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Remind him of the importance of being unintoxicated for that next session. PATTERN AND CONTEXT OF DRINKING OR DRUG USE Past Use Exploring the history of your client’s substance use will help you to determine the chronicity of his problem. It will also reveal the conditions under which he has been able to abstain or moderate his drinking or drug use, as well as the triggers to heavy substance use. This information will help to guide your selection of treatment goals and will also be particularly useful when planning relapse prevention (see Chapter 16, Relapse-prevention Training).
Use summaries to: . . . Highlight important discoveries. Prompt a more thorough exploration. Give the broader picture when your client seems blocked. Provide an opportunity for your client to hear her own stated reasons for change. , ‘On the one hand, you have said that you like drinking because . . while, on the other hand, you are concerned about . . So it sounds like you are torn two ways’). Close a discussion. CONFIDENCE TO CHANGE Raising your client’s confidence in her ability to change is an intermediate step towards changing her drug use.
These are discussed below. Alcohol use: Ask your client how frequently he drinks. Does he drink daily or have periodic bouts of binge drinking? Find out how much alcohol your client drinks per week, on a typical drinking day and on a heavy drinking day. Your client may feel a little self-conscious about reporting exact amounts. It can be useful to overestimate your client’s level of drinking, thereby allowing him to bring the estimate down to the correct level, without feeling embarrassed about admitting the large amount he 22 TREATMENT APPROACHES FOR ALCOHOL AND DRUG DEPENDENCE drinks.