Substance Abuse Counseling Program: Theory Definitions

Brief Therapy
The term "Brief" is defined as "no more than is necessary." This is a style of therapy which requires the counselor to accurately assess what the individual client is needing in order to reach his/her goal (i.e., to identify and practice engaging in non-substance using activities). This therapy is very goal driven in that the client and counselor maintain focus on the identified goal and are constantly reassessing the effectiveness of services (i.e., Has the goal been met? Is the client maintaining abstinence from substances?). The counselor is seen in a role which is similar to a family doctor in that the client may only need to participate in therapy during which time he/she is experiencing a difficulty. Treatment is more intermittent, and the need for additional services is seen as normal rather than indicative of failure.
Compare Brief Counseling Model to Medical Model >>

Solution Focused Therapy
This is a specific type of Brief Therapy which focuses on how the clients want their lives to be in the future rather than on focusing on their current problems. By identifying and working toward how life will be without the presenting problem, the presenting problem disappears. It proposes that if a client can identify and achieve some small positive change that is meaningful to him/her, then he/she is more motivated to make additional changes. This theory focuses on behavioral alternatives to substance use and addresses what a client can do to effectively meet his/her goals. The result of utilizing this theory is that the client is more invested in change and the change can be generalized into other areas of his/her life.

Motivational Interviewing Theory
Although this theory is a problem-focused approach, we find it useful in assisting us in identifying how the client views the problem that was identified by his/her referral source. This theory states that people go through five stages of readiness for change before a personal change (i.e., a change in substance use) can be made and maintained. According to this theory "denial" is an expected stage through which a client will go during the recovery process. It proposes that the counselor must assess the client's current stage of change, and must design interventions which are congruent with the client's stage before change can be effective.

• Precontemplation: The client does not view his/her substance use as problematic. The therapist's task is to "raise doubt."
• Contemplation: The client thinks that maybe he/she has a problem, "yet probably not." The client is "on the fence." The therapist's task is to explore the pros and cons of continued use or of making a change in his/her use.
• Determination: The client is sure that his/her use is problematic and knows he/she needs to make a change, yet the client does not make any changes. The therapist's task is to assist the client in preparing for change.
• Action: The client takes action to change his/her behavior. The therapist's task is to support the client in the new behavior.
• Maintenance: The client continues to maintain the desired change over time. The therapist's task is to support the change and to explore potential problems (Emergency Roadside Repair Kit).
• Relapse: The client reverts to previous behavior. The therapist's task is to help the client to refocus on his/her goal and to resume the desired change.

Last Modified: Mar 28, 2009 10:19 PM