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The Harvard Cocaine Recovery Project, a National Institute on Drug
Abuse-funded randomized clinical trial, was initiated in 1986 to
compare different approaches for treating cocaine abusers. Modified
Dynamic Group Therapy (MDGT), one of the models used in the study,
is a short-term supportive-expressive psychodynamic group approach
specifically adapted for cocaine addicts. While many previous
studies of substance abuse treatment were compromised by
extraordinarily high dropout rates, this approach retained nearly
70% of group members for the entire length of treatment. This book
describes MDGT and provides a practical guide to implementation.
Based on an understanding of the psychological vulnerabilities of
addicts, the MDGT model addresses the modifications in
psychodynamic technique that are necessary for addicts' needs. It
focuses on four main areas of difficulty involving self-regulation;
affect, self-esteem, relationship, and self-care problems. Both
supportive and expressive, the approach helps group members
identify, process, and modify the characterological traits that
mask addict's vulnerabilities. With this approach, a well-led group
can heighten self-esteem, improve self-care, combat feelings of
isolation and shame, and strengthen the individual's capacity for
positive change. Concomitant involvement with an individual
therapist/counselor is encouraged as a means to support and
facilitate the group therapy, especially early in group treatment,
and to maintain a flexible individual and group treatment context
for self-exploration and understanding. Bringing the model to life
are detailed vignettes and transcripts of groups in different
phases of recovery. These casesdemonstrate techniques, illustrate
technical issues, and illuminate major themes that unfold during
treatment.
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