- Home
- Non 12-Step Information for Professionals
- Addiction Research
- The Addiction Counselor’s Desk Reference
The Addiction Counselor’s Desk Reference
- By Misc Author
- Published 11/16/2007
- Addiction Research
- Unrated
This section provides an overview of counseling techniques that may be useful with addicted clients. Arranged in alphabetical order, each technique is identified with a clinical model, as described in the preceding section.
We classify these techniques on a three-point scale: (1) directive, (2) moderately directive, and (3) nondirective. At one end of the scale, directive techniques openly confront and challenge the client to take specific action (e.g., complete homework).
At the opposite end, nondirective techniques, the counselor empathically supports the client. When using moderately directive techniques, the counselor focuses both on giving support and assisting the client in taking action (e.g., active scheduling):
• Acting as if (individual psychology—directive): In a role-play situation, clients act out the way they would like to be in various life scenarios and explore alternatives. The underlying premise is that with practice these behaviors feel more natural (G. Corey, 2000).
• Active listening (person-centered—nondirective): The counselor uses a cluster of skills to increase accurate understanding about what is being said. Good listening requires that the counselor interact with the client, offering affirming comments about what has been said, rephrasing the client’s comments to encourage further commentary, and other appropriate expressions (see “C linical Microskills” later in this part; Egan, 1994).
• Activity scheduling (behavior therapy—moderately directive): The counselor works with the client to initiate activities that move the client from inactivity to a more productive and vital state. Aside from these activities, scheduling— itemizing choices and strategies—may immediately impact the client positively (Corsini & Wedding, 2001).
• Analogies or images to illustrate problems (REBT—moderately directive): Analogies or images are used to see a problem from a different viewpoint (G. Corey, 2000).
• Assertion training (behavior therapy—moderately directive): Assertiveness, the ability to express one’s needs and thoughts confidently without being either passive (hiding or muting) or aggressive (forcing and badgering), is useful for clients who cannot express anger or frustration, who have difficulty saying no, who allow others to take advantage of them, who have difficulty expressing affection, or who feel they do not have the right to express thoughts and feelings.
This training is a collection of techniques—behavior rehearsal, exposure, modeling, and reinforcement (Meichenbaum, 1977). Elaboration of each is listed separately.
• Attending and listening (individual psychology—nondirective): The counselor learns the core of a client’s thoughts and feelings by being psychologically involved, engaging the client with eye contact, and paying close attention to both verbal and nonverbal communication (Howatt, 2005).
• Behavior modeling (behavior therapy—moderately directive): Also called vicarious learning (developed by Bandura), the client learns by first observing the counselor (or someone else) perform a specific action, then imitates the modeled behavior (Corsini & Wedding, 2001).
• Bibliotherapy (behavior therapy—moderately directive): Reading assignments stimulate discussion, convey new values and attitudes, help reframe the problem, and provide possible solutions (G. Corey, 2000).
• Brainstorming (individual psychology—moderately directive): This is an uncritical discussion of all responses to open-ended, thought-provoking questions and problems, each designed to stimulate a list of ideas pertinent to various choices and options (Egan, 1994).
• Catching oneself (individual psychology—directive): This technique is useful with clients who catastrophize, are perfectionists, have eating disorders, and demonstrate obsessive-compulsive behavior. It raises awareness of selfdestructive behavior or irrational thought without self-condemnation. Clients learn to anticipate events and change their behavior patterns (G. Corey, 2000).
• Challenging (choice theory—directive): This is an invitation to recognize thoughts and/or behavior that is self-defeating, harmful to others (or both), and to change that behavior (Howatt, 2000).
• Cognitive modeling (behavior therapy—moderately directive): The counselor performs tasks while engaging in self-encouragement to demonstrate how clients may talk themselves successfully through a task (Howatt, 2005).
• Cognitive restructuring (behavior therapy—nondirective): The counselor teaches clients to identify and evaluate their thoughts and to replace negative ones with more realistic and appropriate thoughts ( James & Gilliland, 2001).
• Congruence (person-centered therapy—nondirective): The counselor is honest and consistent in word and behavior (G. Corey, 2000).
• Contingency contracts (behavior therapy—directive): The client and counselor develop a contract together designating behavior to be performed or changed. Rewards are based on the achievement of stated goals, the conditions under which they will be received, and the specific time frames for completion (Howatt, 2000).
• Continuum line (REBT—directive): Clients rate their feelings about their addiction on a scale of 1 to 100 with 1 being the worst (they hate it) and 100 being the best (they love it).
This provides an understanding of where the client is in the treatment process and generates middle-ground options for clients manifesting black or white thinking (Howatt, 1995).
• Contracting for change (transactional analysis—directive): Clients work with the counselor to develop a contract that specifically states what they plan to change in order to reach self-designated goals. The counselor is a witness and a facilitator (Howatt, 2000).
• Counter-conditioning (behavior therapy—moderately directive): Also known as reciprocal inhibition (Wolpe, 1982), the client practices being able to calmly respond to a stressful situation. The client learns to lower anxiety levels by breathing deeply, stretching, and relaxing shoulder and neck muscles.
• Decatastrophize (cognitive—directive): Using “what if” questions, clients discover that their problems may have grown out of proportion in their mind. This reduces anxiety so that positive collaboration and cooperation can take place between client and counselor (Howatt, 2000).
• Description (existential—nondirective): Clients vividly describe to the counselor what they are feeling or experiencing, thus facilitating a better understanding between them (Howatt, 1995).
• Disputing perfectionism (REBT—nondirective): The counselor shows clients (who thinks they must always be good at everything) that perfectionism is self-defeating (Corsini & Wedding, 2001).
• Diversion (cognitive—directive): The counselor distracts a sad or anxious client’s attention away from the present concern, breaking an emotionally laden thought pattern, so that the client can return to the appropriate treatment track (G. Corey, 2000).
• Empathy (person-centered therapy—nondirective): The counselor sees and feels the client’s world as though immersed in that world. By assuming the internal frame of reference of the other, the counselor understands the client’s private pain ( James & Gilliland, 2001).
• Encouragement (individual psychology—directive): The counselor praises clients’ strengths and progress, recognizing, labeling, and accepting their positive qualities. This increases clients’ self-confidence, counters discouragement, and helps them set realistic goals (G. Corey, 2000).
• Exaggeration (Gestalt—directive): The counselor asks the client to exaggerate a certain thought, emotion, or body movement that has just been expressed, allowing the client to become more aware of hidden feelings and defense mechanisms (Howatt, 2000).
• Extinction (behavior therapy—moderately directive): Undesirable behaviors are discouraged and eventually eliminated by removing rewards that stimulate the behavior (Corsini & Wedding, 2001).
• Feedback (behavior therapy—moderately directive): Praise, encouragement, and specific constructive suggestions for modifying errors help clients learn new behaviors ( James & Gilliland, 2001).
• Fruit basket technique (REBT—directive): The counselor shows a fruit basket with good and bad fruit to demonstrate that although the client may have some flaws and done some bad things, the client also has virtues and is basically a good person (Howatt, 2000).
• Goal setting (interpersonal—directive): Brainstorming specific objectives and strategies and then arranging emerging plans in the best sequence for a positive outcome mobilizes the client to appropriate action (Corsini &Wedding, 2001).
• Graduated exposure (behavior therapy—directive): Step-by-step exposure to reallife situations enables clients to practice skills or preferred behavior in anxietyprovoking situations (Howatt, 2000).
• Graduated task assignment (behavior therapy—directive): Clients learn to reduce anxiety while developing new skills by taking an assigned task (often given as homework) that begins simply and then gradually becomes more difficult and complex (Howatt, 1995).
• Helper self-disclosure (individual psychology—moderately directive): The counselor appropriately shares selected and focused experiences, behaviors, and feelings with clients. This builds the client-counselor relationship and encourages the client to disclose hidden feelings and thoughts (Howatt, 2005a).
• Humor and jolting language (sarcasm; REBT—moderately directive): Appropriate humor by the counselor can relax clients and encourage them to open up. Sarcasm may help clients identify their irrational beliefs and laugh at their behavior (Howatt, 2000).
• Imagery (cognitive—directive): Metaphors and/or visual pictures developed by counselor and client may help clients develop insight about their thinking and provide the counselor with a clearer impression of clients’ automatic thoughts (G. Corey, 2000).
• Immediacy (individual psychology—directive): Addressing what is going on in the present counseling session may help the client see that what is occurring is a sample of everyday life (G. Corey, 2000).
• Language exercises (Gestalt—directive): An examination of speech patterns that helps clients increase self-awareness and personal responsibility by acknowledging their thoughts, feelings, and actions (Howatt, 1995).
• Magic wand (individual psychology—directive): Clients pretend they have a magic wand and can wish for anything to allow them to look beyond present circumstances and define their real wants in life (Howatt, 2000).
• Offering options (individual psychology—directive): The counselor offers clients a choice among several options (Corsini & Wedding, 2001).
• Paradoxical intention (reality therapy—moderately directive): Clients are instructed to consciously exaggerate debilitating thoughts and behaviors, creating an awareness of how out of proportion their response is to the situation. Also called prescribing the symptoms and antisuggestion (Wubbolding, 1988).
• Paradoxical intervention (logo therapy—directive): The counselor places clients in a double bind to cut through their resistance by asking them to exaggerate or even perfect a problematic behavior (G. Corey, 2000).
• Paradoxical technique (REBT—directive): Clients are asked to perform the presenting irrational behavior at a certain time every day, thus removing the gratification received from performing the irrational behavior (Howatt, 2000).
• Playing the projection (Gestalt—directive): Clients pretend to be the recipient of the statements that they make about others. These statements, often projections of attributes that clients possess, bring awareness of inner conflicts (G. Corey, 2000).
• Push-button technique (individual psychology—directive): Clients close their eyes and alternately picture a pleasant and an unpleasant experience while paying attention to the feelings accompanying each experience. This teaches clients that they can create whatever feelings they wish by relying on their thoughts (Corsini & Wedding, 2001).
• Reframing (cognitive—directive): Reframing provides a different interpretation of a particular situation, allowing a client to understand an original complaint from different angles (G. Corey, 2000).
• Reinforcement (behavior therapy—directive): A pleasant stimulus increases a desired behavior ( James & Gilliland, 2001).
• REBT self-help form (REBT—directive): The client completes this form and the counselor uses it to determine the nature and extent of a client’s faulty beliefs.
(These REBT forms can be obtained from the Institute for Rational Emotive Therapy, 45 East 65th Street, New York, 10021, 212-535-0822; Howatt, 2005.)
• Role play (behavior therapy—moderately directive): Playing different roles enhances clients’ ability to interact effectively with others in differing situations. Clients begin by acting out a designated situation and then develop their own scenario. They then keep track of difficult situations that occur outside therapy.
One of these situations is chosen for role-playing, with either coaching or modeling by the counselor. After each role-play, feedback is given pertaining to the client’s strengths and weaknesses (Corsini & Wedding, 2001).
• Self-monitoring (cognitive—directive): Clients monitor and record their thoughts just prior to, or during, problem behavior. During counseling sessions, the client discloses these thoughts, providing clues to the behavior and its treatment ( James & Gilliland, 2001).
• Sharing hunches (Gestalt—directive): The counselor or group members share feelings and perceptions of other members in a tentative manner or in the form of an intuition or hunch. This provides clients with insight into how others see them (should only be done with clients’ permission; G. Corey, 2000).
• Spitting in the client ’s soup (individual psychology—directive): When counselors determine that clients are getting a reward from maladaptive behavior, they may spoil the reward for clients by making them aware of the nature and consequences of this behavior (Howatt, 2000).
• Staying with the feeling (Gestalt—directive): When clients experience unpleasant feelings, the counselor encourages them to stay with these feelings. By experiencing and confronting negative emotions, courage develops, as does growth through experiencing pain (G. Corey, 2000).
• Systematic desensitization (behavior therapy—directive): Clients imagine various scenes so they gradually overcome fearful responses to anxiety-producing events. Clients are first helped to relax physically, then asked to imagine a low-anxiety item from a prepared list and maintain focus on that item while remaining calm until no more anxiety is felt.
The counselor then has the client move on to imagine a more stressful scene, repeating the procedure step by step until the client can respond to the worst item on the list with calmness instead of fear ( James & Gilliland, 2001).
• Teaching the ABC model (REBT—directive): This teaching tool is based on the idea that irrational beliefs are the core of an individual’s problems: A—activating event; B—belief about that event; C—the consequence(s) of the belief. It teaches clients that their belief about an event, and not the event itself, leads to the subsequent feelings or behaviors (Corsini & Wedding, 2001).
• Two-chair technique (Gestalt—moderately directive): Chairs, set up across from each other, allow clients to dialogue with themselves and play all the roles. Clients change chairs when they change roles (Howatt, 2000).
Additional Resources
Gilliland, B. E., & James, R. K. (1998). Theories and strategies in counseling and psychocounseling (4th ed.). New York: Allyn & Bacon, is a well-written and detailed review of the most commonly used counseling theories useful in addiction counseling.
Howatt, W. A. (2000). The human services counseling toolbox. Pacific Grove, CA: Brooks/Cole, is a reference tool containing information on theory, techniques, and strategies for working with persons with addictive disorders. This book was developed with students who were learning how to become addiction counselors.
Corsini, R. J., & Wedding, D. (Eds.). (2001). Current psychotherapist (6th ed). Belmont, CA: Brooks/Cole; one of the most complete and detailed books on counseling theory in print today. Sommers-Flanagan, J., & Sommers-Flanagan, R. (2004). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques. Hoboken, NJ: Wiley.
We classify these techniques on a three-point scale: (1) directive, (2) moderately directive, and (3) nondirective. At one end of the scale, directive techniques openly confront and challenge the client to take specific action (e.g., complete homework).
At the opposite end, nondirective techniques, the counselor empathically supports the client. When using moderately directive techniques, the counselor focuses both on giving support and assisting the client in taking action (e.g., active scheduling):
• Acting as if (individual psychology—directive): In a role-play situation, clients act out the way they would like to be in various life scenarios and explore alternatives. The underlying premise is that with practice these behaviors feel more natural (G. Corey, 2000).
• Active listening (person-centered—nondirective): The counselor uses a cluster of skills to increase accurate understanding about what is being said. Good listening requires that the counselor interact with the client, offering affirming comments about what has been said, rephrasing the client’s comments to encourage further commentary, and other appropriate expressions (see “C linical Microskills” later in this part; Egan, 1994).
• Activity scheduling (behavior therapy—moderately directive): The counselor works with the client to initiate activities that move the client from inactivity to a more productive and vital state. Aside from these activities, scheduling— itemizing choices and strategies—may immediately impact the client positively (Corsini & Wedding, 2001).
• Analogies or images to illustrate problems (REBT—moderately directive): Analogies or images are used to see a problem from a different viewpoint (G. Corey, 2000).
• Assertion training (behavior therapy—moderately directive): Assertiveness, the ability to express one’s needs and thoughts confidently without being either passive (hiding or muting) or aggressive (forcing and badgering), is useful for clients who cannot express anger or frustration, who have difficulty saying no, who allow others to take advantage of them, who have difficulty expressing affection, or who feel they do not have the right to express thoughts and feelings.
This training is a collection of techniques—behavior rehearsal, exposure, modeling, and reinforcement (Meichenbaum, 1977). Elaboration of each is listed separately.
• Attending and listening (individual psychology—nondirective): The counselor learns the core of a client’s thoughts and feelings by being psychologically involved, engaging the client with eye contact, and paying close attention to both verbal and nonverbal communication (Howatt, 2005).
• Behavior modeling (behavior therapy—moderately directive): Also called vicarious learning (developed by Bandura), the client learns by first observing the counselor (or someone else) perform a specific action, then imitates the modeled behavior (Corsini & Wedding, 2001).
• Bibliotherapy (behavior therapy—moderately directive): Reading assignments stimulate discussion, convey new values and attitudes, help reframe the problem, and provide possible solutions (G. Corey, 2000).
• Brainstorming (individual psychology—moderately directive): This is an uncritical discussion of all responses to open-ended, thought-provoking questions and problems, each designed to stimulate a list of ideas pertinent to various choices and options (Egan, 1994).
• Catching oneself (individual psychology—directive): This technique is useful with clients who catastrophize, are perfectionists, have eating disorders, and demonstrate obsessive-compulsive behavior. It raises awareness of selfdestructive behavior or irrational thought without self-condemnation. Clients learn to anticipate events and change their behavior patterns (G. Corey, 2000).
• Challenging (choice theory—directive): This is an invitation to recognize thoughts and/or behavior that is self-defeating, harmful to others (or both), and to change that behavior (Howatt, 2000).
• Cognitive modeling (behavior therapy—moderately directive): The counselor performs tasks while engaging in self-encouragement to demonstrate how clients may talk themselves successfully through a task (Howatt, 2005).
• Cognitive restructuring (behavior therapy—nondirective): The counselor teaches clients to identify and evaluate their thoughts and to replace negative ones with more realistic and appropriate thoughts ( James & Gilliland, 2001).
• Congruence (person-centered therapy—nondirective): The counselor is honest and consistent in word and behavior (G. Corey, 2000).
• Contingency contracts (behavior therapy—directive): The client and counselor develop a contract together designating behavior to be performed or changed. Rewards are based on the achievement of stated goals, the conditions under which they will be received, and the specific time frames for completion (Howatt, 2000).
• Continuum line (REBT—directive): Clients rate their feelings about their addiction on a scale of 1 to 100 with 1 being the worst (they hate it) and 100 being the best (they love it).
This provides an understanding of where the client is in the treatment process and generates middle-ground options for clients manifesting black or white thinking (Howatt, 1995).
• Contracting for change (transactional analysis—directive): Clients work with the counselor to develop a contract that specifically states what they plan to change in order to reach self-designated goals. The counselor is a witness and a facilitator (Howatt, 2000).
• Counter-conditioning (behavior therapy—moderately directive): Also known as reciprocal inhibition (Wolpe, 1982), the client practices being able to calmly respond to a stressful situation. The client learns to lower anxiety levels by breathing deeply, stretching, and relaxing shoulder and neck muscles.
• Decatastrophize (cognitive—directive): Using “what if” questions, clients discover that their problems may have grown out of proportion in their mind. This reduces anxiety so that positive collaboration and cooperation can take place between client and counselor (Howatt, 2000).
• Description (existential—nondirective): Clients vividly describe to the counselor what they are feeling or experiencing, thus facilitating a better understanding between them (Howatt, 1995).
• Disputing perfectionism (REBT—nondirective): The counselor shows clients (who thinks they must always be good at everything) that perfectionism is self-defeating (Corsini & Wedding, 2001).
• Diversion (cognitive—directive): The counselor distracts a sad or anxious client’s attention away from the present concern, breaking an emotionally laden thought pattern, so that the client can return to the appropriate treatment track (G. Corey, 2000).
• Empathy (person-centered therapy—nondirective): The counselor sees and feels the client’s world as though immersed in that world. By assuming the internal frame of reference of the other, the counselor understands the client’s private pain ( James & Gilliland, 2001).
• Encouragement (individual psychology—directive): The counselor praises clients’ strengths and progress, recognizing, labeling, and accepting their positive qualities. This increases clients’ self-confidence, counters discouragement, and helps them set realistic goals (G. Corey, 2000).
• Exaggeration (Gestalt—directive): The counselor asks the client to exaggerate a certain thought, emotion, or body movement that has just been expressed, allowing the client to become more aware of hidden feelings and defense mechanisms (Howatt, 2000).
• Extinction (behavior therapy—moderately directive): Undesirable behaviors are discouraged and eventually eliminated by removing rewards that stimulate the behavior (Corsini & Wedding, 2001).
• Feedback (behavior therapy—moderately directive): Praise, encouragement, and specific constructive suggestions for modifying errors help clients learn new behaviors ( James & Gilliland, 2001).
• Fruit basket technique (REBT—directive): The counselor shows a fruit basket with good and bad fruit to demonstrate that although the client may have some flaws and done some bad things, the client also has virtues and is basically a good person (Howatt, 2000).
• Goal setting (interpersonal—directive): Brainstorming specific objectives and strategies and then arranging emerging plans in the best sequence for a positive outcome mobilizes the client to appropriate action (Corsini &Wedding, 2001).
• Graduated exposure (behavior therapy—directive): Step-by-step exposure to reallife situations enables clients to practice skills or preferred behavior in anxietyprovoking situations (Howatt, 2000).
• Graduated task assignment (behavior therapy—directive): Clients learn to reduce anxiety while developing new skills by taking an assigned task (often given as homework) that begins simply and then gradually becomes more difficult and complex (Howatt, 1995).
• Helper self-disclosure (individual psychology—moderately directive): The counselor appropriately shares selected and focused experiences, behaviors, and feelings with clients. This builds the client-counselor relationship and encourages the client to disclose hidden feelings and thoughts (Howatt, 2005a).
• Humor and jolting language (sarcasm; REBT—moderately directive): Appropriate humor by the counselor can relax clients and encourage them to open up. Sarcasm may help clients identify their irrational beliefs and laugh at their behavior (Howatt, 2000).
• Imagery (cognitive—directive): Metaphors and/or visual pictures developed by counselor and client may help clients develop insight about their thinking and provide the counselor with a clearer impression of clients’ automatic thoughts (G. Corey, 2000).
• Immediacy (individual psychology—directive): Addressing what is going on in the present counseling session may help the client see that what is occurring is a sample of everyday life (G. Corey, 2000).
• Language exercises (Gestalt—directive): An examination of speech patterns that helps clients increase self-awareness and personal responsibility by acknowledging their thoughts, feelings, and actions (Howatt, 1995).
• Magic wand (individual psychology—directive): Clients pretend they have a magic wand and can wish for anything to allow them to look beyond present circumstances and define their real wants in life (Howatt, 2000).
• Offering options (individual psychology—directive): The counselor offers clients a choice among several options (Corsini & Wedding, 2001).
• Paradoxical intention (reality therapy—moderately directive): Clients are instructed to consciously exaggerate debilitating thoughts and behaviors, creating an awareness of how out of proportion their response is to the situation. Also called prescribing the symptoms and antisuggestion (Wubbolding, 1988).
• Paradoxical intervention (logo therapy—directive): The counselor places clients in a double bind to cut through their resistance by asking them to exaggerate or even perfect a problematic behavior (G. Corey, 2000).
• Paradoxical technique (REBT—directive): Clients are asked to perform the presenting irrational behavior at a certain time every day, thus removing the gratification received from performing the irrational behavior (Howatt, 2000).
• Playing the projection (Gestalt—directive): Clients pretend to be the recipient of the statements that they make about others. These statements, often projections of attributes that clients possess, bring awareness of inner conflicts (G. Corey, 2000).
• Push-button technique (individual psychology—directive): Clients close their eyes and alternately picture a pleasant and an unpleasant experience while paying attention to the feelings accompanying each experience. This teaches clients that they can create whatever feelings they wish by relying on their thoughts (Corsini & Wedding, 2001).
• Reframing (cognitive—directive): Reframing provides a different interpretation of a particular situation, allowing a client to understand an original complaint from different angles (G. Corey, 2000).
• Reinforcement (behavior therapy—directive): A pleasant stimulus increases a desired behavior ( James & Gilliland, 2001).
• REBT self-help form (REBT—directive): The client completes this form and the counselor uses it to determine the nature and extent of a client’s faulty beliefs.
(These REBT forms can be obtained from the Institute for Rational Emotive Therapy, 45 East 65th Street, New York, 10021, 212-535-0822; Howatt, 2005.)
• Role play (behavior therapy—moderately directive): Playing different roles enhances clients’ ability to interact effectively with others in differing situations. Clients begin by acting out a designated situation and then develop their own scenario. They then keep track of difficult situations that occur outside therapy.
One of these situations is chosen for role-playing, with either coaching or modeling by the counselor. After each role-play, feedback is given pertaining to the client’s strengths and weaknesses (Corsini & Wedding, 2001).
• Self-monitoring (cognitive—directive): Clients monitor and record their thoughts just prior to, or during, problem behavior. During counseling sessions, the client discloses these thoughts, providing clues to the behavior and its treatment ( James & Gilliland, 2001).
• Sharing hunches (Gestalt—directive): The counselor or group members share feelings and perceptions of other members in a tentative manner or in the form of an intuition or hunch. This provides clients with insight into how others see them (should only be done with clients’ permission; G. Corey, 2000).
• Spitting in the client ’s soup (individual psychology—directive): When counselors determine that clients are getting a reward from maladaptive behavior, they may spoil the reward for clients by making them aware of the nature and consequences of this behavior (Howatt, 2000).
• Staying with the feeling (Gestalt—directive): When clients experience unpleasant feelings, the counselor encourages them to stay with these feelings. By experiencing and confronting negative emotions, courage develops, as does growth through experiencing pain (G. Corey, 2000).
• Systematic desensitization (behavior therapy—directive): Clients imagine various scenes so they gradually overcome fearful responses to anxiety-producing events. Clients are first helped to relax physically, then asked to imagine a low-anxiety item from a prepared list and maintain focus on that item while remaining calm until no more anxiety is felt.
The counselor then has the client move on to imagine a more stressful scene, repeating the procedure step by step until the client can respond to the worst item on the list with calmness instead of fear ( James & Gilliland, 2001).
• Teaching the ABC model (REBT—directive): This teaching tool is based on the idea that irrational beliefs are the core of an individual’s problems: A—activating event; B—belief about that event; C—the consequence(s) of the belief. It teaches clients that their belief about an event, and not the event itself, leads to the subsequent feelings or behaviors (Corsini & Wedding, 2001).
• Two-chair technique (Gestalt—moderately directive): Chairs, set up across from each other, allow clients to dialogue with themselves and play all the roles. Clients change chairs when they change roles (Howatt, 2000).
Additional Resources
Gilliland, B. E., & James, R. K. (1998). Theories and strategies in counseling and psychocounseling (4th ed.). New York: Allyn & Bacon, is a well-written and detailed review of the most commonly used counseling theories useful in addiction counseling.
Howatt, W. A. (2000). The human services counseling toolbox. Pacific Grove, CA: Brooks/Cole, is a reference tool containing information on theory, techniques, and strategies for working with persons with addictive disorders. This book was developed with students who were learning how to become addiction counselors.
Corsini, R. J., & Wedding, D. (Eds.). (2001). Current psychotherapist (6th ed). Belmont, CA: Brooks/Cole; one of the most complete and detailed books on counseling theory in print today. Sommers-Flanagan, J., & Sommers-Flanagan, R. (2004). Counseling and psychotherapy theories in context and practice: Skills, strategies, and techniques. Hoboken, NJ: Wiley.
