Clients will test boundaries just to see what will happen when they do. If you’re prepared for such tests, and can avoid some predictable errors in response, you’ll find that the course of treatment runs smoother.
Wasn’t it Archimedes who promised that given a lever long enough and a place to stand, he would move the world? In using leverage, think of credibility as the place you stand.
Understanding how leverage works in the context of addiction treatment can give you the tools to identify your client’s agenda, and help them over the “rough spots” that inevitably occur when you work with offenders.
First, they don’t understand why they’re in treatment, or how it could possibly benefit them. Second, they’re ticked off about having been coerced.
Having a judge or a parole officer holding the big stick on them may be enough to get them into treatment, but it’s usually not enough motivation to get them beyond the minimum of compliance.
If estimates are correct that a typical offender has driven under the influence between 60 and 100 times prior to first arrest, it’s clear the actual problem is far, far greater than arrests alone can document.
It seems to me that a successful approach to DWI must be based on the assumption that drunk drivers are a diverse population.
One state estimates around a fifth of offenders are rearrested within three years of the prior conviction. Expand that window to five or ten years and the rate is likely substantially higher.
One or two (risk factors) is not as suggestive of repeat offending as four or five. But it does allow a clinician to apply a rough risk profile to a particular offender.
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.