Three Approaches to Treating Addiction, Part 1: The Counselor’s Own Entering into Abstinence

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March 14, 2013 by Dr. Bob Weathers

Cynthia Osborn (2012), in a recent overview of psychotherapeutic approaches to working with addiction, proposed a holistic approach, or “informed eclecticism.”  I would like to summarize three evidence-practiced models, with examples from each, which might add helpfully to those individuals in recovery whose primary work may be occurring in the 12-step program; in the spirit of holistic, informed eclecticism and adding auxiliary support and behavioral encouragement to that quality, ongoing 12-step work.

Osborn first introduces cognitive-behavioral approaches, along with their cardinal assumptions about addiction, treatment, and recovery.  I was particularly impressed here by Osborn’s assertion that, to be truly helpful (for example, with the recovering addict who is struggling with cravings), any substance abuse counselor:

“Should also have an appreciation for the first-hand experiences of the client struggling to stay clean. That is, by abstaining from something important to him or her (e.g., a behavior, beverage, or food item) and entering into an actual ‘abstinence contract’ while practicing as a counselor, the substance abuse counselor (whether recovering or not from chemical addiction) can acquire greater empathy for the client’s subjective experiences.”  (p. 145)

I doubt you would get any resistance to this idea among the population of those individuals in recovery!  What an enormously important, even crucial, addition this would be in terms of the counselor’s to accurately empathize with the up’s-and-down’s of sobriety; in this case, particularly in its early, and most vulnerable stages.


Osborn, C.J.  (2012).  Psychotherapeutic approaches.  In Capuzzi, D., & Stauffer, M. (Eds.), Foundations of addictions counseling (2nd ed., pp. 142-164).  Upper Saddle River, New Jersey.



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