Modifying Behaviors and Finding ‘Your Empowering Solution’

Woman smiling and flexingWhen we were scratching around wondering what to call our counseling practice, we coined and rejected a lot of possibilities. Some names we considered were obscure, some taken, some boring, and a few were just plain silly. Then we took a look at what it is we actually do, and what we don’t do.

The main thing that separates us from most alcohol rehab programs is the fact that we don’t have a “program.” What we do have is a lot of experience and research into what works for different people. The primary offering we have for our clients is the certainty that the solution to their specific problems and set of circumstances will be, like themselves, unique. It will truly be their empowering solution, not ours, or AA’s, or Moderation Management’s, or someone else’s canned prescription. We don’t dictate, we help you find Your Empowering Solution (Y.E.S.).

Happily, we let our logo be Y.E.S., which is good since we spend a lot of time and effort on getting people to “just say yes.” “Yes” to getting their lives back. “Yes” to regaining health, independence, friends, family, joy, and laughter. We don’t believe in “just say no.” That’s about as unhelpful a piece of advice as has ever been coined. Saying “no” takes zero time, energy, attention, or effort. All it really does is create a behavioral vacuum that inevitably sucks the client right back into the same old familiar behaviors—especially when the old behaviors are justified by unfounded or irrelevant beliefs in “powerlessness,” “disease,” and “genetic predestination.”

If a client wants to alter a behavior, she or he will have to start saying “yes.” Saying “yes” to new behaviors that will ultimately result in a life that is more satisfactory than the old one. Changes that do not result in a better life will simply lead to relapse, discouragement, and despair.

Facilitating client-based solutions, however, means that clinicians must also be willing to say “yes.” Yes to new ideas, methods, therapies, models, and supports. It means not replaying old programs, formulas, steps, or any of the other standardized regimens traditional treatment force feeds to clients. It means acquiring skills, listening attentively, working creatively, and respecting clients’ strengths, interests, and abilities. It means working through their powerfulness. It’s hard work. It’s exciting work. It’s rewarding for both counselors and clients, but it isn’t for the timid, whether clinician or client.

Searching for new solutions with each and every client means taking in information: personal and interpersonal history; financial, legal, educational, vocational, and social status; ethnic and cultural considerations; age and gender issues; and emotional and psychological development factors. It means parsing out relevant information and integrating that into a comprehensive treatment plan. It means constantly amending that plan as circumstances require and measuring success in the clients’ terms. It means having a very high tolerance for ambiguity.

It also means holding clients accountable for their behaviors—past, present, and future. This is where a lot of clients will drop out, preferring the secure conformity of traditional disease and powerlessness based models with their unending “recovery,” alcohol fixation, and predictable relapses. Let them go. Wish them well. That too may be their empowering solution. Not everyone is cut out for an independent and creative life.

Perhaps the hardest part for us as providers is admitting that we are not the right program for a lot of potential clients, maintaining a good referral base, and using it. Most of us are loathe to admit that we don’t have “the answer” to everyone’s problems. The truth is, for any of us, of the clients who present themselves, we are the right choice for about a third of them, an adequate choice for another third, and the wrong choice for the rest. That’s our down and dirty self-evaluation model. What’s yours?

© Copyright 2008 by Edward Wilson, Ph.D., MAC. All Rights Reserved. Permission to publish granted to GoodTherapy.org.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

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  • amyhop

    April 29th, 2008 at 10:35 AM

    This is fantastic! I love the model that you are using, giving the patients a choice in their therapy and helping them to realize up front that you are not necessarily there to change their lives for them but to give them the tools for them to modify their lives and behavior for the better. I like that fact that you encourage them to say yes to new behaviors and give them the resources they need to make this happen.

  • Sandra

    April 29th, 2008 at 10:36 AM

    What do you do with a client when you realize that this is not going to be the best therapeutic situation for him or her?

  • David

    April 29th, 2008 at 10:39 AM

    Yeah I think that would be very tough to have to turn someone away. When this is the case do you have other referrals lined up for the client? Have you ever been in a situation where you soldier through a case with a patient because the patient does not want to go with someone else?

  • Jeni

    April 30th, 2008 at 6:51 AM

    I would think that you would want to break this very gently to a patient and work with him to discover the other resources which are going to be out there for him which can be of value through his situation. I personally love all that the name of the practice stands for, because I think it gives you strength just to know that you are going to make a difference in your own life and that these are the therapists who can give you the knowledge for how to make this happen.

  • gamecock96

    April 30th, 2008 at 6:52 AM

    The philosophy which supports holding patients accountable is so important. Too often people get caught up in the whole victim mentality- we have to do waht we can to give them the power to fight back and persevere.

  • Ed

    May 1st, 2008 at 7:25 PM

    We appreciate the comments, as always. Regarding referrals: most of our clients are self-referred through our website and it does a very good job of screening out clients who are looking for something else. That said, there will still always be clients who, at least, need help sorting out their options. Happily, I spent about ten years researching how to predict which clients would benefit from traditional treatment, who wouldn’t, and who would be harmed by it. That makes referral easier and we maintain good connections with a number of alternatives. And, finally, when no really appropriate ones exist, we modify and accommodate accordingly.

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