What exactly is an “addiction therapist” anyway? You may have decided to take a look at your drug and alcohol use to consider whether it’s a problem, or you may have already decided that it is a problem and want to stop or cut back. You’ve decided you want some professional feedback on your situation and want to know what, if anything, you might do about it. So you search the internet for “addiction therapist” or look on GoodTherapy.org or ask around, etc., and get a couple of numbers and set up a consultation or two. But then what?
Well, the first thing to consider is that an addiction therapist—or therapist who specializes in treating addictions—is still a therapist, so those qualities you’d want in any mental health provider ought to be present. That is, you should feel safe and “heard”; and you should be able to imagine that yes, this is someone with whom you could share your deepest and darkest secrets. Is he or she empathic and genuinely curious about you specifically (rather than making assumptions)? Does he or she say things like “Well, you sound like an addict to me” when you yourself are not sure? I come from the collaborative school of therapy, where (except in rare instances) client and therapist decide together what’s right, rather than have the latter “label” the client in some kind of authoritarian manner.
It never hurts to ask the therapist’s background. Here are some questions you might ask, if these seem pertinent to you: What experience does the therapist have in treating addiction? Has he or she worked at or with a rehab or treatment center? How long has the therapist been in practice? Does he or she have personal experience with addiction? This may or may not matter to you, but it would be good to make sure the therapist has experience in addiction (as opposed to it being one of 30 disorders the person specializes in). Addiction is, after all, a complex problem. Of course, the person could be new in the field, and you might feel like you just “click” with him or her. I was an intern, too, after all; fortunately, my clients gave me a try!
Some people, if they’ve decided they want to try to stop or cut back their drinking, really want to work with someone who has “been in their shoes,” who understands what addiction is on a personal level and has experienced what it’s like to battle this particular demon. They want someone who is sober themselves. Others might not be as concerned with that; they just want to feel comfortable and safe with the therapist.
You’re probably getting the idea right about now that this is a highly personal choice. If so, you’d be correct. Unlike finding a dentist or orthopedist, a therapist is not just a professional who has knowledge about the problem. Knowledge and experience are important, yes. But because therapy is so intimately personal, therapy must first and foremost feel safe and comfortable to the potential client (by that I mean inviting, protective, nurturing, and caring). The idea is that you sense that the therapist “gets it” and can fill in the blanks for you when you can’t find the words (and be accurate about it and emotionally on target).
In other words, there is no “good” addiction therapist, just as there is no “right” therapist in general—there is only the right person and fit for you.
Something to keep in mind regarding whether or not the therapist is him- or herself sober: I think it is important to ask how she or he got sober. How the therapist handles these questions, by the way, is going to be a clue as to whether or not this therapist is a good fit. You should feel properly heard and responded to and not just getting a scripted or “canned” response.
How a therapist became sober is sometimes an indication of his values and “biases”; after all, everyone has them (therapists are people, too). Did the therapist find sobriety via religion? A 12-step program? Therapy? If so, what kind of therapy? Cognitive behavioral? Psychodynamic? Some combination therein? This is an important question.
You might hear something like, “Well, AA is the only thing that works.” Now, if you’ve just begun AA and are finding it to be the best thing since sliced bread, this kind of statement might be welcome; on the other hand, if you’re not so keen on 12-step and want to explore other avenues, it’s important that your therapist will support you in search. Some clients need to explore a variety of options to see what fits best; you might want to be supported in your exploration. Others want straight suggestions. Is that how this therapist likes to work? I encourage you to ask him or her what his biases are, as well as treatment approaches and “style.” I think it helps to ask about the therapist’s biases or experiences with different types of therapy or recovery.
Personally, I find that it’s usually a combination that works best: weekly therapy plus some kind of group support, especially in the beginning, and every client is different, needing different things at different stages. There are no pat answers when it comes to human beings.
Next time I’ll discuss ways of talking to your therapist about something that bothers you and why that might be easier said than done.
Related articles:
A Moment of Clarity : Fear vs. Faith in the Therapeutic Process – Part 1
Do I Really Have a Drinking Problem?
The Elements of Good Therapy
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