Treatment of drug & alcohol problems requires many skill-sets, ranging from a basic understanding of the addiction process to cultural competencies. One of these essential skill-sets is counseling. Effective counseling techniques have been identified through research and practice. These techniques can be broken down into five general categories: establishing the therapeutic relationship, facilitating the client's investment in treatment, establishing and working toward specific goals, advancing the client's knowledge of abuse and addiction and assisting the client in the development of life skills.
Establishing the Relationship
All work completed in counseling rests upon a foundation of trust and acceptance. This foundation is built by using techniques such as demonstrating unconditional respect to the client, expressing empathy, active listening (which is accomplished by paraphrasing and accurately reflecting both cognitive and emotional content expressed by the client).
Facilitating Client Investment
For counseling to be effective, the client must be invested in the process. To gain investment, the counselor must use techniques which elicit the client's investment in the process, such as motivational interviewing (a process which helps the client identify their own motivations for change), values clarification and self-assessment of long-term and short-term consequences of alcohol and drug use.
Establishing Goals
With a trusting relationship and the client now invested in the process, work can begin on identifying goals. The counselor employs techniques which support the client in setting these goals, such as assisting the client in identifying short-term objectives, exploring personal strengths, identifying available resources and personal capabilities and finding support within the client's environment. The end result of this work is the development of a plan for change that includes a relapse prevention plan, which is used to address both the external and internal triggers to substance use.
Advancing Client Knowledge
After the goals have been established, the counselor uses techniques that advance the client's knowledge about substance abuse in general, and how this information applies to the client's personal experience of addiction. These techniques include education on the damaging effects of substance abuse, objective observations of the client's thinking and behavioral patterns, and confrontation of inconsistencies between the client's goals and behavior. Depending upon the individual's circumstances, the counselor may also encourage the client to join a support group such as AA or NA to help the client in gaining more information.
Assisting in the Client's Development
As alcohol and drug use often originates as an attempt to cope with emotional or situational conditions which the client feels unable to cope with otherwise, it becomes important to address these issues of undeveloped life skills. The counselor does this with techniques such as training in anger management, assertiveness development, stress management training, building communication skills, practicing emotional coping and building decision making skills.
References
- Arnold M. Washton, PhD & Joan E. Zweben PhD; Treating Alcohol and Drug Problems in Psychotherapy Practice: Doing What Works; 2008.
- Substance Abuse and Mental Health Services Administration
