Drug Counseling Video #10 Individual Counseling Skills.
Two basic drug counseling skills involve the use of motivational enhancement and the knowledge of the stages of change a client may be moving through. Stages of change include pre-contemplative, contemplation, preparation, action, maintenance, and possible relapse. Skills needed for motivational interviewing include the ability to express empathy, develop discrepancies, roll with resistance, and support self-efficacy.
By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Time for a life change?
Photo courtesy of Pixabay.com
The stages of change model comes originally from a book titled “Changing For Good” by Prochaska, Norcross, and DiClemente.
This model has been widely applied to substance abuse treatment but is also applicable to mental health, weight loss, or even improving test scores in underperforming schools.
We teach this model to beginning students in Substance abuse counseling programs and it is gradually becoming a part of Professional Clinical Counseling and Marriage and Family Therapy training.
It is helpful for professionals to understand how it is that people change so we don’t get ahead of or behind our clients in the process of change. This model also helps predict the possibility of relapse and is applied to relapse prevention.
The Stages of Change model is not just for professionals. It is included in the Mental Health First Aid program and is now being taught to clients and consumers.
Below are the links to a series of posts I wrote on the stages of change. This is my explanation of the model and some additional insights from Ken Minkhoff at Zia Partners and my fellow Change Agents.
My apologies to Prochaska, Norcross, and DiClemente if I have in any way distorted their model. For their version read the book. See also materials on Stages of Change at the SAMHSA website.
Stages of Change or How Do We Change Pre-Contemplation
Stages of Change part two – Contemplation
How do People Change? Preparation
Stages of Change – Early Action
Stages of Change – Late Action
Maintenance is a Part of Change
Related posts are at:
Is Relapse a Part of Recovery?
Getting some recovery – preventing relapse
Staying connected with David Joel Miller
Seven David Joel Miller Books are available now!
My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.
Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.
Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.
As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.
Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.
Planned Accidents The second Arthur Mitchell and Plutus mystery.
Letters from the Dead: The third in the Arthur Mitchell mystery series.
What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?
Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.
For these and my upcoming books; please visit my Author Page – David Joel Miller
Want the latest blog posts as they publish? Subscribe to this blog.
For videos, see: Counselorssoapbox YouTube Video Channel
By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Recovery and Resiliency. Photo courtesy of Pixabay.com
Recovery does not happen suddenly, out of nowhere. It takes time and work. From my way of thinking there are customary predictable stages of recovery. People may move through these stages at varying rates, some people move backward at times, but the goal for all should be to reach a final place where recovery is stable and less at risk.
The concept of recovery used to be mostly applied to substance abuse. Recently the concepts of wellness and recovery have been incorporated into Mental Health and physical health issues.
In a series of earlier posts, we talked about stages of change. Those stages begin with Pre-contemplation, the I don’t have a problem and even if I did I wouldn’t want to change anything, to Contemplation, yeah so – maybe I do have a problem but I am not sure I am ready to do anything about it. After that is Preparation, sometimes called Determination, and finally, the action process, which we divided into Early Action and Late Action phases. The last part of this recovery journey was Maintenance.
In this model, Relapse is seen not as part of recovery but as the inability to maintain recovery once we reach it. This is understood as a common result of failure to do the maintenance activities. There has been lots of literature on relapse, triggers and lifestyle changes to make to avoid relapse. Much less has been written about what someone might expect during recovery.
Here are the four stages of recovery as I see them
People in this stage are seeking answers, working on themselves, and investing time in their recovery. This is the time when people are taking action steps or may begin to do maintenance to hold onto the gains they have made. Lots of people will describe themselves as “in recovery”
People who describe themselves as recovering have moved from the point of being hopeless and lost to having hope and seeing their symptoms reduced. The urges and cravings may decrees even if they are never totally gone. People with mental health symptoms, while not fully back on their feet, may find they are able to do more things more days. Symptoms while present are shrinking.
Some people are afraid to say this. They are afraid that feeling recovered, they will let down on working on themselves and relapse. The A.A. Big Book uses this language on the title page of Alcoholics Anonymous, “The Story of How Many Thousands of Men and Woman Have Recovered from Alcoholism.”
People who call themselves “recovered” are quick to point out that they are not cured. Just as when someone is diagnosed with diabetes they may get their disease under control but they will never go back to being a non-diabetic. With any chronic, relapsing disease you may recover but you are never really cured.
People who are recovered begin to get their life back. They may go back to work, volunteer or be able to participate fully in everyday life.
Every recovered person will have bumps on their road of life. This is a real-life, good happens and bad happens. A person’s recovery is secure when they are able to withstand the things that happen, good or bad, in life without a return to active symptoms.
Doing the maintenance steps helps, so does building a comprehensive support system. The real test of someone’s recovery is – can bad or unexpected things happen in your life without triggering a return of your symptoms.
Best wishes on your recovery and having the happy life you deserve.
Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency
Staying connected with David Joel Miller
Seven David Joel Miller Books are available now!
My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.
Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.
Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.
As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.
Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.
Planned Accidents The second Arthur Mitchell and Plutus mystery.
Letters from the Dead: The third in the Arthur Mitchell mystery series.
What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?
Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.
For these and my upcoming books; please visit my Author Page – David Joel Miller
Want the latest blog posts as they publish? Subscribe to this blog.
For videos, see: Counselorssoapbox YouTube Video Channel
By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Change.
Photo courtesy of Pixabay.com
Last time we began our discussion of the stages of change by describing how someone might be confronted with a situation where others think you have a problem, a need to change, even before we recognize that something is a problem. We called that stage of change Pre-contemplation.
Lots of people end up in the therapist’s office, court, child custody mediation, a Drunk driver program, or substance abuse treatment who never thought they had a problem. Sometimes they are sent with an ultimatum, do this treatment or else. Sometimes it is a spouse or a boss who says change or else. Sometimes it is too late and the or else has taken effect.
Often they resist thinking that they have a problem despite being required to go to some type of treatment. An interesting thing happens too many of these people, sooner or later. They see other people confronting their problems and those people’s lives are getting better. This is especially powerful in group settings where a group member gets a new job or relationship, someone gets to see their kids again or gets a license back, or someone loses a lot of weight.
Sometimes this mental change can occur after they read a book on solving a particular problem and they start to consider if they might need to change. Once the willingness to think about change occurs they have reached step two in the process of change model.
In this stage, the person who is on the road to change is gathering information. That does not mean they agree they have a problem, they may, they may not, but they are open to looking at the facts. So let me continue my weight loss story from our last episode.
I get home and I ask my roommate “Have I gained any weight?” She giggles politely. Maybe it was more like a hysterical laugh. So I go looking for the scale that used to be in my bathroom. Not there. I check in the closet, under the bed, I find it on a top shelf in the garage. I weigh myself. That can’t be. I don’t weigh that much! Do I? This scale must be broken, that’s why I put it in the garage right?
The next day at work I weigh myself on the certified scale. It gives me a bigger number than my garage scale. This can’t be right. I go to another department and try their scale. It gives me a bigger number yet. I go back to the first scale and reweigh myself. Now the truth hits me. I have put on weight. Not a little, but a lot. The weight gain is getting harder to deny.
Some people get this moment of truth when the judge sentences them. Some when their spouse leaves them or the family doesn’t want them around. For some people, it may be the DUI. Some people get to this realization the second or third time their parole officer sends them to a drug program. Maybe they realize it after the fiftieth job interview that does not result in a job. Could it be me? Do I lack the skills? Do I have a problem?
Whatever it takes eventually those who change get to this point. I am hoping that for you all you need is a little number on a scale. Whatever it is we both have a choice at this point. Change or go on the same course as before.
I could get off the scale at this point and just ignore or accept the fact I am now heavier, maybe even fat, or I can do something about it. I am no longer contemplating. But what will I do next?
Do you have any stories about the changes you have made? Want to share them? You can make a comment if you chose.
Check back next blog for the next installment about how people change.
Other posts on this topic can be found at Pre-contemplation, Contemplation, Preparation, Early Action, Late Action, Maintenance, relapse, recovery, triggers, support system, more on support systems, Resiliency
Staying connected with David Joel Miller
Seven David Joel Miller Books are available now!
My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.
Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.
Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.
As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.
Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.
Planned Accidents The second Arthur Mitchell and Plutus mystery.
Letters from the Dead: The third in the Arthur Mitchell mystery series.
What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?
Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.
For these and my upcoming books; please visit my Author Page – David Joel Miller
Want the latest blog posts as they publish? Subscribe to this blog.
For videos, see: Counselorssoapbox YouTube Video Channel
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