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Where real support is the result of caring, enabling usually springs from guilt, fear, or a misplaced sense of responsibility for someone else.

It’s difficult to squeeze a lot of motivational work into the course of outpatient counseling. Clinicians are anxious to get to the behavior change part.

The trick is to find another reward to replace the one that’s no longer available. For instance, if we’re no longer going to have a cigarette with coffee after dinner, what other reward could we substitute in its place?

Some members are talkative enough, but others participate minimally and a couple are openly hostile and challenging.

With ‘coerced’ clients, it’s easy to fall into a little game with the client striving to appear in compliance while covertly doing whatever he wants.

An agenda refers to the client’s underlying plan or program. Not just what he hopes to accomplish, but the things he’s determined not to do.

For some clients, particularly those with problems with rules and authority, their experience with boundaries is probably as important as anything that happens in counseling.

Takes a while to become really good at it, but most do. Addicts are not always great manipulators — that would be somebody so skilled you never realized you were being manipulated — but they’re bold, persistent, and creative when it comes to getting what they want

As a professional, you have an agenda to fulfill. So too does the addict. His agenda is very different, but he’s even more committed to it.

Resentments can damage recovery. And the worst damage is done by the most justified resentments.