Group psychotherapy with spinal cord injured substance abusers

Some studies have suggested that nondisabled people follow the dictates of a 'kindness norm' when reacting to those who are disabled. Spinal cord injured substance abusers have sometimes used the kindness of others to help maintain their addictive behavior. A special unit for such substance abusers in a Veterans Affairs hospital has used group psychotherapy as one of the principal methods for moving beyond the kindness norm and challenging its patients to struggle with their substance abuse. Therapists in this group have had to become aware of the special content of denial in this population, of the role of physical problems specific to spinal cord injury, and of the need to set aside clinical issues at times in order to make on the spot responses to practical problems associated with the injury.