Roles

In the Intensive Recovery Program, the group structure and expectations are unique. The group is expected to hold each member accountable for their behavior, at times with confrontational "pull-ups." An older client, D, expressed her ambivalence about the confrontational style. Her behavior during the group, in which she addressed another member's behavior pattern of nitpicking other clients, was passively confrontational and designed to hurt. During her "pull up," she addressed the client's psychiatric diagnosis, a detail that should not have been shared, and tried to enlist other group members in her cause. This behavior did not match with her supposed opposition to confrontation.

Another counselor and I were leading the group in order to openly address these interpersonal problems, which came to our attention during lunch. When confronted, D not only maintained her opposition to confrontation, but criticized the group norm of holding each member accountable. She stated that she was only responsible for her behavior and the behavior of others. The other counselor agreed, stating that she is merely accountable for others' behavior. D expressed confusion about the difference between accountability and responsibility in spite of the patient efforts of the other counselor.

In order to elucidate the concept and give her perspective on her interactions with the group, I asked her what her role was in the group. She gave a circuitous response that directed the question back to her opposition to confrontation. Undeterred, I pressed her for behaviors she exhibits in the group and a metaphor for them, such as caretaker or scapegoat. She still could not think of any, so I offered a suggestion of my own, the caretaker, as she is the eldest of the group and tries to nurture others. I then connected her role with the reciprocal determinism of group interaction, in that the group impacts the individual as the individual impacts the group. This is why you are accountable for others' actions and why the counselors insist upon the maintenance of those group norms.