Is sobriety a condition for therapy?

United Kingdom · CPD points & talks · Psychologists

Is sobriety a condition for psychotherapy?

This is a question that faces many psychotherapists in the course of their careers. When a patient presents for therapy and the patient has an active relationship with a substance, does the therapist challenge this relationship? Can psychotherapy continue when a patient is under the influence of the substance in his or her daily life?

In my own practice, I've encountered this question, and have come across two approaches. One approach recommends abstinence in order for psychotherapy to be effective, as the patient needs to avail themselves to the psychotherapy process without the substance which could derail the process and cloud ego development. Another approach views use of the substance like any other symptom in the patient's life, which will resolve once the underlying difficulties have been worked through. The patient is seen as needing the substance for self-soothing and self-regulation, and the idea is that once the patient attaches to the therapist and begins to internalise the therapy, the need for the substance will abate and be replaced by a renewed capacity to face reality.

Dan Wolf, Director of Houghton House Addiction Recovery centres, shares his view here. If you're interested in his full talk on working with addiction, worth 3 CPD points, click here.

-Leanne

Calabash · South Africa
Calabash Articles · South Africa
Calabash Partners · South Africa
Calabash Contributors · South Africa
Calabash Speakers · South Africa
Calabash Talks · South Africa
Calabash Sign up · South Africa
Calabash Sign in · South Africa
Neuro CPD talks · South Africa
Clinical Issues CPD talks · South Africa
Australian Counselling Association CPD talks · South Africa
Article · Points of Consideration for Post-Graduates Seeking Employment · South Africa
Article · SAPC Dialogues: Introduction to Public Mental Health · South Africa
Article · Napping in Young Children · South Africa
Divorce CPD talks · South Africa
job-seeking CPD talks · South Africa
Stuttering CPD talks · South Africa
Talk · Codependency: Identifying & addressing an underlying, untreated addiction in our clients · South Africa
Talk · Building Brains: Sub-Cortical structures of the brain · South Africa
Talk · Understanding the Mind-Gut Connection · South Africa
Terms of Use · South Africa
About Contributors · South Africa
About Calabash · South Africa
Calabash · Australia
Calabash Articles · Australia
Calabash Partners · Australia
Calabash Contributors · Australia
Calabash Speakers · Australia
Calabash Talks · Australia
Calabash Sign up · Australia
Calabash Sign in · Australia
Couples CPD talks · Australia
Australian Counselling Association CPD talks · Australia
Neuro CPD talks · Australia
Article · Literature & Mental Health · Australia
Article · Managing Parent Counselling · Australia
Article · Multidisciplinary Aspects of Stuttering Treatment · Australia
self-help CPD talks · Australia
Mental health CPD talks · Australia
Spirituality CPD talks · Australia
Talk · Promotion of Access to Information Act (PAIA): What health care professionals need to know · Australia
Talk · The Enneagram's Intelligence Centres & Core Underlying Emotions · Australia
Talk · Dyslexia: Conceptual framework and therapeutic interventions · Australia
About Partners · Australia
Terms of Use · Australia
Frequently Asked Questions · Australia
Calabash · New Zealand
Calabash Articles · New Zealand
Calabash Partners · New Zealand
Calabash Contributors · New Zealand
Calabash Speakers · New Zealand
Calabash Talks · New Zealand
Calabash Sign up · New Zealand
Calabash Sign in · New Zealand
Dialectical Behavioural Therapy CPD talks · New Zealand
Australian Counselling Association CPD talks · New Zealand
Personality CPD talks · New Zealand
Article · Kids, Teens & Screens: Webinar · New Zealand
Article · Medications for ADHD · New Zealand
Article · Medication for Anxiety · New Zealand
Neonatal ICU CPD talks · New Zealand
Supervision CPD talks · New Zealand
Bereavement CPD talks · New Zealand
Talk · Confidentiality in Schools · New Zealand
Talk · ADHD Screening: The process & benefits · New Zealand
Talk · Mind Brain Body Connection and the Rhythms of Regulation · New Zealand
How It Works · New Zealand
About Contributors · New Zealand
About Calabash · New Zealand
Calabash · United Kingdom
Calabash Articles · United Kingdom
Calabash Partners · United Kingdom
Calabash Contributors · United Kingdom
Calabash Speakers · United Kingdom
Calabash Talks · United Kingdom
Calabash Sign up · United Kingdom
Calabash Sign in · United Kingdom
Neuro CPD talks · United Kingdom
Australian Counselling Association CPD talks · United Kingdom
Imago Relationship Therapy CPD talks · United Kingdom
Article · Tips for New Therapists by Dr. Anusha Lachman · United Kingdom
Article · Infant Communication · United Kingdom
Article · Medications for ADHD · United Kingdom
Breastfeeding CPD talks · United Kingdom
Human Rights CPD talks · United Kingdom
Cognitive Behavioural Therapy CPD talks · United Kingdom
Talk · Demystifying Tinnitus · United Kingdom
Talk · Tour of the Enneagram Triads · United Kingdom
Talk · Perspectives on the Oedipus Complex: Freud, Klein & Lacan · United Kingdom
About Partners · United Kingdom
About Contributors · United Kingdom
Uploading a Talk · United Kingdom
Calabash · United States
Calabash Articles · United States
Calabash Partners · United States
Calabash Contributors · United States
Calabash Speakers · United States
Calabash Talks · United States
Calabash Sign up · United States
Calabash Sign in · United States
Dialectical Behavioural Therapy CPD talks · United States
Psychodynamic Therapy CPD talks · United States
Children, Teens & Families CPD talks · United States
Article · Infant Communication · United States
Article · PTSD in Mothers of Premature Infants · United States
Article · Colinda Linde on No Shows in Therapy · United States
Tinnitus CPD talks · United States
Epilepsy CPD talks · United States
Gender Based Violence CPD talks · United States
Talk · Working with Adolescents in Psychotherapy · United States
Talk · Growing a Capacity for Self-reflective Practice amongst Educators, Allied Professionals and Parents in the Early Years · United States
Talk · The Enneagram: A Jungian perspective on persona & shadow aspects · United States
Uploading a Talk · United States
Terms of Use · United States
How It Works · United States
Calabash · Canada
Calabash Articles · Canada
Calabash Partners · Canada
Calabash Contributors · Canada
Calabash Speakers · Canada
Calabash Talks · Canada
Calabash Sign up · Canada
Calabash Sign in · Canada
Clinical Issues CPD talks · Canada
Australian Counselling Association CPD talks · Canada
Allied Health Professionals CPD talks · Canada
Article · Narcissism is on the rise and has many faces – empathic practitioners beware! · Canada
Article · How my therapist missed my diagnosis: a patient’s experience of PND · Canada
Article · Why conventional hearing tests are not sufficient · Canada
Communication CPD talks · Canada
Hegemonic Masculinty CPD talks · Canada
Bereavement CPD talks · Canada
Talk · ADHD Screening: The process & benefits · Canada
Talk · The Enneagram's Intelligence Centres & Core Underlying Emotions · Canada
Talk · Understanding and Managing Central Auditory Processing Disorder · Canada
About Contributors · Canada
About Calabash · Canada
About Partners · Canada
Psychologist in Sydney