establishing rapport

The initial interactions between the patient and therapist are extremely important, as substance abuse patients often will be silently sizing up their therapists to determine whether they can be trusted and know what they are doing (Perez 1992).

The lack of a positive start to treatment may lead a patient to choose not to return for further sessions, or may foster negative expectancies in the patient that often exacerbate passive resistance or contentious behavior in session. On the other hand, a positive start to treatment may instill hope in the patient, thus encouraging him or her to stay in treatment and to consider the prospects of therapeutic change more seriously.

The following are some common methods by which therapists can connect with their substance-abusing patients as treatment begins:

II. Establishing Rapport at the Outset of Treatment
The initial interactions between the patient and therapist are extremely important, as substance abuse patients often will be silently sizing up their therapists to determine whether they can be trusted and know what they are doing (Perez 1992). The lack of a positive start to treatment may lead a patient to choose not to return for further sessions, or may foster negative expectancies in the patient that often exacerbate passive resistance or contentious behavior in session. On the other hand, a positive start to treatment may instill hope in the patient, thus encouraging him or her to stay in treatment and to consider the prospects of therapeutic change more seriously. The following are some common methods by which therapists can connect with their substance-abusing patients as treatment begins: Speak directly, simply, and honestly. Ask about the patient's thoughts and feelings about being in therapy. Focus on the patient's distress. Acknowledge the patient's ambivalence. Explore the purpose and goals of treatment. Discuss the issue of confidentiality. Avoid judgmental comments. Appeal to the patient's areas of positive self-esteem. Acknowledge that therapy is difficult. Ask open-ended questions, then be a good listener.
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