This article seeks to articulate the place for counselling in the treatment of addiction. With harmful and hazardous alcohol and drug misuse, education and prevention measures are preferred with some brief solution focused interventions (Department of Health 2012). For opiate addiction, medical interventions to stabilize and reduce harm are rightly to the fore (Health Service Executive Social Inclusion Unit, 2010)
I am Clinical Director of Tabor Group, a Cork-based treatment agency guided in treating addiction by the Minnesota Model of care. This approach is based on a ‘disease concept’ of addiction and favours the long-term goal a ‘drug free lifestyle’ for clients. I am often asked “what is your success rate?” and in my experience, many who opt for ‘drug free lifestyle’ treatment options, relapse is common and is therefore seen as failure. To assist service users in achieving a drug-free lifestyle counselling is essential.
In this article, I present the case for counselling in the management of addiction at Tabor Group and this article uses the American Society of Addiction Medicines (2011) definition of addiction to answer the question posed in the title. This definition will structure the article as I present addiction as
I will quote directly from this definition and also use it to reflect on my professional experience of the value of counselling in the treatment of addiction. This will prepare the way for presenting the role of counselling in treating addiction.
Multi-agency Treatment of Addiction on one hand there is growing acceptance of harmful and hazardous misuse of alcohol and drugs which requires education and prevention services and where treatment services are necessary they may be brief and solution focused (HSE 2012) On the other-hand there is a growing awareness of the complexity of needs that often accompanies addiction (MacGabhann et al, 2004; Najavits, 2002) From this awareness results an emphasis on the need for multiple agencies to be involved in the rehabilitation of people affected by addiction (Department of Community Rural and Gaeltacht Affairs, 2009).
General Practitioners, Pharmacists, Detoxification Services, Community Drugs Workers, Homeless Services, Social Workers, Key Workers, Case Managers, Community Enterprise Schemes, Adult Learning and Training agencies, Probation Services, Treatment Agencies of various types, 12 Step Fellowships, Family Support Services, and Parenting Programmes all have valuable roles to play in rehabilitation. From my experience of engagement in delivering treatment for 20 years in the Health Service Executive Southern Region, all of these agencies have a caring dimension and staff is equipped with some level of listening skills and capability for empathic response. Part of the response to the overwhelming complexity of need in many of our addicted population is to see that a realistic goal for individual care plans is to reduce the harm caused by the addiction rather than a goal of full rehabilitation including a drug-free lifestyle.
With such an approach, the emphasis is on maintaining a stabilisation in the individual’s situation. This includes assisting the person to refrain from illicit drug use, from criminality in order to obtain illicit drugs and keep the person safe from risky behaviour by introducing them to a stable dose of prescribed methadone. As a result, the key agencies of General Practitioner and Pharmacist come to the fore in the delivery of care. Allied services have an important support role. Counselling can also be part of this important support role allowing the person explore healthy options and the motivation to pursue them.
In Part two, Mick Devine Clinical Director of Tabor Group will talk about his experience of how counselling will come in to it own when the service user responds to the challenge of establishing a drug free lifestyle as central to managing addiction. This article first appeared in Éisteach
Tabor Group is a leading provider of residential addiction treatment services in Ireland. We provide support and care to hundreds of clients each year suffering from addictions to alcohol, substances, gambling and food. Tabor Group offers hope, healing and recovery to addicted people and their families through integrated and caring services. For more information on Tabor Group’s services Click Here
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