Topic: compliance and noncompliance

The experience of addicts and alcoholics, particularly at the lower end of the socioeconomic scale, makes it clear that we could use more inpatient resources, not fewer.

It presupposes a patient who agrees with the recommendations, which, particularly with addictions, may not be the case.

If we want to see any progress, we’ll have to figure out a way to break this apparent impasse.

Their fondness for risk and excitement makes them ill-suited to a ‘straight’ lifestyle they would no doubt describe as boring.

Repeat DUI/DWI offenders can pose tough challenges for treatment programs and counselors. The needs of the client and the demands of the legal system don’t always work together.

A big fine, for instance, isn’t necessarily a better deterrent than a lesser one that is administered quickly and effectively.

But if the client also conveys a strong desire to get a degree or a worthwhile job, or start a family or get out of debt – these also constitute motivators for success.

If Bob gets a job, his mom will ask him to move out of the basement, and he’ll have to get a roommate, which he doesn’t want, so better to remain unemployed.

You can be firm and still leave room for someone in authority to make an exception.

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.