By Ben Lerner. Clinically reviewed by Kris Blount, Clinical Director.
When most people picture addiction therapy, they imagine one person, one therapist, and a couch. At Willow Grove Recovery in Palmyra, Tennessee, residents meet one-on-one with their therapist once a week. Group therapy runs about eight hours a day.
That ratio says a lot about how therapy actually helps people recover. I sat down with our clinical director, Kris Blount, to talk through what happens in those hours, which approaches our therapists use, and what it looks like when someone starts to change.
Therapy Starts With a Plan Built Around One Person
Every resident gets a client-centered treatment plan after detox. The first job is understanding what led to the addiction in the first place.
“Sometimes addiction may come about as a response to a lifetime of trauma or some incidents of trauma,” Kris told me. “Sometimes clients will experience trauma as a result of the substance that they were using. So again, it becomes that cycle.”
From there, the plan is built in steps. “You can’t jump from first floor to third floor,” she said. “You have to build the steps in.” Early steps might be as simple as learning the names of the people in your group and learning to tell your story.
Why Group Therapy Does Most of the Work
“At Willow Grove we are very focused on group,” Kris said. “Group is an evidence-based treatment practice.” Residents move through several kinds of groups each day.
Process Groups
These are where residents talk through what they’re dealing with right now. Kris prefers to hold them early in the day, while people are fresh and have time to think things over afterward.
Psychoeducational Groups
These teach. Topics include the role of addiction, family dynamics, how trauma shapes our reactions, how anger affects communication, and healthy ways to respond to grief and disappointment.
Experiential Groups
Willow Grove has goats, chickens, and a garden on campus. Residents also do ice baths, an anger wall, volleyball, and basketball. Kris explained why that matters: “Taking a basketball game, for example, it teaches teamwork, it teaches how to deal with frustration, it teaches getting disappointed, and you have to deal with all those things in real time with real people.”
Your Problem Is Less Unique Than It Feels
Here’s my own take on why group works so well.
Addiction convinces people that their situation is special. Their pain is different, their story is different, and so of course nothing has worked for them. That belief can turn into a kind of entitlement about suffering, and it becomes the reason there’s no solution.
Group therapy blows that up. You sit in a room with people who have felt exactly what you feel, and you realize millions of people are dealing with addiction. It’s human nature. And if it’s human nature, then the tools that worked for other people can work for you too.
Individual and Family Therapy
The weekly one-on-one session is where residents work on the specific issues they may not be ready to bring to the group.
Family therapy happens as needed. Often that means couples therapy, which Kris says “may be the first time that they have been able to sit down and have some real communication in a long time.” When it’s clinically appropriate, adult or teenage children can join too, since the whole family has been affected.
Therapy Approaches Used in Treatment
Willow Grove’s clinical programming is evidence-based. Approaches our therapists draw on include:
- Cognitive behavioral therapy (CBT), which helps people recognize and change the thought patterns behind their use
- Motivational interviewing, which helps people find their own reasons to change
- Grief recovery work
- Trauma-focused options such as EMDR and trauma yoga
- Vulnerability work inspired by Brené Brown’s research
Kris leans heavily on motivational interviewing. Instead of telling someone what they should want, she asks questions like, “Tell me what life would be like for you if your relationship with your child were different.” The person starts describing that future themselves, and that becomes something worth working toward.
What Therapists Do When Someone Won’t Talk
Plenty of people arrive unwilling to discuss their past. Kris doesn’t push them into the details. She talks with them about the avoidance itself: why they’re avoiding it, and how it feels to avoid it.
“I have found in a lot of cases that as I’m talking with them about why are you avoiding it, how does it feel to avoid it, they will start to self-disclose,” she said.
She told me about a young person in a recent group with an extensive abuse history who avoided the subject again and again. She shifted the focus to how it had affected them and how it made them feel. Then other group members spoke up, saying they remembered feeling the same way, and that after working through it they now had hope, courage, and assertiveness. That gave the young person hope too.
She also uses analogies. Someone who’s been told they’re broken might hear her describe a clay jar that’s been dropped and glued back together, and how that jar ends up stronger, more beautiful, and held together by the glue.
When Someone Has Been to Rehab Before
People who have been through treatment several times can become what Kris calls “treatment savvy.” They’ve sat through enough groups on CBT and motivational interviewing that they could lead one, yet the material never reached them personally.
Her answer is to make it individual. Rather than repeating the standard relapse prevention steps, she asks what each step would look like for that specific person. She also pairs experienced residents with newer ones, and leans on hands-on activities so people can practice the skills instead of reciting them.
What Change Looks Like
Kris loves watching people progress. Many arrive with no eye contact, disheveled and sick. As they get through detox and start engaging with peers and staff, “you can see the spark come on in their eye. You can see the confidence begin to grow.”
She has a phrase she tells residents often: “Head up, shoulders back, walk through it. You are beautiful. You are capable.”
If You’re Worried About Someone You Love
If you’re reading this late at night because someone in your family can’t stop drinking or using, call our admissions team at (931) 410-6400. The line is open 24/7.
Admissions can walk you through the next steps, and if your loved one isn’t ready to accept help, they can connect you with an interventionist. Willow Grove accepts Ambetter, Blue Cross Blue Shield, and UnitedHealthcare, and admissions can check your coverage on the call.
