapy – Quick Guide for Clinicians, and Substance Abuse Treatment: Group Therapy Inservice Training (a training manual), in addition to group workbooks/facilitator guides for anger management, stimulant use disorder, and serious mental illness.
The book itself is small in size but packed with helpful information and creative ideas. As a new counselor lacking in clinical skills, I supplemented with activities to engage the clients. Group Exercises for Addiction Counseling never failed me.
A more recent discovery of mine. This guide provides detailed instructions accompanied by thought-provoking discussion questions for each intervention. I was impressed with both the quality and originality; an instant upgrade to “house-tree-person.”
My favorite icebreaker activity involves passing out blank slips of paper to each group member and instructing them to write a “fun fact” about themselves, something no one else in the group would know. I provide them with examples (i.e. “I once had a pet lamb named Bluebell” or “I won a hotdog eating contest when I was 11 and then threw up all over the judges’ shoes”).
Depending on the crowd, you may want to tell clients not to write anything they wouldn’t want their peers to know. (I adopted this guideline after a client wrote about “sharting” himself.) Once everyone has written something, have them fold their papers and place in a container of some sort (a gift box, paper bag, plastic bowl, etc.) Group members take turns passing around the container (one-at-a-time) and picking a slip to read aloud. They must then guess who wrote it. (I give three guesses; after that, I turn it over to the group.)
A similar but more structured activity is to write out questions ahead of time and have clients take turns drawing and answering the questions. Questions can be silly, thought-provoking, or intending to illicit a strong emotional response (depending on the audience and goals for the group).
“People Search” involves a list of traits, feats, talents, or experiences. Each client receives the list and is given x amount of time to find someone in the group who is a match; that individual will then sign off. The first person to have their list completely signed sits down; they win. I typically let clients continue to collect signatures until two additional people sit down.
(Prizes optional, but always appreciated.) During the debriefing, it’s fun to learn more (and thereby increase understanding and compassion).
“First Impressions” works best with group members who don’t know each other well. It’s important for group members to know each other’s names (or wear name tags). Each group member has a sheet of paper with various “impressions” (i.e. judgments/stereotypes). For example, items on the list might be “Looks like an addict” and “Looks intelligent.” Clients write other group members’ names for each impression. In addition to enhancing a sense of community, this activity provides an avenue for discussing harmful stereotypes and stigma.
Affirmations groups can be powerful, generating unity and kindness. The effect seems to be more pronounced in gender-specific groups. There are a variety of ways to facilitate an affirmations group, ranging from each person providing an affirmation to the client on their right to individuals sharing a self-affirmation with the group to creating a self-affirmation painting. Another idea is to give each client a sheet of paper. (Consider using quality, brightly-colored paper/posterboard and providing markers, gel pens, etc.) Clients write their name on it and then all the papers are passed around so each group member has the opportunity to write on everyone else’s sheet. Once their original paper is returned to them, they can read and share with the group. This can lead to a powerful discussion about image, reputation, feeling fake, etc. (Plus, clients get to keep the papers!)
“Most Likely to Relapse/Least Likely to Relapse” works best with a well-formed group and may require extra staff support. It’s good for larger groups and can be highly effective in a therapeutic community. Clients receive blank pieces of paper and are tasked to write the names of who they think is most likely and least likely to relapse. After writing their own name on the sheet, they turn it in to staff (effectively allowing staff to maintain a safe and productive environment). Staff then read each sheet aloud (without naming who wrote it). If they choose, clients can share what they wrote and provide additional feedback. (Most do.) Clients selected as “most likely” (in either category) have the opportunity to process with other group members and staff.
Access group therapy worksheets and handouts here.
In need of fresh material? It can be easy to fall into a rut, especially if you’re burnout or working with a particularly challenging group. The following three PDF downloads are lists of ideas for group topics.
PRACTICAL TIPS FOR PSYCHOEDUCATION & PROCESS GROUPS
As a group facilitator, consider incorporating some sort of experiential activity, quiz, handout, game, etc. into every session. For example, start with a check-in, review a handout, facilitate a discussion, take a 5-minute bathroom break, facilitate a role-play, and then close the group by summarizing and providing clients with the opportunity to share what they learned.
If an experiential or interactive exercise isn’t feasible, provide coffee or snacks; sitting for 45 minutes is difficult for some, and 90 minutes can be unbearable.
Another idea is to have a “fun” or “free” group in the curriculum. Ideas include going bowling, having a potluck, Starbucks run, game group (i.e. Catchphrase, Pictionary, etc.), escape room, nature walk, etc.
DEALING WITH CHALLENGES
Clients are not always willing therapy participants; some are court-ordered to attend or there to have privileges restored. Some attendees may be there “voluntarily,” but only to save their marriage or keep a job, not believing they need help. In residential treatment, clients attend mandatory groups as part of the daily schedule — participate or you’re out.
Even when attendance is truly voluntary, a group member may be in a bad space. Maybe they’re stressed about the rent or just got into a fight with their significant other. Or what if the AC is broken and the group room is 80 degrees? What if a client has unpleasant body odor or bad breath or an annoying cough?
Multiple factors combine and it’s suddenly a sh**show. (I’ll never forget the client who climbed onto a chair to “rally the troops” against my tyranny.) Anticipating challenges is the first step to effectively preventing and managing them.
Click here for a helpful article from Counseling Today that addresses the concept of client resistance.
Tips for Dealing with Challenging Clients & Resistance in Group
1. If possible, co-facilitate. One clinician leads while the other observes. The observer remains attuned to the general “tone” of the group, i.e. facial expressions, body language, etc.
2. Review the expectations at the beginning of every group. Ask clients to share the guidelines with each other (instead of you telling them). This promotes a collaborative spirit.
3. After guidelines are reviewed, explain that while interrupting is discouraged, there may be times when you interject to maintain the overall wellness and safety of the group. (Knowing this, a client is less likely to get angry or feel disrespected when/if it happens.)
4. If you must interrupt, apologize, and explain the rationale.
5. Avoid power struggles at all costs, especially when a client challenges the benefits of treatment. (The unhealthier group members will quickly side with a challenger, leading to a complaint session.) Challenging the efficacy of treatment (or you as a clinician) is often a defense mechanism. Sometimes, the best response is simply “okay,” or none at all… and keep moving. You can also acknowledge the client’s perspective and ask to meet with them after group (and then get back on topic). If the group is relatively healthy, you may want to illicit feedback from other group members.
6. If a client becomes angry or tearful, give them time to vent for a moment or two (don’t “Band-Aid”); they may be able to self-regulate. (If they do self-regulate, share your observations and offer praise.)
7. If a client’s anger escalates to a disruptive level, ask them to take a break. At this point, their behavior is potentially triggering to other group members. Don’t raise your voice or ask them to calm down. Direct them step out and return when they’re ready. You may have to repeat yourself several times, but remain firm and calm, and they will eventually listen.
8. If a client is disrespectful (cursing at you or another client, name-calling, insulting, etc.) while escalated, let them know it’s not okay, but don’t attempt to provide feedback. (A simple, “Hey, that’s not okay,” will suffice.) Bring it up with the client later when they’re able to process.
9. Once the disgruntled client exits the room, acknowledge what happened and let the group know you will follow up with the client. If another client wants to talk about it, ask them to share only how it made them feel, but stress that it’s not okay to talk about an absent group member. (“How would you feel if we talked about you when you weren’t here?”) Strongly suggest that they wait until the person returns (and is open) to have a group discussion.
10. After a major blow-up (and once everyone is calm), it can be beneficial for the group to process it with the person who escalated. Group members can empathize/relate, share their observations and/or how it made them feel, and offer feedback.
11. If other disruptive behaviors occur in group (side conversations, snoring, etc.) address them in the moment (without shaming, of course). Point out the behavior and explain how it’s disruptive to the group. Refer back to the group guidelines. Ask group members to comment as well. If you let a behavior persist, hoping it will eventually stop, you’re sending the message that it’s okay, not only to the person who is disruptive, but to the entire group. This impacts the integrity of the group and opens things up for additional disruptive behaviors.
12. For clients who monopolize, who are constantly joking, or who attempt to intentionally distract by changing the topic, point out your observations and encourage group members to give feedback.
13. If, on the other hand, clients seem disengaged or unmotivated, seek out their feedback, privately or in the group, whichever is clinically appropriate.
14. If there’s a general level of disengagement, bring it up in the group. Remain objective and state your observations.
15. Anticipate that at times, people may not have much to say. (And while yes, there’s always something to talk about, that doesn’t mean someone is ready to or has the emotional energy to.) Maybe they’re distracted or tired or feeling “talked out.” It’s good to have backup plans: watch a psychoeducational film, take a walk in the park, listen to meditations or music, provide worksheets, education reading material, or coloring sheets.
16. Always keep in mind a client’s stage of change, their internal experiences (i.e. hearing voices, social anxiety, paranoia, physical pain, etc.), external circumstances (i.e. recent medication change, loss of housing, conflict with roommates, etc.), and history of trauma. What looks like resistance may be something else entirely.
Adverse Outcomes in Group Psychotherapy | Roback, H. B. (2000). Adverse outcomes in group psychotherapy: Risk factors, prevention, and research directions. The Journal of Psychotherapy Practice and Research, 9(3), 113–122.
Differences that Make a Difference | Change-Caffaro, S., & Caffaro, J. (2018). Differences that make a difference: Diversity and the process group leader. International Journal of Group Psychotherapy, 00: 1-15.
Group Interventions| Ezhumalai, S., Muralidhar, D., Dhanasekarapandian, R., & Nikketha, B. S. (2018). Group interventions. Indian Journal of Psychiatry, 60(Suppl 4), S514–S521.
Group Therapy for Substance Use Disorders | Wendt, D. C., & Gone, J. P. (2017). Group therapy for substance use disorders: A survey of clinician practices. Journal of Groups in Addiction & Recovery, 12(4), 243–259.
Marketers use psychological tactics to influence, convince, and even deceive consumers. This article explores some of the lesser-know marketing traps and how you can avoid them.
Marketing Tactic Traps: How Advertisers Use Psychology to Sway
I’m sure it’s no surprise when you Google “bathing suits,” and shortly thereafter, swimwear ads litter your Facebook feed. Wikipedia defines marketing as “the business process of identifying, anticipating and satisfying customers’ needs and wants.” But what about marketing tactic traps?
There’s an entire branch of research dedicated to understanding consumer behavior via psychological, technological, and economical principles. However, you may be less aware of misleading marketing tactics intended to foster false trust or play on subconscious fears.
Here’s a real life example: Recently, I used DoorDash to order breakfast from Silver Diner. I was shocked when the total came to nearly $70. Luckily, my husband was too; he suggested going directly through the restaurant. I selected the equivalent menu items and it was $30 cheaper!! DoorDash not only raised entrée prices, but charged additional fees on top of the delivery fee and tip. To think, I wouldn’t have compared prices had my husband not been (duly) outraged; I almost fell victim to “brand trust.”
Consider the companies you trust. Why don’t you question their products, services, prices, etc.? Are you brand-washed?
To avoid misleading marketing tactic traps, always compare prices, read reviews from verified buyers, avoid grocery shopping when you’re hungry, steer clear of end-of-aisles deals, buy off-season, etc.
This article explores a few lesser-known ways marketers influence consumers by using psychological principles (marketing tactic traps), and how to avoid them. When you, the consumer, know the science behind advertising strategies, you’re better equipped to make educated decisions (and will avoid feeling betrayed by a food delivery app!)
A false sense of health
Advertisers use health-related buzzwords like “gluten-free” or “organic” to lure buyers with an impression of being nutritious. In one study, consumers viewed items stamped with healthy-sounding catchphrases as healthier than non-stamped foods.
Real life example: Years ago, I accompanied a friend to the grocery store. In the dairy section, she grabbed a jug of whole milk. I knew she wanted to lose weight, so I suggested skim. Dubious, she expressed concern because it wasn’t “vitamin D-rich.” Had she consulted the nutrition facts instead of scanning labels, she would know whole and skim have equal amounts of the vitamin.
The Health “Buzzword” Marketing Tactic Trap
Avoid this marketing tactic trap by reading nutrition facts and ingredients before buying. (Sure, those Fruit Loops are made with whole grain, but the first ingredient is sugar!)
Beware of fast-paced music in a crowded store… it’s a trap!
To avoid this marketing tactic trap, remain aware of your environment when shopping and if possible, go when crowds are thin (or at least wear ear buds).
An unconscious fear of dying may lead you to buy more bottled water – and water bottle companies capitalize on it!
(Um, what? I thought the occasional 7-Eleven purchase of Deer Park was a combination of laziness and convenience on my part, not an ominous and looming fear of my fragile mortality.)
The Bottled Water Marketing Tactic Trap
In 2018, researchers asserted that “most bottled-water advertising campaigns target a deep psychological vulnerability in humans, compelling them to buy and consume particular products. Bottled water ads specifically trigger our most subconscious fear [of death].” It was also suggested that bottled water symbolizes something safe and pure – compelling when you want to avoid health risks.
According to the study, bottled water appeals most to people who measure their personal value by their physical appearance, fitness levels, material and financial wealth, class, and status.
Whether or not this study withstands replication, consider a filter!
The rationale: It’s easier for someone to visualize the comfort of a fluffy beach towel or the shade of an umbrella when it’s hot and bright (compared to when it’s pouring rain), thereby increasing the desire to make a purchase. Interestingly, this seems to hold true for sunny or snowy conditions, but not rainy weather. It was speculated that rain gear is typically purchased to avoid unpleasant conditions, not to increase enjoyment.
Be wary of the weather when shopping for that beach trip or ski vacation in the mountains; you may end up spending more than intended.
Even the wisest consumer can be “seduced.” Marketers both overtly and subtly influence our buying behaviors. Your brain will unavoidably betray you at times; you can either accept this or become a hermit. (You may also consider shopping where there are lenient return policies, but be wary of policies that seem too lenient, as this may be a ploy.)
The relaxation trap– don’t get too comfortable!
A 2011 study indicated that relaxed consumers perceived items at a higher value when compared to their less-relaxed (although not stressed) counterparts.
If you’re a bargain-hunter, stay alert to how you’re feeling before entering a store or searching on Amazon; otherwise, you may think you’re getting a great deal when you’re not. (And if you use social media, know that ads may have more sway when you’re sleepy.)
In the midst of marketing tactic traps, misleading ads, and #fakenews, stick with the facts and don’t be swayed.
A list of common questions and phrases used in therapy – includes a free PDF printable version of this resource
Do You Speak Therapist??
Therapists have their own unique (and purposeful) language. We may use clinical jargon when talking to other clinicians, but when we’re with our clients (and most likely, with other significant people in our lives), we are focused and thoughtful. We speak therapist.
Therapy is a tool for self-discovery; as therapists, it’s important to know how to effectively employ this tool. (For example, a hammer, while a useful tool, would not be effective if someone used the handle to pound a nail instead of the head.) What we say and how we say it is powerful: open-ended questions, reflections, clarifications, etc.
The following is a list of questions/phrases I find myself using in individual therapy and group sessions to explore, empathize, empower, and motivate change, including a few versions of the “miracle question” (a question used in therapy that asks the client to imagine what their life would look like if, miraculously, all of their problems disappeared and everything was perfect).
Click below to access a printable PDF version of this list.
(Updated 5/20/20) A list of movies about mental health and substance abuse – includes PDF printable discussion questions
The following is a list of movies about addiction and mental disorders that are appropriate to show in treatment settings. This post includes movie summaries and downloadable PDF handouts with questions for discussion.
Please note that some of the films on this list are graphic and may not be appropriate for children or adolescents.
Hint: The handouts contain spoilers; do not provide until after the movie ends.
Movies About Addiction & Mental Illness
Disclaimer: This post contains affiliate links. As an Amazon Associate I earn a small commission from qualifying purchases.
103 minutes (1 hour, 43 minutes), R-rating for language and drug use
Summary: Julia Roberts plays a mother, Holly, whose 19-year old son, Ben, surprises her by returning home for Christmas. Ben is newly in recovery; his addiction has placed a tremendous strain on the family in the past. Ben’s younger siblings are happy to see him, but Holly, fearing that he is not ready, is apprehensive. That evening, the family attends church. When they return, they find their home burglarized and the dog missing. Ben blames himself, believing someone from his past took the dog to get his attention; he leaves to look for the dog. Holly goes with him, but they’re later separated, and Holly attempts to track Ben. Eventually, she ends up at an abandoned barn where she finds her son on the floor, unresponsive. The movie ends with her administering Narcan to Ben.
127 minutes (2 hours, 7 minutes), R-rating for strong language and content relating to drugs, sexuality, and suicide
Summary: Winona Ryder plays Susanna, a young woman with borderline personality disorder, who is sent to a psychiatric hospital after a suicide attempt in the late 1960s. She befriends Lisa (Angelia Jolie), who carries a diagnosis of sociopathy (antisocial personality disorder). Initially, Susanna is in denial about her mental condition and is not open to treatment. However, she reaches a turning point after a tragedy.
123 minutes (2 hours, 3 minutes), PG-13 rating for mature thematic elements including substance abuse/recovery, some sexual situations, language, and brief violence
Summary: Trevor (Haley Joel Osment) starts a chain reaction of goodness for a social studies project with a plan to change the world for the better. In this film, Trevor is a high school student whose mother, Arlene (Helen Hunt), struggles with alcoholism and whose father is abusive. He rises above unfortunate circumstances with the kindhearted idea to do a good deed, but instead of requesting payback, asking the receiver to “pay it forward” to at least three people – and on and on. While the movie has a bittersweet end, the message is uplifting and powerful.
Summary: Charlie is an unpopular high school freshman, a “wallflower,” who is befriended by two seniors, Patrick and Sam (Emma Watson). The movie is about their friendship and Charlie’s personal struggles with the recent suicide of his friend and his own mental illness. Throughout the film, Charlie has flashbacks of his aunt, who died in a car accident when he was 7. It’s eventually revealed that Charlie’s aunt molested him; a sexual encounter with Sam triggers Charlie’s repressed memories. Charlie has a mental breakdown.
Other great resources for using clinical films as therapeutic interventions include the book Movies & Mental Illness: Using Films to Understand Psychopathy, 4th ed. (by Danny Wedding and Ryan M. Niemiec) and the site Teach With Movies.