Psychotherapy
Introduction of the Counselor
I am a psychotherapist at a private, multidisciplinary hospital. Am aged 45 years and have been practicing psychotherapy counseling for over 15 years. I am a licensed substance and alcohol abuse counselor as well as a nationally certified counselor and supervisor. I have a doctoral degree in both counselor education and supervision. My primary theoretical orientations are client oriented and cognitive behavior. The bulk of my clinical practice has involved adults struggling with substance abuse and alcohol addiction.
Identification of parameters as well as a narrative history was achieved in session 1. In session 2, I was able to teach her the cognitive model for comprehending behavior and suggested it is as the framework for us to use. In an instance of an alcohol-related behavior or distressing feeling, we would strive to identify the relevant inferences she applied to the situation. I underscored the relationships of thoughts, cognitions (thoughts) and behavior. For the purpose of homework, I required her to keep a Triple Column, where she would list situations, feelings as well as thoughts related to the urge to drink.
In session 3, we sought to explore alternative options the problem of drinking in addition to examining their impacts. Her drinking habit experienced a sharp decline during the 1-week vacation. So much so that she reported having had 10 days alcohol-free by session 4. She described cognitions preceding former drinking as “having a nerve” and “forgetting an insult”. Many of the meanings that she supplied were largely polarized, and we had discussion over this error identified as “black and white thinking.” Working as a team, we explored other options that were “grays.” I made a suggestion that she had successfully taken the first step toward meaningful change.
This was evident in session 5 when she reported having lasted almost a month of consistent abstinence. She attributed her success thus far to her application of the model when she looked forward to a “drinking situation” coupled with working with the established meanings. After noting reasons of her success, she took time to reflect on the miracle question along with her response of the need to “pull it together.” She described “pulling it together” as a period in her life when she had managed to remain alcohol-free and accomplish set goals. This seemed to provide her with the inspiration to sustain her sobriety. On her own volition, she took a decision to avoid as much as possible high drinking situations. She seemed to have come to the realization of the need to maintain a lifelong, eternal abstinence by espousing that “once an alcoholic, always an alcoholic.” She felt she had developed a whole new construction of meaning relating to the drinking problem. This complimented Hensley’s (2001) constructivist framework of counseling, which entails of a client’s own meaning construction of belief pertaining to alcohol use regardless of cultural norms, influence, or any other suggestions from whichever quarter. She talked of her relationship with alcohol as healthy. She reported difficulty with assertion and that a conversation with her husband resembled “an interrogation” from him.
In session 6, she talked about a visit by her grandchildren. She focused on its attendant demands along with its problems. She reported having continued with the abstinence for 6 weeks and described her mood as “more even”. She also noted that she now angered “less easily.” For the entire while, she was underwent the action stage of change, where she practiced and monitored her new behaviors. She was able to maintain her abstinence though she faced many tempting situations for alcohol drinking. Her solid commitment to the new behaviors was evident through her assertions such as, “I wish never to back to my old life … thing are really starting to work for me” and “I really feel in control. How I wish I was always like this.” As a result, we termed this phase positively as “successfully having stopped drinking.” However, she reported that she previously achieved such a stage. This made clear that sustenance would be a major challenge that we would have to work especially hard on. Together, we sought for potentially high-risk situations that we could anticipate and planned adequately for them.
During session 7, we discussed about 2 slip-ups. We sought to understand individual situations in from the cognitive point of view in addition to examining the alternate meanings, their results, and behavioral options available. In session, she expressed confidence of having achieved full control over the alcohol problem. In addition, she reported feeling “free” for the very time in years. At this point, we agreed to have a follow-up visit 1 month later.
At our ultimate meeting, we distinguished drinking alcohol as a habit from consciously choosing to drink, in respects to the results of her alcohol addiction. To this effect, we adopted a “shift of set,” where she was motivated to advise an individual in a story having a variety of alcohol-related issues. Thereafter we deliberated on the positive value of our engagement, the work we had accomplished, as well as w hat she found helpful in the cognitive method. I made sure to encourage her to call if she felt she needed another meeting.
We ended the psychotherapy after a total of 9 sessions held over a period of 5 months. I drafted and forwarded a letter to her primary care physician, containing a summary of the treatment. Six months, later a follow-up visit revealed continued abstinence. This proved that the individual therapy method was best place in this case considering that AA had been applied but resulted in no positive results to the patient. Alternatively, group therapy would be beneficial depending on the group’s focus.
Conclusion
In this case study, I have presented the Individual therapy method used to help a formerly alcohol addict. The individual therapy is a common therapeutic approach often complimented by other approaches such as group therapy or couples therapy. As a psychotherapist, the individual therapy framework enabled application of techniques from a variety of theoretical orientations to help the client to overcome the alcohol addiction problem. The behavioral approach I adopted helped us both to get to the root of why she drunk. Understanding the causal reason for the drinking habit helped us overcome the problem in the end. In addition, the individual therapy helped the client to become aware of high drinking situations and how to avoid them or control herself. Finally, I must admit that while this was a success story, there are other such instances where the individual therapy method may fail to result in complete resolution of the alcohol addiction problem in a person.
