What is One-on-One Counselling for Addiction Treatment

One-on-one counselling or individual counselling is where the client meets with their counsellor to address specific needs laid out by the client. This is a client-focused treatment plan and is a good first step in addiction treatment, as the sessions can be tailored and adapted as needed to help the client succeed. Individual therapy can be a very intensive, but effective treatment for alcohol addiction or drug addiction as the therapist is able to better connect with the client and build a rapport to make them feel understood.

What is the Process of One-on-One Counselling?

While every individual practice or clinic will have their own procedures, these are the general steps for one-on-one counselling:

Intake and Information Gathering

This process may feel a bit like an interview, where the counsellor tries to find out as much information as possible about the client, why they are seeking therapy, their background, how they communicate, what they are hoping to achieve through therapy, etc. The first step is just as important for the client, as they can get a sense of their comfort level with the counselor, and whether or not they think the counselor will be a good fit. It is important to remember that the beginning stages of any kind of treatment will push comfort levels, but a good counsellor will make the client as comfortable as possible.

Assessment and Suggested Plan

After the initial intake, the counsellor will assess the client’s situation, and suggest a course of action. This can include the particular type of therapy, the frequency of appointments, and gives the client an idea of what they can expect from therapy sessions. Some types of therapies will have a prescribed amount of time whereas others will be ongoing, and another assessment can be set up at a later date to measure the progress.

Course of Treatment

The counsellor and client will work through the course of treatment prescribed in the treatment plan, working towards whatever goal was established. In a therapy type that’s ongoing, there may be some checkpoints after a certain number of sessions to ensure that the treatment is still aligning with the original goals established, and that both parties feel that progress is being made.

Termination

Some therapies come to and end because the specific goal was accomplished, and the client no longer needs one-on-one counselling. Other times, the therapy has enabled the client to cope with their situation, or has imparted strategies that help the client manage their issues more independently. As one-on-one therapy can be quite intensive, it may not be needed for the entire duration of the client’s treatment plan – group therapy can be another option to maintain results achieved in individual therapy.

Who Can Provide Counselling?

There are many different types of therapies, and just as many designations for professional help. It can be confusing trying to determine which counsellor or therapist is most appropriate for the individual seeking treatment. Here is what some of the more common designations mean:

Counsellor

According to the Canadian Counselling and Psychotherapy Association, the counsellor’s role is to provide the opportunity for people to work towards living more satisfyingly and resourcefully. There is not a strict distinction between counsellor and psychotherapist, however counselling often focuses on more mindful based practices. Counsellors often specialize in a certain field, like marriage, career or addiction counsellors.

Therapist

The term therapist is also unregulated across Canada, and can be used in many different contexts. Technically, a therapist can be anyone who delivers a type of therapy, so the title can range across fields from physiotherapists to aroma therapists. When seeking out a medical professional for any type of therapy, it is important to do your research. Practicing therapists should have a Bachelor’s degree, followed by a Masters degree in their relevant field.

Psychotherapist

A psychotherapist is a practitioner who typically treats patients who have been diagnosed with a mental disorder, such as schizophrenia, bipolar disorder, etc. There is not a specific licence to be a certified psychotherapist in Canada, and legislation varies from province to province, however a Masters degree is required to practice.

Psychologist

Psychologists are those who have a Doctorate degree in psychology. To become a registered psychologist, practitioners must be accepted by the governing board in their respective province. As psychologists have the proper training, they are able to make diagnoses regarding mental health disorders. Because of their extensive knowledge and training, their services would also be more expensive for the patient.

Psychiatrist

Psychiatrists are medical physicians who specialize in mental health issues. The biggest differences between psychiatrists and psychologists is that psychiatrists have completed medical school, and they are therefore able to prescribe medication to their patients. Just like most specialized doctors, a referral from your general practitioner is required to see a psychiatrist. A patient would not receive counselling directly from a psychiatrist, but would be referred to another practitioner after a diagnosis.

What Are the Benefits of One-on-One Counselling for Addiction?

Individual counselling is highly beneficial for anyone experiencing alcohol abuse or drug abuse. While family members or significant others may provide support, an addict’s chances of success in their recovery process are greatly improved with individual addiction counselling. One-on-one treatment programs are also able to be adapted based on the needs of the client, as they transition from withdrawal symptoms to addressing potential mental health problems.

During the detoxification process, an individual will feel very unstable and vulnerable, so an individual session may be preferable over group counselling. While 12-step programs and group sessions can be helpful in later stages of a detoxification program, the important first steps are often best handled with one-on-one therapy.

Because substance abuse disorders and alcohol dependence are still very stigmatized in our society, building a rapport with an individual treatment provider can help the patient to regain their confidence and greatly benefit their mental health. Removing the shame and stigma from relapse and treatment is critical to success, and an effective counsellor will do that.

What Types of Therapies Use One-on-One?

Different types of therapies can be used to elicit different information from the patient at the discretion of the therapist. Some may be more effective than others depending on the situation and the results the patient wants to achieve. Some common therapy types include:

Cognitive Behavioural Therapy (CBT)

CBT is a type of psychotherapy that teaches patients to change their thought patterns and the way they react to situations or stress to establish a healthier behaviour, and a more positive lifestyle. CBT is intended to be a short-term therapy, typically in response to a specific problem an individual is facing. This cognitive response restructuring results in behavioural changes that can make a lasting impact on individuals battling drug addiction or anxiety disorders.

Dialectic Behavioural Therapy (DBT)

Based on the principles of CBT, DBT is a form of therapy that focuses on managing extreme emotions in the context of social situations. It is the preferred treatment for patients who are exhibiting severe problematic, destructive behaviour who are in high-risk situations, or who may be suicidal.

Person-Centred Therapy (PCT)

This type of therapy is guided by the patient, and modeled on the belief that every individual has the capacity to understand themselves and realize their own path. The therapist is there for positive reinforcement, and does not impose their own beliefs on a situation or necessarily give advice. This type of therapy is not usually suitable for the early stages of addiction treatment, however can be beneficial as the patient is on the path to sobriety.

Aversion Therapy

Aversion therapy is controversial, and was frequently used in addiction treatment in rehab programs in the past. In aversion therapy, the practitioner creates an association between the substance the patient is addicted to, and some sort of negative experience like pain or illness. For example, a practitioner may show images of alcohol and then administer an electric shock, so that the patient associates having a drink with the pain of getting a shock. A common example of this treatment is an individual keeping an elastic band on their wrist, and snapping it whenever they have a craving as a type of punishment. Aversion therapy is certainly not as common as it once was, but is still sometimes used in conjunction with other types of therapy.

Art Therapy

Art therapy is a treatment tool where the patients express themselves and work through difficult emotions through their own creative process. This type of therapy is not necessarily to hone artistic skills, but about self expression when the individual may not be comfortable speaking to or precisely articulating their past experiences. Art therapy is an effective tool in addiction treatment as the patient may have had a wide range of complicated experiences while under the influence of drugs and alcohol that may be difficult to articulate in words.

Different treatment centres will offer different treatment options, often in combinations. The trend in research now is to offer more nurturing and mindful-based therapies, versions corrective and conditioned behaviour therapies.

How Can You Support Someone Undergoing One-on-One Counselling?

If a loved one is undergoing alcohol counselling or drug counselling, it’s important to respect their process – they may want to discuss it with you, but they may not. Remind them that seeking help is not shameful, and that they are creating a positive change. It can be a tiring process for all parties involved, so it will be important to be extra patient. Whether it’s your partner, your child or your parent going through therapy, remember that it is a process and not an overnight solution.