Drug Rehab Counseling
Most drug rehabs employ addiction professionals who are competent in one or more of the fundamental types of counseling skills required for therapeutic interventions. These skills include creating a rapport with the client, in addition to engaging with the client to create a therapeutic relationship. All clinical staff must be genuine and not pass judgment on the client; they should also always treat the client with respect and practice active listening techniques during sessions.
Therapists in drug rehab must be non-threatening and able to handle a patient’s potential ambivalence about abstinence without frustration or stress. An addiction professional’s ability to relate to a patient with empathy, genuineness, respect, and warmth is vital to recovery. Since many patients in drug rehab have just recently stopped using drugs, therapists tend to confront them without judgment and educate them despite the patient’s tendency to deflect information.
Most recovery from drug addiction occurs in an intensive setting, be it inpatient or outpatient rehab facilities. Financial restrictions or family and work obligations can prevent a patient from getting the most comprehensive and effective drug treatment currently recommended by the addiction professional community; in these situations, wasting time on methods that do not work can have disastrous consequences. As such, it is essential for staff to be able to recognize when a particular type of counseling or therapeutic intervention is not working for a client. Being vigilant about a client’s reaction and responsiveness to the current treatment modality results in quick modifications to the treatment plan. Addiction staff must be secure enough in their own abilities to refer a client to someone better able to help a particular client that he or she, for whatever reason, has failed to reach. The best clinical professionals work as part of a team and are willing to either assume or relinquish control over a patient’s treatment where appropriate.
Given the limitations in resources available to pay for treatment or time available to participate in the intensive part of the process, addiction treatment staff members are often faced with preparing patients for the fact that some of the issues brought forth during the assessment may not be addressed during the current course of treatment. For instance, the patient’s anticipated length of participation may not be long enough to address a specific issue or engage in a particular therapeutic intervention. In other cases, it may be that there is not enough availability on a specialist’s calendar to see every patient for the amount of time required to resolve an issue.
Since many patients will likely have to address issues other than just their own substance addiction (for instance, underlying mental health diagnoses), it may be that treatment staff elect to stabilize the substance abuse during the intensive program before moving on to more complicated issues. In addition, many patients will also require the therapist to engage important players in the client’s life; staff may need to engage family, friends and employer. Ultimately, staff will time different therapeutic interventions such that the intensity of the particular intervention is enough to allow the patient to reach closure on the most serious issues before discharge.
Addiction professionals in the best drug rehab programs have experience dealing with clientele from different cultures, religions and socioeconomic strata. They are also committed to referring clients to recovery resources in their community after discharge and often network outside of the facility in order to develop relationships with other treatment providers. In some cases, drug rehabs will employ counselors and other staff who have also gone through recovery. Although people in recovery can be invaluable resources for the newly sober, these staff can struggle with remaining objective and not over-identifying with their patients. It is especially important that these staff members realize that not all patients will respond to substance abuse treatment the same way that they did. The best therapists understand that part of recovery is allowing each patient to develop this or her own set of recovery skills and resources.
Drug rehab counselors are proficient in providing one-on-one addiction counseling. The best individual counselors are able to exercise superior listening skills by reflecting on and paraphrasing patient observations, in addition to exhibiting solution-based problem-solving skills. Addiction professionals also recognize that treatment will likely fail if a strong therapeutic bond does not quickly develop between patient and therapist, or if session intensity and relationship boundaries are not properly managed. As with any type of psychological therapy, drug treatment counselors must also identify and manage transference, counter-transference, denial and resistance.
Drug rehabs tend to also offer group therapy in addition to individual therapy, as it is particularly conducive to addiction recovery. Therapists who run group therapy sessions must know the difference between group therapy and group support. The overriding purpose of group therapy is to focus on the present, as well as encourage group process dynamics. Therapists also use the group, as a whole, to confront individual participants when necessary and to easily switch the group from one that is focused on addiction education to one focused on personal interactions and back again. Therapists who are flexible enough to effectively manage this process are real assets to any drug rehab facility.
It is essential that leaders of group sessions also understand the dynamics of substance abuse and be adept at handling defense mechanisms that addicts often employ to avoid confronting their issues. In particular, counselors need to understand denial, minimization, resistance, and projection and be readily able to address any of these defenses that manifest while in group. In addition, group leaders must be able to identify any topics of discussion that are not appropriate for group work and suggest that the patient bring the matter up in their own individual sessions.
Due to the often-fragile nature of those newly sober, leaders take an active role in structuring and facilitating early recovery groups. They lead the group toward the treatment goals (abstinence, problem solving, social skills, conflict resolution, developing trust and interpersonal cooperation). If done well, the members will eventually be able to organize themselves and continue on the path toward achieving these goals.
Group therapists in drug rehab encounter particular types of issues that may require them to take a more active role, either directing the session or intervening in cases of client resistance. Although the group should be centered on the clients themselves, the counselor still plays an active role, especially in the early sessions.