When 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, therapist in Rolling Hills Estates, California. All Rights Reserved. Permission to publish granted to GoodTherapy.org.
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