The ACCEPT Model

The ACCEPT

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Model

Acceptance is a key in the treatment of substance abuse. As the addict must accept that he or she has a problem, the therapist must accept the client as they are without judgement or enabling behavior and acknowlege that the client is an addict. The model we feel is most successful for the treatment of substance abusers and their families involves the following features:

Assessment The first step in the treatment of substance abuse and codependency is to assess the degree of addiction. Relatively few clients come into therapy with substance abuse as a presenting problem, and the main defense mechanism of the illness is denial. Techniques to elicit the depths of the problem are essential skills for ALL therapists. Compassion Compassion is vital in all healing work. It is the ability to be totally present for the client in the moment, in the pain. It is not sympathy nor pity, but rather a 'feeling with' the person. This allows the therapist to not judge or fix, but rather to hear the tears and hold the vision that we are all on this little planet struggling for wholeness. True compassion is what protects us from codependence. Confrontation The ability to confront (gently!!) is necessary to break through the entrenched system of denial. Using a neutral tone citing examples from the client's own story is the most effective means. Most addicts have been screamed at, bargained with, threatened, and given ultimatums. Neutrality can be difficult for therapists. We want our clients to get better and may experience negative countertransference when they don't. The key here is to be non-judgmental and detached as to the outcome. This breaks the cycle in which the therapist becomes the enabler. The therapeutic task is assess the client, confront the denial, then help them treat the substance abuse. It is rarely productive to figure out why someone uses drugs or alcohol, only that they do to excess, with a negative impact on themselves and their families. Education Education is crucial for the client and for the therapist. As clinicians, we need to be informed about substance abuse, its pervasiveness in society, how it impacts families for generations, and its treatment. For the addict, education is a tremendous weapon against both denial and relapse. It is also one of the hallmarks of treatment of the codependent and the adult child of an alcoholic. Knowing one's own history helps to break multi-generational patterns of addiction, so when we speak of education we mean both factual information on the process of addiction and the courage to research ancestral patterns. Psychotherapy addressing the body-mind-spirit continuum in the addict and the family Successful treatment for the addict and the enabler must address the three realms of the body, the mind and the spirit. Cravings are physical as well as psychological, and detoxification may need medical support. Addiction often combines obsessive-compulsive features with denial, so the thinking of the addict is often distorted. As many addicts start using drugs to fill "the empty hole", a spiritual solution is sometimes part of the healing journey. Twelve Step Referrals We have found the most success in integrating Twelve step programs such as Alcoholics Anonymous, Narcotics Anonymous, Codependents Anonymous, etc. with psychotherapy to treat addiction. The Twelve steps address the powerlessness of the individual over the problem, the acceptance of responsibility for the consequences of the addiction and the willingness to ask for help from a spiritual source. The group setting assists in countering the isolation and loneliness that many addicts feel. Sponsors, addicts who have been in recovery, are available 24 hours a day, seven days a week.

All of these concepts are elaborated on in more detail as you continue with the course.

Introduction

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