Be trustworthy

As explained above, therapists must demand a higher standard of behavior from themselves than they can expect from their substance abusing patients. Patients who act and think in combative, passive aggressive, and/or mistrustful ways in their everyday life often expect that others will treat them in like fashion. Therefore, it is corrective experience for patients when they realize that their therapists will continue to demonstrate honesty and concern, even when the patients themselves have been less than friendly or truthful in return.

As difficult as it is to gain the trust of the substance-abusing patient, it can be impaired or lost quickly and with relatively little provocation. Therefore, the therapeutic relationship must be managed in a delicate, painstaking fashion. In the process of accomplishing this goal, therapists must recognize their own anger when patients lie to them, and must strive to keep such feelings in check.

Instead, therapists need to find a diplomatic way to address the "apparent inconsistencies" in what the patients say and do, and to remain nonjudgmental (Beck et al. 1993).

III. Maintaining a Positive Alliance over the Course of Treatment
5. Be Trustworthy, Even When the Patient Is Not
As explained above, therapists must demand a higher standard of behavior from themselves than they can expect from their substance abusing patients. Patients who act and think in combative, passive aggressive, and/or mistrustful ways in their everyday life often expect that others will treat them in like fashion. Therefore, it is corrective experience for patients when they realize that their therapists will continue to demonstrate honesty and concern, even when the patients themselves have been less than friendly or truthful in return. As difficult as it is to gain the trust of the substance-abusing patient, it can be impaired or lost quickly and with relatively little provocation. Therefore, the therapeutic relationship must be managed in a delicate, painstaking fashion. In the process of accomplishing this goal, therapists must recognize their own anger when patients lie to them, and must strive to keep such feelings in check. Instead, therapists need to find a diplomatic way to address the "apparent inconsistencies" in what the patients say and do, and to remain nonjudgmental (Beck et al. 1993).
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