ABSTRACT
Preparing a potential group member to join a psychotherapy group is a critical step in forming a therapeutic alliance. The chemically dependent patient may experience the challenges of withdrawal and neurological impairment that may accompany abstinence. Attention to managing the first contacts may decrease premature dropouts and treatment failures. Many prospective group members may have been coerced into treatment by spouses, employers, the legal system or medical providers. Preparation may involve agreement on tasks, agreement on goals and on establishing a bond between patient and therapist. Providing informed consent includes alerting the potential member about the likelihood of repeating dysfunctional patterns of engagement and the inevitability of reenactments. Group agreements and therapeutic contracts may become the foundation for unproductive power struggles. Selection of group members and composition of the group depend on whether the therapist constructs a homogeneous or a heterogeneous group.
