PSYCHOSOCIAL INTERVENTIONS

• No single counselling approach is appropriate for all clients. Matching counselling techniques to a client's aims is crucial in determining successful outcomes. Counsellors should employ motivational interviewing when clients present showing no or little commitment to change. Once a client has demonstrated a commitment to change and has low levels of anxiety, CBT should be considered as the preferential technique used for those clients in maintenance programmes. However, IPT approaches may be regarded as the most appropriate counselling style for those clients with a low dependency.
• Counselling should be used to address the multiple needs of a client, not just their substance misuse.
• Counselling is most effective when it is combined with other treatments such as methadone prescribing.

• Research indicates that, for most clients, the threshold of significant improvement is reached at about 3 months in counselling. After this threshold additional treatment or counselling may produce further progress towards recovery in some cases.
• Substance misusers with a dual diagnosis should have both disorders treated in an integrated way, except in circumstances where a client has a profound mental health problem.
• Counselling should be provided by professionals who have the necessary qualifications and experience for BAC accreditation. Counsellors should operate in accordance with the BAC codes for both 'counselling' and 'supervision'.
• Professionals should use 'counselling skills' with clients for whom they are providing other services. Formal counselling should only be provided by a professional who is not responsible for provision of other services.

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Alcohol Guidelines index

The above information is copyright of Dr Bruce Trathen MBBS MRCPsych (2006). ISBN 0-9545164-0-0. The author grants permission for these guidelines to be downloaded, copied and distributed freely, but does not grant permission for their sale.