We hear it a lot in the counseling field — the key to success is retaining the client in treatment.
A very intuitive notion. After all, unless the client is participating, how can he possibly benefit?
And research does suggest that staying in counseling for at least 90 days is important in terms of getting the optimal results.
No argument there. That line of reasoning has generated a rash of enthusiastic efforts to improve retention rates. For some programs, it’s become the ultimate success measure.
But sometimes the program forgets to answer the really important question: is the client actually making progress? The measurable sort, in relation to goals and objectives.
Treatment is supposed to produce positive change. Otherwise there’s no real point to it. We have no cure, so even in remission, the client is still an addict. The challenge is to sustain the remission, going forward.
That goal requires substantial behavior change. I’m using behavior in the broad sense – not just actions, but thoughts and feelings. Success requires change with respect to all three.
That is, if the addict is to make the difficult transition from a life devoted to drug-taking to one devoted to recovery. It ain’t easy. Few things we ever do will prove anywhere near as challenging.
So treatment has a responsibility to actively promote change.
I’m a fan of client-centered therapy, but we shouldn’t go overboard. The client should direct the course of treatment, but not in any direction he feels like taking it. That’s not how we accomplish important goals. We do that through focus.
Treatment needs to move proactively towards the changes needed for sustained recovery. If it isn’t, then it may be treatment for an addict, but it’s not addiction treatment.