60 MORE Substance Abuse Group Therapy Activities

We previously posted a list of 60 substance abuse group therapy activities to give readers an idea of what kinds of topics they might encounter during a theme/support group.

We received positive feedback on the list, so we found 60 more to keep you inspired!

Please note that Two Dreams utilizes process groups as opposed to theme/support groups. Process groups are focused on self-exploration and giving/receiving feedback. They provide a safe environment in which members can practice newfound interpersonal skills and behaviors. Process groups are mostly unstructured with no singular topic of discussion. Theme groups are focused on support and finding commonalities between members. They tend to have more structure than process groups and focus on a single topic.

Two Dreams prefers to hold process groups in order to enhance the holistic treatment experience and to help clients equip themselves with the tools needed for their own recovery.


60 MORE Group Therapy Activities

  1. Practice trusting your fellow group members by having one person wear a blindfold and another person help them to complete a task without the use of vision. Tasks might include walking through an obstacle course, drawing a picture on a blackboard, cleaning up objects off the floor, etc.
  2. Write down a list of worries and/or fears, then tie the list to a balloon and release it into the air to symbolically let go of your burdens.
  3. Imagine the group is going to a deserted island and can only bring ten items. Decide as a group which ten items to bring.
  4. Discuss the meaning of friendship. What makes someone a true friend? What makes someone a fake friend? How much should friends be involved in your recovery process? What would you like your friends to do to help you, and are they doing anything to help you already?


  5. Write a list of your gifts, strengths, and talents. Then write a list of problems or issues that concern you, such as world hunger, animal cruelty, homelessness, etc. Draw connections between your strengths and your problems, suggesting ways you can use your personal talents to make the world a better place. Share your lists and ideas with the group.
  6. Discuss self-harm. What constitutes self-harm? What are some of the reasons people choose to self-harm? Is substance abuse a form of self-harm? Brainstorm a list of activities to do instead of self-harm, should the temptation arise.
  7. Decorate the outside of a box with words and images that represent the side of yourself that you show to the world. Decorate the inside of the box with words and images that represent the side of yourself that you keep hidden from the world.
  8. Discuss the role of religion in substance abuse and recovery. Is religion necessary for recovery? How do faith and religion differ? Is the Higher Power referenced in 12-step programs necessarily a religious icon?
  9. Pick an individual with whom you have a strained relationship. Write a list of bad things you wish would happen to them; really vent your emotions. Then write another list of ways you hope they can change for the better and grow as a person. Share both lists with the group and discuss your emotions.
  10. Decorate a mirror with compliments and self-loving mantras.
  11. Discuss how anger makes every part of your body feel. How do your eyes feel? How does your neck feel? How do your hands feel? Etc. Brainstorm ways to relax and “cool down” each part of the body when you feel angry.
  12. What is your spirit animal and why? What qualities do they possess that you have? What qualities do they possess that you wish you had? Do you physically embody the spirit of this animal, or are the qualities you admire those that you wish others saw in you, or those that you feel inside?

    Sprit animal dolphins

  13. Think of something you know how to do really well and write down step-by-step instructions so that someone else could read them and do the task as well as you could. Share your talents and knowledge with the group.
  14. Discuss the following sentiment: our emotions are the only things that are real in this world; everything else is just a perception.
  15. What makes you laugh? What makes you cry? Do you think your emotions should have the power to control your actions? What can you do to take that power away?
  16. Make a vision board with images and words describing your hopes and dreams for the future. Share with the group.
  17. Discuss the following quote: “There are two ways of spreading light: to be the candle or the mirror that reflects it,” Edith Wharton. Do you think you act more often as a candle or a mirror? Do we choose our own paths, or are others to blame?
  18. Are humans inherently bad or good by nature? Draw or decorate your own mandala, and/or draw positive things next to negative things, ex. a rain cloud watering beautiful flowers. Discuss the intertwining nature of good and evil.
  19. Everyone in the group should write their name down on an individual piece of printer paper, then pass the paper around for each member to write compliments on. Discuss the importance of group support.
  20. Is breaking the law ever justified? Why or why not? Dicuss Kohlberg’s six stages of morality…do you do the right thing to avoid punishment, gain reward, be regarded as a good person, because you believe in the law, because you believe in social contract, or because you feel what is right/wrong in your heart?
  21. Draw a picture of your “inner critic.” Give this sinister character a name, exaggerated features, and speech bubbles containing self-criticisms. Try to think about this character talking to you whenever you find yourself being self-critical. Talk to the character and tell them to leave you alone.
  22. “Steal” a line from a poem or book you’re particularly fond of and expand on it in your own way, writing new lines to follow.
  23. Draw a bubble around your name to symbolize a boundary of personal space. Inside the bubble, write how it feels to be inside the comfort of your boundaries. Write what you like about your bubble. Write why we all need bubble boundaries and how we can respect our bubbles, as well as the bubbles of others. On the outside of the bubble, write how it feels when people disrespect your personal boundaries. Write down things you can do or say when someone is not respecting your personal space.
  24. Share negative personal statements followed by “but…” positive statements. For example, “I am needy, but I am also loving,” or “I eat too much unhealthy food, but I’ve started meal-prepping.”
  25. Think about your qualities in terms of the four elements: Earth, Air, Water, and Fire. Share your lists with the group, and help others identify their elemental qualities as well.

    Stone circle

  26. Discuss the quote, “God grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.” What things in your life can you change? What things can’t you change?
  27. Think about your daily routine and brainstorm self-care activities you can incorporate into the schedule. For example, during your commute to work you can listen to a positive podcast or book on tape. While you’re watching TV you can do yoga.
  28. Describe the strangest dream you’ve ever had. Describe the best dream you’ve ever had. Describe any dreams you’ve had related to substance use. What do you think these dreams mean? Are your dreams trying to tell you something?
  29. Write a mock obituary for yourself. What would it say? What would you like it to say? What would others write for you and what would you prefer them to write?
  30. If your house caught on fire and you could only save one thing before escaping, what would it be? What does this say about your values?
  31. Describe your “happy place” in detail to the group. Why did you choose this place? Is it a real place, or imaginary? Do other group members have similar visions?
  32. People tend to act differently around different groups of people. What sorts of personalities do you embody around your friends? Family? Romantic interests? Strangers? Which “you” is most representative of your true self?
  33. Try “freeze and change” acting in which two people start improvising a scene using dynamic movements and when another group member sees a pose that inspires them to change the scene, they yell “freeze!” and take the place of the frozen actor. They then start acting out an entirely different scene and the other actor must adapt to their new scenario. Discuss adaptation and flexibility.
  34. Write a letter to someone with whom you have conflict; express everything you would like to say to them in person but shouldn’t.
  35. Write a breakup letter to your drug of choice. Detail the reasons why you cannot “be together” anymore.
  36. Can utopic societies exist? Would you want to live in a society that is, by definition, “perfect?”
  37. What is your biggest fear? Have you ever had to face this fear before? Was it as bad as you thought it would be? How did you handle it and/or how can you handle it in the future? What steps are you taking to stay in control of your emotions and fears?

    Scared of heights

  38. When are words not enough to resolve a conflict? What actions can you take in these situations to help resolution? Can you rebuild trust and/or love once it has been broken? How so? What constitutes a good apology?
  39. Write a list of small things you can do to make someone’s day better. For example, you could pay someone a compliment or smile when you pass someone on the street. How does helping others, in turn, help you?
  40. Describe one of your biggest goals in life. Break down the goal into small, concrete steps and draw a road map to success. Does the goal seem more manageable in tiny pieces?
  41. Write a letter of love, support, and encouragement from your future self.
  42. Draw an “emotional reset button” as a visual reminder that you control you emotions and can change them on command. Brainstorm techniques for quickly resetting your emotions when the situation calls for it.
  43. Discuss the importance of having alone time. What do you like to do in your free, quiet time? What are some other activities you could pursue to enhance that time? Do you have a private place you can go when you need to be alone? How long should your alone time last, and can you set aside this time every day in your schedule?
  44. How do you reward yourself for good behavior? When does rewarding good behavior become excessive? Make a list of small goals and pair them with reasonable rewards for completion.
  45. Make a list of excuses you can use to get away from bad situations or to escape when you need a moment to calm down.
  46. Write down a series of different negative emotions (sad, lonely, left out, etc.) and under each make a list of ways your support system can help you out.
  47. What would you do if you saw a friend being bullied? What about a stranger? What can/should you do in those situations?
  48. Do you typically see the glass as half full or half empty? If you see the glass as half empty, what can you do to change your perspective? How does perspective relate to the choices you make in life?
  49. Are you an introvert or an extrovert? What is the difference? Is one better than the other? Can an introvert become an extrovert, or vice versa? Can introverts and extroverts get along?
  50. Pick one new habit that you want to focus on. Why did you pick this habit? How will it help you become a better person? Make a chart or calendar to note every time you engage in your new habit. Set a goal and an intention.
  51. Who would you call in case of an emergency? Who would you call if you won the lottery? Did you pick the same person in both instances? Why or why not?
  52. Start an affirmation journal. Record your positive traits and actions. Help others by suggesting affirmations to include in their own journals. Discuss the power of positive affirmations.


  53. Discuss trust. Who do you trust? Is it difficult to open up and trust someone? Why or why not? Can trust be recovered once it is broken?
  54. Make a list of ways to feel “high” without the use of substances.
  55. Where have you travelled and where would you like to go? Discuss the important of exploring different places and cultures.
  56. Discuss respect. What is respect? What does the word “respect” make you think of? How do you show respect? How can you recover from feeling disrespected?
  57. Discuss situations in which you’ve had to be the “bigger person” and do the right thing even when others are doing the wrong thing.
  58. When is it better to walk away, rather than to argue?
  59. Are you holding onto any grudges? What are they? How can you move past them and let go?
  60. What do you do when you get discouraged? Brainstorm productive ways to cheer yourself up and get moving again.


If you liked this list, please feel free to share it or link to it! Also, please leave a comment below if you have other ideas, or would like to add to the discussion.

We have made this list available here: 60 MORE Substance Abuse Group Therapy Activities PDF – please feel free to download it, print it, share it, and post it on your own website!

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Click here to view the original list of 60 Substance Abuse Group Therapy Activities.

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