Communication is the key to all successful relationships. It is the foundation on which trust, the cornerstone of relationships, is built. In a client-provider relationship, this trust is known as the therapeutic alliance, which helps patients know the treatment provider has their best interest at heart. Findings suggest that a strong therapeutic alliance helps reduce psychological distress during treatment for substance use disorders and facilitate necessary gains in maintaining sobriety, such as increased motivation, self-efficacy or coping skills. Here are a few essential communication strategies that treatment professionals can adopt to improve relationships with clients and promote trust, in support of positive outcomes.
How to Implement Clear Communication at the Beginning of Treatment
There are four criteria that clinicians should immediately discuss with clients to avoid confusion during treatment and establish framework for positive communication.
These criteria include:
- Clients’ ambivalence towards change
- Patient goals, such as abstinence versus decreasing alcohol use
- Preference for treatment, including group-based, one-on-one, monitored treatments, etc.
- Differences in the privacy and cost of varied treatments
Certified Advanced Alcohol and Drug Counselor Sarah Espenshade of Espenshade Counseling has clients sign a treatment agreement, which very explicitly outlines expectations of treatment and what communication will look like upon intake to promote trust and transparency. This is a two-way street for clients and professionals, which encourages both parties to utilize direct communication regarding issues, such as relapse, rather than a fear-based relationship, which condemns and penalizes clients for slipups.
“If we have concerns about somebody’s drinking or substance use or addictive behaviors, we want to go directly to that person if possible and be pretty explicit with them in a compassionate, caring way that we’re concerned they may have lapsed in substance abuse or drinking, and we want to help them get back on track,” Espenshade says.
Unique Communication Challenges with Alcohol Use Disorder Clients
Establishing healthy communication skills with clients can protect against common roadblocks that patients and providers encounter on the road to recovery, including:
- Denying the problem: As The Hazelden Betty Ford Foundation writes, “refusing to accept a painful reality that alters the perception of ourselves is a psychological defense called denial.” Clients may use this natural instinct to protect against insight or awareness that they feel threatens their self-esteem, security and mental or physical health.
- Lacking coping skills: Alcohol is a substance that can induce a feeling of calmness. Often times those struggling with substance use disorders lack the necessary coping skills to deal with the various curve balls life throws, which may cause them to resort to self-medicating, instead.
- Protecting the addiction: One of the symptomatic issues associated with substance use disorders is the need to protect the addiction. Drugs or alcohol can hijack the pleasure/reward circuits of the brain causing cravings for more in order to keep feelings of anxiety and stress at bay, the National Institutes of Health finds.
Treatments and Therapies to Improve Communication with Alcohol Use Disorder Clients
“A big part of the treatment and the recovery process is really teaching clients how to respond in a more effective, appropriate way and recognize that sometimes, we need to have tough conversations, and it’s coming from a place of genuine caring and concern,” Espenshade says.
Providers can utilize various approaches to encourage clients’ engagement in the more challenging conversations that play a major role in addiction recovery. These therapeutic approaches and evidence-based practices include:
- Motivational interviewing: Motivational interviewing is a counseling method that helps people resolve ambivalent feelings and insecurities to find the internal motivation needed to change their behavior. Research has shown that this intervention works well with individuals who start off unmotivated or unprepared for change, versus those who are already motivated to change. This supportive manner of communication encourages clients to talk about their need for change and to express their commitment to change out loud.
- Cognitive Behavioral Therapy (CBT): Cognitive Behavioral Therapy is another common type of psychotherapy, or talk therapy, that helps patients become aware of inaccurate or negative thinking in order to view challenging situations more clearly and respond to them in a more effective manner. Initial sessions of cognitive behavioral therapy may cause patients to feel physically drained as it may entail an exploration of painful feelings, emotions and experiences. However, the coping skills learned will help patients manage and conquer negative feelings and fears.
- Dialectical Behavioral Therapy (DBT): Dialectical Behavior Therapy is a psychotherapy method that helps those in addiction recovery learn skills—such as mindfulness, distress tolerance, interpersonal effectiveness and emotional regulation—that can be applied to daily routines and interactions. This type of therapy is:
- Support-oriented to help individuals identify their strengths and build on them
- Cognitive-based to help individuals identify thoughts, beliefs and assumptions that make life harder
- Collaborative to encourage clients to work out problems in their relationships with their therapist.
- Remote communication: Telehealth communication tools can help those in recovery remain connected to their support system and aware of their sobriety journey. Many treatment programs, including those offered at Espenshade Counseling, use text, email, GPS monitoring and Soberlink, a remote alcohol monitoring device, to increase access to communication and emphasize client accountability. “We started to use Soberlink a lot more often to expose clients and their families to a variety of different modality for treatments. Providing a lot of accountability reinforcement makes a huge difference versus the old-school approach to treating addiction, which was much more confrontational,” Espenshade says.
When treatment professionals demonstrate clear and effective communication with their clients, it encourages them to do the same. Using communication as a two-way street makes the sobriety journey easier and helps prepare clients for any roadblocks along the way. Learn more about how Soberlink can assist patients on their road to recovery.
About the Author
Soberlink supports accountability for sobriety through a comprehensive alcohol monitoring system. Combining a breathalyzer with wireless connectivity, the portable design and technology includes facial recognition, tamper detection and real-time reporting. Soberlink proves sobriety with reliability to foster trust and peace of mind.