Chapter 8&9 in textbook
- When the consequences of drinking or taking drugs are so bad that the individual
decides to do something about their drug or alcohol use.
- Negative cycle and negative consequences have gone on for too long.
-Some users must hear the same thing from many different people to actually go through
with the life change… These people can be friends, teachers, family members, mentors,
significant others and counselors.
- Reasons for change vary between each individual.
How people can indirectly influence someone’s decision to move into treatment?
- Taking their children
- Leaving them (divorce)
How people can directly influence someone’s decision to move into treatment?
- A direct way it creating an ultimatum for the addict, if you don’t go to treatment… I’m
done with you
Counselors challenge to move a patient into treatment:
- A councilors challenge is to push the right buttons for a client to keep them down the
path of treatment
- This is a personal change that holds some key elements
- Change that is pretty sudden, like in intervention episodes where these people are
headed to treatment that day
- Needs to be sudden because it wont give people a chance to change their minds
- To gradually stop engaging in a behavior is not as effective as a sudden change.
- Moderating the addictive behavior is not seen as effective
- Usually a surprising element to this like in intervention
- Change in this case is a personal decision and therefore resistance is normal
- A form of resistance from the individual
- most common
-To maintain some sort of self-esteem ex. “My drinking never effected my children
because I never drank inside the house”) Projection
-Projecting issues onto someone else, blaming someone else for their issues)
-Used as a way to avoid responsibility, this addiction makes sense)
-Someone who looks like there engaging in treatment, what you want them to do but
behind closed doors there is a lot going on that many don’t know about)
-Use this as a way to be liked, a way people want to like them)
-Perfectionistic, things have to be just so before I go to a treatment program… ex. Really
busy time at work as soon as it’s not as busy ill go)
-See this in many cases with teens, use behavior as a way to communicate, most
provocative defense mechanism.)
- Addict is in a delusion that about the negative consequences and negative impact that
there drug/ alcohol abuses have on themselves and those around them.
- They use rationalizations to maintain the denial and delusions.
- The biggest defense mechanism
- Happens in most cases
- Impossible for the addict to change if they are still in denial
- If you cant admit there is a problem treatment isn’t helpful
- Biggest aspect of AA is a serenity prayer (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
- Procrastination is the number one reason why people do not implement change
- Exertion or effort is needed to overcome resistance and unpleasantness.
- See this in all sorts of cases
6 Styles of Procrastination:
-Waits and waits for the perfect time to take action, and because of this misses out on
opportunities for growth)
-The talker, has unrealistic expectations, talk about what they are going to do but take little action towards those dreams)
-Comes up with fearful reasons for not taking action)
-Rejects help doesn’t follow good advice and continues to have the same problems… “I
can do this on my own”)
Crisis- maker procrastinator
-Creates crisis to distract from taking the right action, they are drama prone and are too
busy putting out fires to take care of their own issues)
Over doer procrastinator
-Will focus on one aspect of the problem at the expense of ignoring the real issues)
- Used to get people to come to intervention
- Usually used for resistant clients
- Away of helping people to work through this
- It’s a mixture of a bunch of different theories (client- centered counseling, cognitive-
therapy, systems theory, and social psychology of persuasion)
- This was created because there is not only one kind of addict.
- Motivation is a readiness or eagerness to change, and you must recognize that
motivation changes or fluctuates over time.
- Very client centered
- What is their unique situation?
- Focuses on cognitive
- Helps them to build commitment and reach a decision to change (goal of this treatment)
- It also builds on systems theory, who’s that network of people around the addict who
enable them… these could be helpful to the therapist to convince the addict to go to
-Usually see a lot of ambivalence, being on the fence… going back and fourth between
treatment and no treatment
- Also an element of the psychology of persuasion
- With most clients you see motivation fluctuating
- Giving advice
- Remove any barriers between the client and therapists
- Providing choice (treatment, therapy, who’s going to call ect.)
- Decreasing desirability of the addictive cycle
- Practicing empathy, allow them to see that you are trying to understand what it would
be like, putting yourself in their shoes, and understanding where they come from - Providing feedback, taking a non directive by active approach
- Clarifying goals
- Helping active
2 view- points that come from motivation Interviewing:
- Not confronting a client about their denial gives the control back to the addict and
usually results in the continued addictive behavior and destructive pattern