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Drug Counseling for Cocaine Addiction

Chapter 4 - Supervision of Group Counselors

Quality supervision is important because it provides support to the group drug counselor, helps him or her develop skills, and ensures that counselors adhere to the treatment protocol. Not all counselors will require the same amount of supervision, with more experienced counselors likely to require less intensive supervision. However, accountability is important, no matter how experienced the counselor is. The program of supervision described in this chapter was used with therapists in the NIDA-supported multisite treatment project from which the efficacy data came (e.g., Crits-Christoph et al. 1999). It is strongly recommended that counselors participate in a regular program of supervision that assesses how well they adhere to this treatment model.

Supervision as part of the research protocol involved videotaping each GDC session, having supervisors rate selected sessions on adherence to the therapeutic model, and discussing clinical issues and adherence with counselors. Supervision sessions took place weekly until counselors demonstrated consistently that they could adhere to the model, and then these sessions occurred every other week.

Supervisors used an adherence scale (see Appendix C) to rate counselors’ adherence to the therapeutic model, both for videotaped sessions viewed regularly and for an overall yearly review. The adherence scale contains three general categories of therapist strategies—Supporting Recovery, Encouraging 12-Step Participation, and Facilitating Group Participation—and a fourth category specific to either a Phase I or Phase II group session. Supporting Recovery strategies include encouraging clients to abstain from substance use and to discuss episodes of use or cravings, and giving clients feedback about their progress in recovery. Encouraging 12-Step Participation involves expressing positive opinions about the 12-Step approach, encouraging attendance at meetings, and reciting the Serenity Prayer aloud with group members. Facilitating Group Participation includes encouraging group members to give each other constructive feedback and positive reinforcement, and creating an atmosphere of trust and confidentiality. For Phase I and II group sessions, counselor adherence is rated based on the degree to which counselors facilitated group progress, with Phase I group sessions requiring more structure than Phase II group sessions.


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