Individuals who verbalize a commitment to abstaining from substance use or who enter therapy for drugs or alcohol, may not always be committed to the same goals for therapy as significant others who want him\her in treatment. I have worked in the chemical dependency field for over 25 years and believe it is important to understand someone’s motivation level when addressing this issue. A person may believe they could control or manage their drinking. Family members/significant others could be under the impression that goal is not realistic. Or a person may not believe their use is a problem and are entering treatment to appease others. This presents a conflict in treatment goals between client (person entering treatment) and others.
A therapist’s role is to help the client clarify goals in treatment. It is important to have mutually understood goals. If, as a therapist, I am presenting tools more consistent with someone who has a goal of complete abstinence, and this individual is not committed to stopping use all together, therapy will not be successful. The first step in the therapeutic process is endeavoring to be on the same page with the client. A helpful tool I use is the motivational wheel.
Once goals are established, we come up with tasks that will help meet these goals. If a person uses substances when his/her goals are abstinence we go over the motivational wheel again. We establish if the use was: a lapse (goal was abstinence but had a slip) or decision to use (goal was not to stop and decided to use). If it is determined to be a lapse, we examine goals and determine what areas may need further focus. Lapses are not uncommon in recovery and may actually help develop focus and commitment to stopping use. If the client made a decision to use, I will explore what may have changed from the initially stated goals.
Recovery is not a event, but a journey. Each person may carve their own individual
path. It may entail some slips or challenges along the way. For some it may take longer to reach this goal than others. What is essential in therapy is that goals in treatment are agreed upon, realistic, clear, and obtainable. If a person is not committed to stopping all together, my role will be to establish safe guidelines in exploring the costs to use and impact on one’s life.
path. It may entail some slips or challenges along the way. For some it may take longer to reach this goal than others. What is essential in therapy is that goals in treatment are agreed upon, realistic, clear, and obtainable. If a person is not committed to stopping all together, my role will be to establish safe guidelines in exploring the costs to use and impact on one’s life.
