Interview With Substance Abuse Counselor: Mr. Smith Term Paper

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Interview with substance abuse counselor: Mr. Smith

For my interview, I selected Mr. Smith (not his real name), a substance abuse counselor who approaches his practice from the point-of-view of Cognitive Behavioral Therapy (CBT). CBT has become one of the most popular therapies for treating substance abuse. When I asked why, Mr. Smith replied: "because it works." Substance abuse has long been regarded as one of the most intractable problems in the mental health profession. Substance abuse has a biological cause; is often exacerbated by environmental factors such as growing up in a society where drug abuse is normalized and prevalent; and then fundamentally rewires the subject's reward center in the brain, so the pleasures of the drug outweigh all other pleasures. One of the few techniques to 'unwire' this negative perspective has been CBT. Mr. Smith believes very strongly in the CBT format: he has a M.A. In clinical psychology but also received special training in the technique, which is quite specific in its orientation and approach

In previous forms of therapy, according to Mr. Smith, there was a focus upon the subject's past and trying to figure out what early experiences were at the root of the addiction. "This doesn't do much to cure the addiction," said Mr. Smith. "Often, you end up talking and talking about things that happened in the past that are really irrelevant to the subject's life. It's important instead to focus on the here and now." CBT helps the substance abuser identify irrational behavior patterns and replace them with rational thoughts.
For example, instead of thinking, "it would be so much easier to get through this if I could just take a drink," CBT encourages the client to remind him or herself of all the times he tried to take a drink to relax, and actually made things worse. Mr. Smith would prompt the client: "did it make it easier when you took a drink at the last work function you went to?" To which the client would respond: "no, I got drunk and embarrassed myself." CBT also teaches the client positive coping mechanisms such as deep breathing, pausing before acting or speaking, and setting weekly goals to become abstinent.

CBT believes that by changing someone's thoughts, it is possible to change someone's actions and vice versa. Mr. Smith works with his clients to set positive, clearly-definable and concrete goals to help them change the structure of their lives, as well as to change their thoughts. Mr. Smith placed the emphasis on 'concrete' when he was talking about setting goals in CBT. A goal is not simply 'to do better.' Rather, the client must set a goal such as: "to go to the gym every day after work instead of going to a bar."

The goal-oriented nature is one of the advantages of CBT. Quite often, clients do not have an extensive….....

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