Substance Abuse Counseling Program: Common Myths of the Brief Counseling Model

1. This model will not produce long-term results.

Unfortunately, most drug and alcohol programs do not have long-term statistics. We do not measure "success" by abstinence. We determine success by a client's ability to identify and reach personal and at times, externally motivated goals that will make a lasting positive change in their lives. However, because our clients set their own goals, the clients are internally motivated for change. Studies show that people who are internally motivated have a greater chance for long-term success.

2. This model is superficial.

This model is designed to meet the client wherever he/she is. This means that we may begin with a more superficial topic if the client is in the Precontemplative stage. As the client progresses, the counseling progresses as well. We identify a "missing piece" at the beginning of treatment. Many times resolving that missing piece is the only thing that is needed at that time. Other times, other issues come to the surface and are then addressed. Our goal is to allow the client to determine how much he/she is able to address during one treatment episode. This results in a positive experience in treatment, thereby increasing the likelihood that the client will seek services in the future if needed.

3. This is a five-week program.

It is often more manageable for a client who is externally motivated to agree to participate for a short period of time. This also focuses both the therapist and the client on achieving his/her goal within a previously agreed upon period of time. The treatment goals are reviewed at least every four to seven weeks (more often if needed). Many times the initial period is sufficient in and of itself. Other times additional services are necessary in order to assist the client in achieving his/her goals. The length of treatment is determined by the progress observed in the client. The clients are discharged successfully when they have completed his/her goals and have demonstrated that they have the skills to remain substance free.

We often use an "aftercare phase" following the "treatment phase." This may consist of less frequent group attendance (i.e., once per month), random urine screens to monitor abstinence, or homework assignments with periodic contact with a counselor. As with everything else, this is completely individualized upon the client's and the referral source's need.

4. This model does not work well with ethnic minority groups, and is designed for the Caucasian population.

This model works especially well with people from a wide variety of cultures and ethnic backgrounds due to its focus on individuality. This individual focus allows for the ability of the counselor to include family and community resources in the treatment plan and services. Many cultures do not sanction the use of therapy. This model supports the dependence on the family and community, and also does not support dependence on therapy.

5. Human Services and other referral sources will not get the services which they need for the legal system.

Human Services and other referral sources support this model once they understand it. This model allows a client to be in treatment for a shorter period of time which allows referral sources to see how the client reacts to life difficulties and potential relapse in the real world setting (outside of therapy). This information is vital to decisions regarding child and community safety. Referral sources support the individualized treatment philosophy and are a strong part of the treatment team. The legal system and the referral sources are viewed as a "given" in the client's world. The client is encouraged to develop realistic treatment goals which include the fact that these individuals are part of his/her life.

6. The counselors remain unaware of the "real" issues by focusing on the positive.

Because the clients feel safe and accepted, they disclose quite accurate information. We use extensive testing instruments which will also point out inconsistencies. We find that once a client has engaged in services, they voluntarily disclose necessary information. We believe that clients truly want to succeed. Because of this desire, clients ensure that the counselor has the needed information (good or bad). Counselors use the intervention of "confusion" to address inconsistencies. We find that clients are usually very aware of the issues in their lives. They have a harder time identifying strengths. It is out of the strengths that the clients find hope. It is because of hope, they are willing to take action.

7. The counselors are easily "snowed" by the client.

The counselors are alerted to inaccurate information by the testing instruments. The initial evaluation takes between three to five hours. The counselors use the intervention of "confusion" to address inconsistent data. All of the clients are required to submit random urine screens as a part of the program. This in addition to close contact with collaborative professionals provide additional objective information throughout the treatment episode.

8. The counselor will support an inappropriate treatment goal.

The counselors use the interventions of "confusion" and of "exploring the pros and cons" to clarify the client's goals. This provides a gentle confrontation or challenge to a client's unrealistic goals. The client's initial treatment goal may not be "huge," yet once it is realistic, it is a place to begin. We will also explore the treatment episode from the referral source's point of view. Many times this intervention assists the client in developing a goal which will be supported by the entire treatment team.

Last Modified: Mar 28, 2009 10:19 PM