This paper will describe my experience attending an Al-Anon support group. It will examine the group composition, the various roles presented in the group, and the group dynamics. It will also evaluate the intervention strategy used, and the cultural competency of the group. Lastly, I describe how attending the group has expanded my development of group facilitating.
Group Description
I attended an open Alcoholics Anonymous (Al-Anon) family and friends meeting on April 19th, 2017 at 10:00 am. The meeting was held in a church and ended around 11:30 am. This was a support group for family and friends who have been affected by relatives and friends with alcoholism. There were about 20 people in attendance and the group was arranged with seats facing the front of the room. Most group members were at least middle-age or older, and most likely are parents of an alcoholic; I was the youngest member in attendance. There were a few people who may have been in their late 30’s, but overall, most members were 50s and above. There were slightly more …show more content…
females in attendance than males, which I found interesting. Some of the members were recovering alcoholics themselves, while others were only affected by other’s problems with alcohol, and did not have an addiction. As stated above, the meeting was open, meaning anyone could attend, therefore, I did not need permission or consent to attend the group. I spoke to the facilitator before the group started, and explained the purpose of me being there and that no names or identifying information would be used.
Facilitators
I will be using initials when writing about group members to protect and maintain confidentiality. The main leader and facilitator of the group, Mr. S, is a recovering alcoholic who has been sober for 13 years. He has a degree in drug and addiction counseling, and is a licensed substance abuse counselor. He has been leading this group for several years. Although he is a recovering alcoholic himself, he also has family members and friends who have struggled with alcoholism. Mrs. J is another one of the leaders; she also co-facilitates a closed Al-Anon group for women only. She did not discuss her education, but did briefly discuss her story of how she handled having a daughter who is an alcoholic. She appeared to be a big support system for the other mothers who have alcoholic children. Mr. S and Mrs. J were the formal leaders of the group, and the older members, i.e. the members who have attended this group the longest, were the informal leaders. Mr. S started the group by welcoming everyone and reading part of the twelve steps (task functions). Although this is a support group for friends and families of alcoholics, it follows similar guidelines and structure of Al-Anon meetings for alcoholics. It is beneficial for friends and family to understand the recovery process that alcoholics go through, that is, if they choose to attend Al-Anon meetings as part of their recovery. Mrs. J opened the floor for discussion and led this section of the group (task and maintenance functions). Mr. S closed out the group in the serenity prayer (task function). The members who appeared to have been a part of the group for awhile were informal/internal leaders. They had more experience in the group and commanded respect (Jackson, n.d.).
Group Observations
I discussed one group role already, internal leader, but there was an interesting phenomenon that occurred with the scapegoat role. The members’ alcoholic friends and family members were often the scapegoats, despite their lack of physical presence at the group. Members were angry at the alcoholic in their life and blamed that person for the challenges and problems in their lives (Jackson, n.d.). This was relevant to newer members, older members had more acceptance regarding the issues alcoholism has brought into their lives. It was an unusual experience for me because I played the role of the quiet one because I had to observe and not participate. Due to this, there were times I felt uncomfortable and self-conscious. There were a couple other members who rarely spoke. I did not notice any deviant group members, or those who deviated from the norm of the group (Jackson, n.d.). There was one moment where I noticed transference, when a group member was discussing their anger over having to provide and support the alcoholic’s children. They were angry about the extra stress that responsibility has caused them, and Mrs. J was taking the brunt of that anger.
I enjoyed observing the group, especially because drugs and alcohol frequently affect the families in the population I work with. I did feel odd or out of place at times because the members shared a common problem that I have not experienced. It was fascinating to feel the mood and tension in the room change from the beginning to the end of the group. When the group started, it was clear the new members felt tense, unsure, and apprehensive, but at the end it felt therapeutic, and pressure had been lifted. Since this was an open group, the group experienced several stages. For new members, it was the beginning stage; they are reserved and only discuss safe topic. Other members were in the working stage; they feel comfortable and relaxed, and are addressing their real issues. There was some middle ground, and some in the agreeing stage of group development (Maguire, 2002, pp. 134-135).
Interventions
The intervention strategy used in this support group is the 12-step mutual support intervention. The purpose of the group is to offer support for family and friends of alcoholics and recovering alcoholics. There is not a wealth of research on the Al-Anon family groups and the 12-step treatment intervention because they are challenging to research. According to research conducted by Donovan, Ingalsbe, Benbow, & Daley (2013), 12-step groups are effective in achieving and maintaining sobriety. They discovered that those who attend meetings regularly, two to four meetings per week, were more likely to remain sober for 5 or more years. The 12-step meetings also provide members with other benefits such as: greater self-efficacy, and improved psychosocial functioning. Long-term members do statistically better at improving their life and maintaining sobriety than newcomers, this supports the notion that continuous attendance of Al-Anon meetings equals a more positive outcome than no attendance (Timko, Cronkite, Kaskutas, Laudet, Roth, & Moos, 2013).
There are other treatment methods for substance abuse problems and addiction, and those affected by substance abuse, either as a user or indirectly. Cognitive behavioral therapy is another effective intervention, but its effectiveness increases when combined with a 12-step self-help/support group (Humphreys, 1999). There are several properties to the 12-step groups that make them effective: bonding, goal direction, structure, the provision of norms and role models, involvement in rewarding activities, and bolstering self-efficacy and coping skills. The sharing of experiences between members is a key component to 12-step groups, and allows bonding to take place between group members (Timko, Young, & Moss, 2012). Al-Anon support groups have been shown to reduce depressive symptoms of group members and increase their coping skills (Kuuluvainen, & Isotalus, 2013).
Cultural Sensitivity Due to the geographical location of the group, nearly all the members were white.
The biggest issue I have with the 12-step intervention is its spiritual/religious connection. That could alienate a large amount of people who do not like the God and prayer aspects of the 12 steps. Another problem with the 12-step intervention is its focus on the individual; this works well for Western and individualistic cultures, but may not be effective for those with a collectivistic culture. This intervention works well with older individuals; the average age of members in 12-step programs is 56 (Timko et al.,2013). There are Alateen groups and meetings for adolescents and teenagers with drinking problems, therefore, the 12-step intervention can also be successful with younger populations. The spiritual and religious elements may also prevent some members of the LGBTQ community from engaging in 12-step support
groups. Since this group took place in California, a highly individualistic state, it was appropriate, but the group could be reorganized for those from Hispanic or Asian cultures. In Pacific Islander and Asian cultures, the catharsis and sharing of personal troubles in 12-step groups is shameful. Most Asian Americans only attend 12-step programs when they are court ordered. A major barrier of 12-step programs for Hispanics is the lack of Spanish speaking groups, and lack of cultural-specific information and topics (Krestan, 2000). To make 12-step groups more culturally sensitive for Hispanics, there should be some groups for Spanish speakers. Family should also play a role because family is important in the Hispanic culture (Shorkey, Windsor, & Spence, 2009). Facilitating groups specifically for individuals in the LGBTQ community can also increase the cultural competence of the 12-step intervention. That way members can feel comfortable talking about their sexuality and gender alongside their alcoholism or substance abuse. In order to make this group more appropriate for Asian Americans, the individualistic language needs to be changed. It is also important to note the Asian cultures view of pathology may differ from the disease model of 12-step programs. Family is important in this culture, and viewed as a single unit. This should be incorporated into treatment, but being cautious of how issues are discussed (Masson et al. 2013).
Professional Development and Conclusion The clients at my internship agency are kinship caregivers, and often the reason for the child or children being placed with them is because the biological parents have alcohol or substance abuse problems, so this group is relevant to my client population. It was a beneficial experience because I do not have much experience with group work. I am involved in my agencies kinship support group, but it varies from the Al-Anon support group. I learned more about the 12-step intervention strategy, and its effectiveness in substance abuse with those ready to make a change. The modules on groups and observing an Al-Anon group were a good starting point for developing my skills in facilitating groups. However, I can increase those skills by attending more groups, including different group types, and asking to lead or start a group within the agency I intern at.