Group Work for Men In Sexual Recovery: A Strategic Model for Sex Addicts. Carol Juergensen Sheets aka Carol the Coach

trauma.

      •Understand the connection between their trauma and compulsions as they create their autobiographies.

      •See the similarities and differences as they hear each other's histories.

      Many men are hesitant about group therapy. "Will I be accepted?" "Will anyone else understand my problems?" "I am afraid to let anyone see the real me." These are common thoughts that men experience. In Week 2, the therapeutic container continues to be formed so that the men begin to learn and trust that they are not alone in their pain and that they're not going to be judged. These early stages of group process are vital to creating a healthy and effective group for the men. Sometimes a very highly anxious beginner may start, and then it is important to encourage him not to reveal too much so he does not scare himself off.

      Build Trust and Rapport through Appropriate Self-disclosure

      Week 2 continues the process of men self-disclosing in non-threatening ways. Men are encouraged to share why they entered treatment initially and what was their motivation to come to a men's recovery/therapy group. Allow men to hear and identify common threads. As the men introduce themselves, it is important to begin to identify the similarities they have with the other group members. This begins to reinforce the connection as well as build trust and rapport. Typically, a shy, quiet or reluctant member will wait until the end to share. We often ask him first to identify the men in group who disclosed similar details in their lives or are experiencing similar feelings. That way, he has already identified the men with which he feels a connection. You may need to draw on the similarities he shares with other men throughout his process depending on how readily he involves himself with the group.

      Setting Structure, Safety, and Commitment

      Safety is a universal issue with groups. Having a set structure and clear expectations reinforces the sense of personal safety and reaffirms each man's level of commitment to the group.

      Check-in

      We provide the Check-in format used in future groups to allow men to share how they are doing and request time to work on their personal issues. The format is quite simple and is as follows:

      •Tonight, I feel __________ (mad, sad, glad, lonely, or afraid). This inquiry keeps them focused on the present and helps them with feeling identification which seems to be a difficult process for men to identify.

      •Brief description of the past week. It is helpful for them to state in 5 sentences (or less) a summary of their week. This keeps everyone on track, helps to provide the therapist a synopsis of who may need group time, and lets all group members see a snapshot of each member's crisis or dilemma.

      •Number of sobriety days. I have found in group that this decreases the chances that a man will slip or relapse and avoid telling the group.

      •If I were to work tonight, I would work on __________.

      Claiming Group Time

      Most men have been discouraged from appearing needy; therefore they may repeatedly go last. An assignment may be to have them go first to process how it feels to seek out the attention of the group. As they share their stories they tend to avoid their feelings and emotions. We believe that all emotions fall into one of the five feeling categories: Anger, Sadness, Happiness, Fear and Loneliness. Force them to pick one! (See Appendix A for Feeling Identification article)

      Although many treatment centers might add guilt or shame to the list of 5, it is my belief that when dealing with addicts guilt and shame are inherent in all of the addicts' experience and therefore it is necessary to experience the 5 primary feelings underneath the guilt and shame to move them into action.

      The group members will typically want to pick several feelings that they are currently experiencing, so encourage them to pick the primary feeling so that they can use it to catapult them into change. If a group member is verbose, limit the amount of details he shares. The details paint the picture and set the stage, but are not the essence of healing and recovery.

      This group is not a support group like Sex Addicts Anonymous where members get to pass or even where everyone gets to check in. Men must know that in each group, they need to expect to do work, and if they don't speak up, they will likely miss out. It is not selfish to "claim time," it is self-caring. Group ends after ninety minutes. If a man has stayed quiet or avoided an issue, it is his loss. Stress accountability for each man getting his needs met. If a man consistently stays quiet, I may assign the group member to check in first next week. It is also important to recognize that as a facilitator, it is a clinical right and responsibility to push a man to address a therapeutic issue. These points are reinforced as we review the rules and expectations.

      Establishing Rules and Expectations

      We end the group by reading the Rules and Expectations for Group. Ask each man to read one section and the facilitator will add any editorial comment as necessary. Predict ambivalent feelings yet stress their commitment to the 15-week group! Also, highlight what we know about therapy and life – the more you put into it, the more you get out of it!

      Connecting Outside the Group

      Unlike some traditional therapy groups, we encourage men to socialize and connect outside the group setting. By Week 2, we ask the men to voluntarily list their name, numbers, and home/email addresses and we circulate these to all the men. This gives them the ability to connect early on in the process if they so choose.

      Accountability Commitment

      In future groups, you will find that the phone list is also used for accountability purposes. A man who has extreme cravings including exposing himself or wanting to have sex with transgendered partners, is asked to call the man he admires most in group before he acts out. This commitment to the group assists him in making healthy decisions and provides an extra tool for him to use. As you can imagine, this list also serves as a tool providing valuable diagnostic information.

      Document Accountability

      There may be a man who is in need of going to extra 12 Step meetings and must list on the dry erase board how many meetings he went to each week. Not only does this reinforce his accountability to the group, but it also provides an opportunity for the group to acknowledge and validate him.