Stepping Stones: A Group Approach to Recovery

Guest column by Lisa Richman, Mazzoni Center

In addition to seeing clients on a one-on-one basis for traditional talk therapy, one of the highlights of my job as a therapist at Mazzoni Center is ‘Stepping Stones,’ a psychosocial support group for LGBTQ individuals with addictions that I co-facilitate each week.

The image that usually comes to mind when you hear the words “groups” or “recovery” is the 12 Step model. And while many people find these kinds of programs very helpful, at Mazzoni, we take a somewhat different approach. There are few rules involved in attending our groups – aside from the basic requirements that we respect one another, and don’t show up high.

Another key difference is that we don’t promote an abstinence-only mantra. If staying totally clean from all substances works for you in your recovery, that’s fantastic – but we don’t believe there is simply “one” way to maintain recovery. Our goal is to provide a safe space for folks to explore, to ask questions, to consider the impact of their behavior, and (with the help of the group) to establish some goals and practical strategies aimed at changing negative patterns and enhancing your overall health and well-being.

So what’s the appeal of a support group?  How does it work?

Well, there’s the elemental factor of finding strength in numbers, and feeling that you’re not alone. I believe being able to share and be heard in a supportive environment is hugely important, especially for women. In my experience, women are more likely to hide their addiction from the people in their lives, for all kinds of reasons, but certainly including shame and stigma. They may be high functioning, they may feel pressure to “hold things together” and maintain the appearance of being just fine – while in fact they feel quite differently on the inside!

Support groups are different from one-on-one therapy, in that the feedback you’re getting comes from OTHER people in recovery, not from a therapist. Of course, as the facilitator, I am engaged in the group and often become involved in the conversations. But I think the most important feedback comes from other group members, because they understand the struggles of maintaining recovery in a very personal way.

We have people in our groups who have been clean for 20 years, and others who are just starting their recovery. Regardless of where you are in the process, everyone can offer a unique and important perspective.

The format at our group is fairly open. It’s what I call a “check-in” group, which means that there are not specific topics that we focus on each week. It’s important to me that every member get a chance to share – and often one person’s story will lead to interesting conversations with the other members, and so on.  And because we’re an open group, anyone can drop in, any week – there’s no ongoing commitment.

That’s not to say we don’t take these issues quite seriously; what we try to do is offer a variety of options that can be tailored to an individual’s needs and situation. Many people struggling with addiction also have co-occurring mental health issues – often trauma – in their history. In those cases, I think it’s also important to be get some sort of individual support, whether it’s with a therapist, counselor, psychiatrist, or whoever can help.

What I’ve found is that most people who come to our groups are struggling to maintain sobriety in a world that doesn’t always value it. Particularly in the LGBT community, socializing primarily in bars and clubs is pretty common, so for someone trying to be social, or trying to date, staying sober can be a real challenge. Simply having a place where you can share these struggles with others who understand you can be a huge help.

The fact is that behavioral change is difficult – whether you have struggled with substance abuse, weight loss, cigarette smoking, or chewing your nails. That’s why our therapists work to meet people where they are in life – which can mean a lot of different things to different people.

Our goal with Stepping Stones, and our other weekly support groups, is to support clients with their immediate needs and concerns, to build relationships, and encourage folks to be open about what they’re thinking and feeling and struggling with every week.

If this sounds like something you’d like to learn more about, considering checking out one of our support groups some week.  (Click here for details).  You can also contact me or one of my colleagues, or look up the support group in your area that best meets your needs.

Lisa Richman


Lisa Richman, LSW, is a therapist in Mazzoni Center’s Open Door Counseling Program.  She co-facilitates the weekly Stepping Stones recovery support group, as well as the Living with HIV support group.




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