Treating Alcohol and Drug Problems in Psychotherapy Practice: Doing What Works by Arnold M. Washton & Joan E. Zweben

Author:Arnold M. Washton & Joan E. Zweben [Washton, Arnold M.]
Language: eng
Format: mobi
ISBN: 9781462504381
Publisher: Guilford Publications
Published: 2011-11-13T16:00:00+00:00

Prior Treatment and Self-Help Experience

In assessing patients with a history of prior treatment for substance abuse, inquiring about the particulars of these treatment episodes can be very informative. In addition to discovering when, where, and what type of treatment was received, it is important to know whether the course of treatment was completed as prescribed or terminated prematurely; whether the treatment was perceived as helpful and, if so, what aspects of the treatment were most helpful; what aspects were least helpful; for how long did patients remain substance-free after treatment; what helped them to remain abstinent; and what contributed to subsequent relapse.

In addition to seeking information about prior treatment episodes, similar information should be elicited about any past or present involvement in 12-step and other self-help programs. It is useful to know, for example, whether patients have ever attended self-help meetings, for how long they attended, and how deeply or meaningfully they were involved in a program. For patients who have attended 12-step meetings it is useful to know if they had a sponsor, worked the steps, read AA literature, did volunteer service, led or spoke at meetings. And for a patient who discontinued his involvement in self-help, what led him to drop out?

For patients who have never attended 12-step meetings or did so only for short periods of time or superficially, it is important to find out why. Many people object to AA and other 12-step programs for a variety of reasons. Some find the spiritual aspect of these programs, with frequent references to God or a “Higher Power” objectionable. Others feel uncomfortable in public meetings, do not relate to the content and philosophy of the program, or fail to identify and connect with others in attendance. It is important to explore the patient’s feelings and objections about self-help meetings without taking the position that these objections represent resistance or denial. It is useful to know about the patient’s attitude and prior experience with self-help programs so that they can be taken into account when later discussing treatment strategies and goals.

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