WE PROVIDE MORE THAN ADDICTION COUNSELING AT OUR ALCOHOL AND DRUG REHAB PROGRAM

I. ADDICTION COUNSELING
Counseling starts with a conversation
Counseling can be one-on-one or in groups
There is more than one approach to addiction counseling

II. RELATIONSHIP COUNSELING
1. Family counseling
2. Couples counseling

III. BIOPSYCHOSOCIAL COUNSELING
1. Mental health counseling
2. Spirituality counseling
3. Vocational counseling
4. Credit counseling

INTRODUCTION

While most people assume that addiction counseling is provided at an addiction treatment program, many don’t realize that drug rehabilitation treatment often provides counseling that focuses on other life domains impacted by addiction. For example, addiction impacts relationships, mental health, spirituality, our careers, and our financial standing. As a result, treatment has expanded its focus from treating the addiction to treating the whole person. This is sometimes referred to as the Biopsychosocial approach ¹ to treatment.

In this section, we explore counseling services currently offered at Sunshine Coast Health Center, complete with information designed to help you understand how the various types of counseling offered are different.

(1) Note: The Biopsychosocial model evaluates and treats the physical, psychological, social, and spiritual symptoms of substance use and related disorders. For more information see the Biopsychosocial section.

I. ADDICTION COUNSELING

Addiction Counseling Starts with a Conversation

Although counseling takes many forms, it is essentially a conversation between a client and a trained professional that is meant to help bring understanding and a shift in thinking. This shift in thinking is designed to encourage a change in behaviour which, for addiction counseling, focuses on the individual’s alcohol or drug use.

Addiction Counseling can be One-On-One or in Groups

Individuals with addictions often consider their problems unique and, therefore, are best understood in a one-on-one session with their counselor. Clients may be surprised to learn that most addiction counseling in residential treatment tends to be provided in a group setting. Groups are considered the most effective method of breaking patterns of isolation which is typical of clients during their active addiction stage. During group counseling, clients have the opportunity to examine their thoughts through sharing, listening and receiving feedback from their peers. In a group setting, clients also learn to develop important social skills. Finally, group counseling is also a more cost-effective method of therapy.

Individual counseling, however, is still a necessary component of a comprehensive addiction treatment program. Clients may prefer to confide with their counselor on “taboo” topics such as sexual abuse, thoughts of suicide, and grief and loss. Clients may simply not be ready to share these traumatic episodes with their peer group. Moreover, individual addiction counseling is a necessary step in developing an individualized treatment plan.

Sunshine Coast Health Center provides a combination of both group and individual counseling. Counselors are assigned a maximum of 8 clients which provides each client a minimum of one hour of individual counseling per week.

The Weekly Treatment Schedule provides an outline of group activities, including group counselling, at Sunshine Coast Health Center.

There is More Than One Approach to Addiction Counseling

Theories abound to the actual cause of drug and alcohol addiction. Some consider addiction a disease similar to chronic conditions such as diabetes and hypertension. Others consider addiction a learned behaviour. A lack of consensus in the field of addiction has led to many approaches to addiction counseling. In this section we highlight the two primary approaches to addiction counseling:

Twelve Step Facilitation (TSF) therapy – this disease-model form of addiction counseling can trace its roots back to the Alcoholics Anonymous movement and Wilmar State Hospital in Minnesota, the institution which gave rise to the “Minnesota Model of Alcoholism Treatment. TSF therapy ¹ assumes that alcohol and drug addiction is an illness that precludes moderate use of these substances and leads to denial of the primary problem, loss of control ². TSF therapy focuses on having the client accept their loss of control over their use of substances, the need for abstinence, and the importance of peer support. TSF therapy assumes that alcohol and drug addiction can be managed but not cured and combines spirituality and peer support to achieve sustained sobriety.

(1) Source: Approaches to Drug Abuse Counseling – Twelve Step Facilitation, Joseph Nowinski, National Institute on Drug Abuse (NIDA).

(2) Note: an example of this would be a client saying, “I can quit whenever I want” or “I could quit if people would just get off my back.”

2. Cognitive Behavioral Therapy (CBT) – this approach to addiction counseling can be traced back to Drs. Albert Ellis and Aaron T. Beck and their work with depression and other mood disorders from the mid 1950’s and early 1960s.

Cognitive Behavioral Therapy (CBT) is basically a treatment method designed to change negative thoughts and feelings. There are three principles of cognitive therapy ¹:

1. your thoughts – not external events – create your feelings
2. negative thoughts that cause depression and anxiety may seem true and valid but are actually distorted and illogical
3. when you change the way you think, you can change the way you feel

Cognitive Behavioral Therapy (CBT) is less focused on the underpinnings of feelings (why you feel the way you do) and instead emphasizes how to change the thoughts and behaviors that are causing the problems while learning productive responses to distressing circumstances. CBT can be used to alter difficult behaviors, such as addictions, procrastination, or phobias and can alleviate conditions such as depression and anxiety.

The main differences between TSF and CBT are the relative emphasis on the importance of peer support, behavior, spirituality and the cause of addiction. TSF assumes that addiction is a disease and CBT assumes a learned behaviour and corresponding lack of stress management and problem solving skills. CBT also assumes that alcoholism and drug addiction are sometimes symptomatic of mental health problems such as depression and anxiety (mental illness, not addiction, is the primary disorder).

By combining Twelve Step Facilitation therapy, Cognitive Behavioral Therapy and relationship counseling (see below), Sunshine Coast Health Center offers an array of individualized treatment options based on the recommendations of counseling staff and needs identified by the client. Ask to speak to the Program Director if you require more information on how our program integrates these distinct addiction counseling modalities to design a client’s treatment plan.

(1) Source: Feeling Good - Let’s Get Started (2002) David D. Burns. Time Life Books.

3. Relapse Prevention Counseling - is a form of Cognitive Behavioral Therapy that focuses on the urges and cravings related to an addiction, identifying and managing high risk situations that lead to a return to substance use and the core personality and lifestyle patterns that lead individuals to put themselves in high risk situations.

Sunshine Coast Health Center utilizes the Terence T. Gorski approach to relapse prevention counseling that focuses on two sequential stages of relapse prevention: (1) teaching clients how to manage high risk situations then (2) focusing on core personality and lifestyle issues. Our relapse prevention program is offered in two stages since Gorski theorizes that prematurely focusing on core personality and lifestyle issues can distract individuals away from learning basic abstinence skills.

While various approaches to relapse prevention counseling exist, Sunshine Coast Health Center utilizes the CENAPS model designed by Terence Gorski because it integrates relapse prevention with the disease model of addiction.

See the Relapse Prevention Programs section for more information on available relapse prevention programming at Sunshine Coast Health Center.

4. Narrative Therapy - Narrative Therapy was initially developed during the 1970s and 1980s, largely by Australian Michael White and his friend and colleague, David Epston, of New Zealand. Their 1990 co-authored publication, Narrative Means to Therapeutic Ends, introduced narrative therapy to North America and has led to a popular following among mental health therapists. Dan McAdams in the United States has developed a narrative therapy, the 'life-story', that has been very influential around the world. Narrative therapy helps clients to discover how their stories they tell about themselves can keep them stuck in life.

Sunshine Coast Health Center clinical staff recognize that clients are the experts in their own lives and use narrative therapy as part of a broader, client-centered approach that encourages rigourous self-examination and personal responsibility. For more information on narrative therapy see the Narrative Therapy Centre of Toronto website; for information on Dan McAdams' work, see the Northwestern University Department of Psychology website.

II. RELATIONSHIP COUNSELING

Relationship counseling is an important part of the addiction program at Sunshine Coast Health Center. However, relationship counseling is more than just about families and marriages: a client’s relationship with his peer group and staff is also important.

II.1. Family Counseling

Family counseling is based on the idea that a family's patterns of behavior influences the addicted individual (and vice versa) and therefore needs to be a part of a client’s treatment plan. Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems ¹.

During the Family & Couples Program at Sunshine Coast, partners and families work together to learn about the family dynamics of addiction as they explore healthier ways for responding to stress, heal from emotional burn-out, and learn how to support the people they love in recovery while also completing their own healing.

Sunshine Coast Health Center provides family counseling during the first three days of the Family & Couples Program. For more information refer to the Family & Couples Programs & Services section.

(1) Source: American Association for Marriage and Family Therapy

II.2. Couples Counseling

Couples counseling (also known as marriage therapy) is defined ¹ as a treatment whose goal is to ameliorate [improve] problems of married, common law or same-sex couples. Various psychodynamic, sexual, ethical, and economic aspects of marriage are considered. Husband and wife can work with the counsellor individually or together. Couples counseling is a broader term for marriage counseling as it encompasses unmarried or same-sex couples.

Sunshine Coast Health Center offers couples counselling as part of the Family & Couples Program. A common question that couples impacted by addiction ask is how to overcome resentments from the past and rebuild their partnerships. During Couples Day, individuals in recovery and their partners explore how to overcome resentments while also learning about five skills for rebuilding healthy relationships. Couples also complete a “trekscape” exercise where they explore the story of their relationship and all the significant events. In this exercise, couples can examine what they will each need to do to create the future they both desire as they heal and rebuild from the impact of the addiction.

For more general information on couples and family therapy see the Help for Families and Partners section.

III. BIOPSYCHOSOCIAL COUNSELING

III.1. Mental Health Counseling

Mental health counseling is an important part of our drug and alcohol treatment program since the prevalence of clients having both addiction and mental illness (also known as concurrent disorder, co-occurring disorder or dual diagnosis). Mental health counseling covers many disorders including mood disorders (depression, bi-polar), anxiety disorders (panic, social phobias, obsessive-compulsive, post traumatic stress disorder), sexual disorders, somatoform disorders, sleep disorders, eating disorder, impulse control disorders, schizophrenia, cognitive disorders (delirium, dementia) and personality disorders.

Sunshine Coast Health Center has a skilled mental health team that includes a Registered Psychologist, Psychiatrist and a Registered Psychiatric Nurse. For more information on our staff qualifications visit the Meet our Staff section.

Mental health counseling is not to be confused with mental health assessments which are the process of diagnosing the existence of mental health problems. Only a doctoral-level psychologist and psychiatrist are qualified to provide mental health assessments. For more information on assessment services offered at Sunshine Coast Health Center visit the Assessment Services section.

III.2. Spirituality Counseling

Spirituality Counseling (also known as pastoral counseling) is defined ¹ as a unique form of psychotherapy which uses spiritual resources as well as psychological understanding for healing and growth.

Our treatment center includes weekly spirituality group education as a way to promote the importance of spirituality ² as part of our Biopsychosocial approach to recovery.

For an additional fee, one-on-one spirituality counseling is also available. Contact our Admissions department for details.

(1) Source: The American Association of Pastoral Counselors (AAPC).
(2) Note: Spirituality is often confused with religion. When religion is emphasized, this is known as faith-based counseling which would include Christian counseling. Although spirituality counselors may openly acknowledge their own religious faith, heritage, and values, they are trained to be objective and empathetic in relating to the client's racial, religious, ethnic, or cultural memberships and preferences.

III.3. Vocational Counseling

Vocational counseling is an important part of our addiction program, not only for our younger clientele but older clients who are experiencing career stagnation or pondering a new career after retirement.

Some of the questions clients may have include:

What can I do?
What job/career would bring me the most satisfaction?
Which job/career would be the best fit for me?
Would I be successful at the career/vocational training or post-graduate education I am considering?

Sunshine Coast Health Center is pleased to offer clients vocational counseling through Rosemary I. Patterson, PhD. A former School Psychologist and now a Career Awareness Specialist, Rosemary is certified to administer and interpret the General Aptitude Test Battery (GATB) and the Canadian Work Preference Inventory (CWPI).

In conjunction with the Career Profile software program, which matches a client's aptitudes and interest patterns to the National Occupation Classification of all the occupations and jobs in Canada, the GATB and CWPI are extremely helpful in answering common career-related questions.

III.4. Credit Counseling

Although personal finances is often a problem for people with addictions to drugs and alcohol, credit counseling (also known as debt counseling) is more commonly provided with gambling treatment. Typically, substance abuse treatment centers will recommend credit counseling for clients as part of a client’s discharge plan.

For assistance in locating credit counseling please contact Sunshine Coast Health Center Admissions toll-free at 1-866-487-9010 or visit Credit Counseling Canada for a list of credit counselling agencies across Canada.