In his last article for Pro Talk, Renaming and Rethinking Drug Treatment, psychologist Robert Schwebel, Ph.D., author and developer of The Seven Challenges program, expressed his views about problems in typical drug and alcohol treatment. In this interview, he focuses on changes that he thinks would better meet the needs of individuals with substance problems.<\/p>\n
The Seven Challenges Program<\/strong><\/p>\n The Seven Challenges is described as \u201ca comprehensive counselling program for teens and young adults that incorporates work on alcohol and other drug problems.\u201d The program addresses much more than substance issues because it also helps young people develop better life skills, as well as manage their situational and psychological problems. Although there is an established structure for each session and a framework for decision-making (see website for the youth version of \u201cThe Seven Challenges\u201d), it is not pre-scripted as in many traditional programs. Rather it is \u201cexceptionally flexible, in response to the immediate needs of the clients.\u201d<\/p>\n Independent studies funded by The Center for Substance Abuse Treatment and published in peer-reviewed journals have provided evidence that The Seven Challenges significantly decreases substance use of adolescents and greatly improves their overall mental health status. The program has been shown to be especially effective for the many young people with drug problems who also have trauma issues.<\/p>\n Just recently, a new version of The Seven Challenges program was introduced for adults and is being piloted in a research project. Soon, a book geared toward the general public by Dr. Schwebel that incorporates much of the philosophy of the program, as well as many of the decision-making and behavior change strategies, will be available.<\/p>\n Q&A: What Should Treatment Look Like?<\/strong><\/p>\n Q: In your last article for Pro Talk, you argued strongly against the word \u201ctreatment\u201d and suggested that we use the word \u201ccounselling\u201d instead. Will you reiterate why you prefer using \u201ccounselling\u201d when talking about professional help for people with substance problems?<\/p>\n Dr. S<\/strong>.: Counselling is an active and interactive process that\u2019s responsive to the needs of individuals. It may include education, but it\u2019s more than that because the information is personalized and offered in the context of a discussion about what\u2019s happening in a person\u2019s life. Effective counsellors help clients become aware of their options, expand those options, and make their own informed choices.<\/p>\n Treatment, on the other hand, sounds like something imposed and passive that an authority (say a doctor) does to someone else or tells them to do. It also implies recipients receive a standardized protocol or regime with a preconceived goal, usually abstinence when we\u2019re talking about addiction. It doesn\u2019t suggest autonomy of choice or collaboration.<\/p>\n <\/p>\n Q: You stress the importance of choice and collaboration, suggesting both are important in addiction counselling. Please tell us more.<\/p>\n Dr. S.: In collaborative counselling that allows choices, clients get to identify the issues they want to work on. They make the decisions. We make it clear that we\u2019re not there to make them quit using drugs\u2026and couldn\u2019t even if we tried. We tell them, \u201cWe\u2019re here to support you in working on your issues, things that are important to you; things that are not going well in your life or as well you would like them to be going.\u201d<\/p>\n We also support clients in decision-making about drugs. They set their own goals about using. One person might want to quit using, while another might want to set new limits. For those who want to change their drug use behavior, we check in with them about how they\u2019re doing regarding their decision on a session-by-session basis. If they have setbacks, we\u2019ll provide individualized support to help them figure out why, We\u2019re not doubting them or trying to \u201ccatch\u201d them. Rather, we\u2019re helping them succeed with their own decisions to change. This type of check-in would not apply to individuals who have not yet decided to make changes.<\/p>\n <\/p>\n Q: Many addiction programs feel that dealing with addiction should be the first priority and that other issues are secondary. What are your thoughts about this?<\/p>\n Dr. S.: I\u2019ll start by saying that they have equal importance. Drug problems have everything to do with what is going on in a person\u2019s life. And, a person\u2019s life is very much affected by drug problems. I do want to say, however, that not everyone who winds up in an addiction program has an addiction. That\u2019s a ridiculous generalization. They may be having problems with binge drinking, issues with family or jobs because of substance misuse, or legal problems because they were unlucky and got caught. (For instance they got arrested for another crime and tested positive for drugs.) They often wind up in places that require abstinence and wonder, \u201cWhat am I doing here?\u201d Then they\u2019re told they\u2019re \u201cin denial.\u201d<\/p>\n Traditional treatment tends to focus narrowly on drug problems, usually pushing an agenda of immediate abstinence. However, drug problems \u2013 whether or not they qualify as \u201caddiction,\u201d are very much connected to the rest of life. Therefore, clients need comprehensive counselling that addresses what\u2019s happening in their overall lives and helps clients make their lives better. So it\u2019s not all about use of substances and making the individual quit. The goal is to support clients and to help them make their own decisions about life and substance use.<\/p>\n We use the term \u201cissues\u201d \u2013 not \u201cproblems.\u201d Whatever is most important to the individual that day is what we work on. A client might say, \u201cI have an issue with my mother.\u201d We don\u2019t just want to have a discussion about the issue; we want to set a session goal so that a client gets practical help with an issue each time. Ideally we try to facilitate a next step, some sort of action that can be taken between sessions. We want to support our clients in making their own lives better. We like to reassure clients that we won\u2019t be harping on drugs all the time: At least half of what we do is about everything else besides drugs. This means that counsellors need to know how to help people with their other problems. Unfortunately, many have a narrow background in drug treatment and don\u2019t yet know how to do that.<\/p>\n <\/p>\n Q: How do you address the issue of \u201cpowerlessness\u201d which a number of young people have told me they struggled with in12-step treatment programs they\u2019ve attended? Don\u2019t adolescents by nature resist anything that threatens to take away their autonomy?<\/p>\n Dr. S.: One of our main messages is \u201cYou are powerful; people do take control over their drug use. You have that power within you.\u201d We also say, \u201cYou don\u2019t need to do it alone. You are entitled to support. We\u2019re behind you. We\u2019re not saying it\u2019s easy and<\/p>\n there won\u2019t be setbacks along the way. If there are, we\u2019ll help you figure out why and how to handle it differently the next time. At the same time we\u2019ll help you with other issues in your life so you\u2019ll have less need for drugs.\u201d<\/p>\n I think there is great harm in the all-or-nothing approach to drug and alcohol problems and that more people would come for help if they were not told that they\u2019re powerless. Also, many more would come if they felt they could make a choice about drugs and did not expect to be coerced.<\/p>\n <\/p>\n A New Version of The Seven Challenges<\/strong><\/p>\n Following is the new adult version of Dr. Schwebel\u2019s The Seven Challenges program:<\/p>\n \u00b7 Challenging Yourself to Make Thoughtful Decisions About Your Life, Including Your Use of Alcohol and Other Drugs<\/p>\n \u00b7 Challenging Yourself to Look at Your Responsibility and the Responsibility of Others for Your Problems<\/p>\n \u00b7 Challenging Yourself to Look at What You Like About Alcohol and Other Drugs, and Why You Use Them<\/p>\n \u00b7 Challenging Yourself to Honestly Look at Your Life, Including Your Use of Alcohol and Other Drugs<\/p>\n \u00b7 Challenging Yourself to Look at Harm That Has Happened or Could Happen From Your Use of Alcohol and Other Drugs<\/p>\n \u00b7 Challenging Yourself to Look at Where You Are Headed, Where You Would Like to Go, and What You Would Like to Accomplish<\/p>\n \u00b7 Challenging Yourself to Take Action and Succeed With Your Decisions About Your Life and Use of Alcohol and Other Drugs<\/p>\n Source:\u00a0 http:\/\/www.rehabs.com\/pro-talk-articles\/what-drug-and-alcohol-treatment-should-look-like-an-interview-with-dr-robert-schwebel\/\u00a0\u00a0\u00a0\u00a0 17th July 2017<\/em><\/p>\n","protected":false},"excerpt":{"rendered":" In his last article for Pro Talk, Renaming and Rethinking Drug Treatment, psychologist Robert Schwebel, Ph.D., author and developer of The Seven Challenges program, expressed his views about problems in typical drug and alcohol treatment. In this interview, he focuses on changes that he thinks would better meet the needs of individuals with substance problems. 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