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RecoveryPlus Workplace

Recovery Plus: Workplace wellbeing 42 September 2016 Some time ago, I was consulting with two teams, both of which are the initial gateway or “call centre” for people seeking addiction and/or mental-health services. The dilemma for these clinicians is how to quickly engage the caller, assess their needs and match them to services – all in 10 minutes or less. In traditional psychotherapy, a therapist plans on developing a therapeutic relationship over weeks and months, even years. So when I say you can develop a therapeutic alliance in 10 minutes or less, it is a bit provocative – but not much. To make sure we are on the same page, when I say “therapeutic alliance”, I’m talking about: LL agreement between you and your client on goals LL agreement between you and your client on strategies and methods to reach those goals LL this agreement occurs in the context of honesty, sensitivity, empathy and understanding (an emotional bond) with the client (Miller, Mee- Lee and Plum). This does not diminish the complexity of the clients who come to us, nor dismiss the work of alliance-building as simplistic. But you are challenged not go to the other extreme, and think, as is all too common: “It’s not important to build a therapeutic alliance in a short phone call. All I need to do is give them a referral number to call to set up an appointment”. Tune in quickly in the first 1-2 minutes. Listen carefully for what is most important in prompting the client to telephone you or keep their appointment to come and talk with you. Listen into a call with a reluctant client. Clinician: “Thank you for calling, what is the most important thing you want that made you decide to call today?” Caller: “My probation officer/family told me to call to get an appointment with an addiction treatment programme?” Clinician: “Oh, so do they think you have an addiction problem?” Caller: “Yes, and it’s what I have to do.” Clinician: “But what do you think? I’m more interested in whether you think you have an addiction problem which needs treatment, not just what others think.” Caller: “Well I don’t think it’s really a problem but I have to go to treatment otherwise I could face consequences because they found something in my urine drug test.” Clinician: “So what is most important to you – to work on an addiction problem or not go back to jail/face the family/other consequences?” Caller: “Not go back to jail.” Clinician: “So how about I find somewhere for you to go that will help you stay out of jail and help you prove that you don’t have an addiction problem. Or, if by chance, you do find out you have an addiction problem, demonstrate you are treating it so you won’t get arrested again?” Now you have just agreed on a goal: stay out of jail. You agreed on strategies and methods: see someone who can work on that goal and prove you don’t have a problem or if you do, that you won’t get arrested again. You agreed on the context: a brief telephone call where you bonded on helping the client get what is most important to him/her. About the author Dr David Mee-Lee is senior vice president for The Change Companies and a psychiatrist, certified by the American Board of Addiction Medicine. He has been the chief editor of all editions of ASAM’s criteria, including The ASAM Criteria – Treatment Criteria for Addictive, Substance-Related, and Co-Occurring Conditions, Third Edition (2013). He has over 30 years’ experience in person-centred treatment and programme development for people with co-occurring mental health and substance use conditions. He has trained and consulted across the US, Australia, Japan, Singapore, Germany and the UK. Create a therapeutic alliance in 10 minutes


RecoveryPlus Workplace
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