Group therapy with methadone-maintained patients: Structural problems and solutions

Psychotherapy with addicts has long been an area avoided by professionals. This situation has usually been explained as being a result of the tendency of many addicts to manipulate their therapists. Since the advent of methadone maintenance in the mid-1960's, a new situation has been created in which therapists have an opportunity to work with addicts without the potential threat of being 'conned' by their patients. Many methadone programs offer their patients group therapy as an efficient way of coping with their problems under professional guidance and with their peers' support. This paper focuses on the psychotherapeutic effort, in the form of group therapy, in a particular mehadone-maintenance clinic, highlighting structural problematic areas of the group therapy process in the clinic. The paper examines nine of these areas and the way in which the clinic attempts to cope with them.