Cognitive Behavioural Framework
Similar to other cognitive behavioural approaches, this program is based on social learning principles. It conceptualises the client’s drinking behaviour as learned maladaptive coping strategies related to major difficulties in their lives. People with addictive behaviours often present with co-morbid mental health issues, a fragile and unstable sense of self, health problems, and chaos in their relationships due to their alcohol use.
The aim of alcohol addiction treatment is to overcome these deficits through skills training in identified areas. Skills are built through examining underlying beliefs and thoughts and teaching specific cognitive and behavioural techniques for managing difficult situations. Skills building attempts to reduce the pressure/ stress on the client and increase the client’s sense of control over their addiction and their life.
Mindfulness meditation is a core part of our treatment program, and underlies the application of most skills and strategies. Numerous studies have shown the benefits of mindfulness practice in reducing impulsiveness, improving concentration and attention, reducing stress and improving immune function. Most importantly, for people with addiction, mindfulness has the quality of helping to notice thoughts and urges without reacting to them in destructive ways.
By the time individuals reach substance abuse treatment, their relationships are generally in turmoil. Our program aims at teaching clients interpersonal skills to manage triggers and reduce stress.
Building and repairing relationships is an important part of this treatment program, and exploration of clients attachment style and ways of relating in the groups are focused upon to increase insight and awareness and allow the development of new interpersonal skills. Group programs also provide an excellent environment for participants to practice interpersonal skills and different ways of relating to others.
Respect for the client
An empathic/ non-judgmental attitude is held by the therapist in order to foster engagement and establish a working therapeutic relationship in which the client feels respected and understood.
The clinician communicates respect for the client, and supports the person’s self-worth and sense of competence. Strategies used to foster an empathic, respectful approach include reflective listening, a focus on the client’s perception of issues, and a collaborative approach to counselling.
Strengths based approach
The program takes a strengths-based approach by reinforcing and building upon client’s strengths and resources for change. This is facilitated by assisting clients to recall past successful strategies at coping with difficult situations, and commenting on the client’s strengths and successes.
Clinicians utilise general strategies that enhance motivation for behavioural change. These include
- Pointing out client’s self responsibility for actions
- ‘This is really for you to decide. Nobody can make that decision for you.’
- Eliciting motivational statements
- ‘What made you realise that you had a problem? How do you know you are ready for taking this step?’
- Exploring ambivalences
- Rolling with resistance
- ‘You want to continue drinking because it relaxes you.’