Solutions for the Treatment Resistant Addicted Client: Therapeutic Techniques for Engaging Challenging Clients

by Roes; Nicholas A

• ISBN13: 9780789011213
• ISBN10: 0789011212
• Edition: 1st
• Format: Nonspecific Binding
• Copyright: 2001-12-10
• Publisher: Routledge

Summary

This useful volume offers field-tested techniques for dealing with the most challenging types of addicted clients: hopeless clients, clients considered to be in denial, and those who are in treatment not because they desire it, but because of a mandate from an outside authority. The techniques you will learn in this book avoid generating resistance on the part of the client and are easily integrated into any treatment model. You'll also find case studies, practice worksheets, and suggestions for therapeutic tasks to assign to your clients.Visit the author's website at www.newhopemanor.org.To view an excerpt online, find the book in our QuickSearch catalog at www.HaworthPress.com.

Author Biography

Nick Roes, PhD, is currently Executive Director of a residential substance abuse treatment facility in upstate New York. Dr. Roes has appeared on hundreds of radio and television talk shows. He has written six previous books and more than one thousand published articles on a wide range of topics. Dr. Roes earned his PhD from Westbrook University in addictions treatment, and he is certified by New York State as a Certified Alcohol and Substance Abuse Counselor (CASAC). He is also a Registered Addiction Specialist (RAS) and Criminal Justice Counselor (CJC). He has been an adjunct instructor for Marist College and a guest lecturer at Rutgers University. He is also a faculty member in the Academy of Addiction Studies and is a frequent presenter of workshops to fellow professionals

Table of Contents

Introduction	1	(4)
SECTION I: MEETING THE CHALLENGE OF HOPELESS CLIENTS	5	(64)
Hope-Inspiring Reflections	7	(10)
Five Types of Hope-Inspiring Reflections	9	(1)
Hope-Inspiring Reflections: Practice and Responses	10	(7)
Scaling	17	(8)
Case Study: Workplace Wallflower	18	(3)
Additional Uses for the Scaling Technique	21	(1)
Case Study: Tipping the Scales	22	(3)
Normalizing and Reframing	25	(10)
Nonproblems	26	(1)
Case Study: To Err Is Human	27	(2)
Normalizing Techniques	29	(2)
Reframing Client Problems: Practice and Responses	31	(1)
Case Study: Progress in Disguise	32	(3)
Exploring Exceptions	35	(10)
Case Study: Exceptional Day	36	(3)
Techniques for Exploring Exceptions	39	(3)
Additional Questions and Requests for Use in Exploring Exceptions	42	(3)
Externalizing Problems	45	(6)
Turning Adjectives into Nouns	47	(1)
Externalizing by Turning Adjectives into Nouns: Practice and Responses	48	(3)
Looking Toward the Future and Clarifying Goals	51	(10)
Case Study: The Miracle Question	55	(6)
Sharing Counseling Notes with Hopeless Clients	61	(4)
Homework	65	(4)
Case Study: Stop Smoking Group Homework	66	(3)
SECTION II: MEETING THE CHALLENGE OF CLIENTS ``IN DENIAL''	69	(28)
Listening, Alternate Definitions of Denial, and Preferred Views	71	(8)
Listening	71	(1)
Alternate Definitions of Denial	72	(2)
Preferred Views	74	(1)
Case Study: Unrealistic Optimism	75	(4)
Consciousness Raising	79	(8)
Developing Discrepancy	79	(1)
Examples of Mystery Questions	80	(1)
Case Study: Backstabbers	81	(1)
Decisional Balance Sheets	82	(1)
Case Study: Decisional Balance Sheets	83	(4)
Clarifying Goals and Looking Toward the Future with Clients ``in Denial''	87	(4)
Turning Complaints into Treatment Goals	87	(1)
Turning Client Complaints into Treatment Goals: Practice and Responses	88	(3)
Other Techniques	91	(6)
Externalizing with Clients ``in Denial''	91	(1)
Case Study: The Beast Within	92	(1)
Sharing Counseling Notes with Clients ``in Denial''	93	(4)
SECTION III: MEETING THE CHALLENGE OF MANDATED CLIENTS	97	(28)
Clarifying Your Role	99	(4)
Differentiating Yourself from the Referral Source	99	(1)
Questions for Mandated Clients	100	(1)
Questions for the Mandated Client's Referring Agency	100	(3)
Preferred Views and Compliments	103	(4)
Preferred Views of Mandated Clients	103	(2)
Complimenting the Mandated Client	105	(2)
Identifying and Amplifying Change	107	(4)
Identifying and Amplifying Pretreatment Change	107	(2)
Identifying and Amplifying Between-Sessions Change	109	(2)
Turning Complaints into Treatment Goals and Promises into Treatment Tasks	111	(4)
Turning Complaints into Treatment Goals	111	(1)
Turning Mandated Client Complaints into Treatment Goals: Practice and Responses	112	(1)
Turning Promises into Treatment Tasks	113	(2)
Other Techniques for Mandated Clients	115	(10)
Scaling with Mandated Clients	115	(1)
Reframing with Mandated Clients	115	(1)
Exploring Exceptions with Mandated Clients	116	(1)
Case Study: ``I Could If I Wanted To''	116	(3)
Developing Discrepancy with Mandated Clients	119	(1)
Examples of Mystery Questions for Mandated Clients	119	(1)
Case Study: ``I Can't Believe It's Not Butter''	120	(2)
Sharing Counseling Notes with Mandated Clients	122	(1)
Homework for Mandated Clients	123	(2)
SECTION IV: BREAKING YOUR OWN RULES	125	(24)
Utilization	127	(6)
Case Study: ``She Ruined My Life!''	129	(4)
Paradoxical Interventions	133	(4)
Advocating for the ``No Problem'' Point of View	133	(1)
Symptom Prescription	134	(1)
Case Study: Learning to Lie	134	(2)
Paradoxical Pattern Intervention	136	(1)
Stop Trying So Hard	137	(4)
Forget About the Problem	138	(1)
Forget About the Solution	138	(1)
Help Your Client to Stop Trying So Hard	139	(1)
Case Study: Looking on the Bright Side	139	(2)
Other Techniques	141	(8)
Self-Disclosure	141	(1)
Write Your Client a Letter	142	(1)
Healing Rituals and Visualizations	143	(2)
Art Therapy	145	(1)
Role-Playing	146	(3)
SECTION V: QUESTIONS AND ANSWERS	149	(16)
Practical Concerns	151	(8)
Ethical Concerns	159	(4)
In Closing	163	(2)
Bibliography	165	(4)
Index	169