ContrastCounselors are trained to ask open-ended questions when the goal is to gather information about the client. As in: “what do you want to do with your life?” The question’s too broad to be answered in word or phrase.

But when you want the alcoholic to make a decision, it’s better to contrast two options.

Let’s say a counselor feels strongly that his young male patient needs a halfway house in order to stay sober after inpatient treatment. But he knows the young man will reflexively resist this. He might frame the issue this way:

Counselor: “Well, Frank, I guess the problem is finding the money for a rental while you search for some type of job. That could take a while, huh? Of course, I’d recommend you consider a brief stay at one of our fine transitional residences…. “

A dominant trait of the reluctant alcoholic is ambivalence, or the state of having powerful conflicting feelings about an issue. It’s an obstacle to good decision-making. We want to simplify difficult choice so as to maximize the chance the alcoholic will make the right one.

Using contrast helps focus the alcoholic’s attention away from fantasy.

Mark: “Dad, I think now that I have this drug thing behind me, I want to study calligraphy.”

Dad: “Fine, Mark. Didn’t the counselors say you need to stick with treatment for a while?”

Mark: “Yeah, but, I really want to do this, and the best program is like 300 miles from here.”

Dad: “Suppose you stuck with the treatment for a while, and then depending on how you did, maybe enrolled in the calligraphy thing in a year or so?”

Mark: “But I want to do it now.”

Dad: “I’m not trying to prevent you, son. We can’t help pay for school, you know. We just don’t have the money.”

Mark: “I know but I can get a student loan.”

Dad: “You’d accumulate a lot of debt.”

Mark: “Like how much?”

Dad: “We could check it out. But tens of thousands. It’s a big decision, taking on that kind of debt. You have to pay it all back, you know. Could take years. Probably will.”

Mark: “So what are you saying?”

Dad: “Well, it seems to me there are a couple options here. You can start school for this program that honestly, you don’t know much about, or stay here and live with your mom and me, and learn about it while you maybe pick up a part-time job, and continue on in counseling. Then make up your mind about school in a year or so.”

Mark: “It does sort of make sense.”

Dad: “Up to you, Mark. But that’s what I’d do if I were in your shoes.”

Mark’s father isn’t actually trying to keep him from attending college; he just thinks Mark needs to stick with treatment until he’s more stable, and doubts that will occur if he’s 300 miles away at school. He makes his point very effectively.

Effective Communication with The Addict or Alcoholic -More from this series:


1 Comment »

The same for counselling as sponsoring, the person you are helping is most likely prone to making the wrong decision. By using this technique of contrasting you are communicating much more clearly to them and giving them the opportunity to think the decision through as rationally as possible. It opens up their mind to delaying the instant gratification of ‘wants’ and fulfilment of that desire. As they progress through understanding their addictions and figuring out the right choice between using or getting help (whether it be a call to a sponsor, tools to minimise craving, etc) the addict needs to go on to becoming self sufficient at making most life choices with a clear and purposeful mind.

Comment by Mark Dempster Addiction Counselling — August 18, 2013 @ 12:18 pm

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