The treatment of substance-abusing patients poses a great set of challenges to therapists. One of the most fundamental and vital of these is the establishment and maintenance of a positive therapeutic relationship.
If therapists succeed in communicating a spirit of:
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acceptance,
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collaboration,
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respect,
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good will,
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and optimism
to their drug-abusing patients, the process of treatment will be enhanced.
If, by contrast, these goals are not achieved, the likelihood of the patients' demonstrating spotty attendance, poor punctuality, and premature termination will increase, thus diminishing the prospects that therapy will have an appreciable effect.
Therapists can facilitate the formation and maintenance of a positive therapeutic alliance with drug-abusing patients by consistently adhering to principles that are part and parcel of a cognitive therapy approach.
Such principles include:
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working with the patient as a team,
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giving clinical rationales in a clear fashion,
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eliciting feedback from the patient,
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exploring the belief systems of the patient,
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being aware of one's own belief systems and how they may impinge on the therapeutic process,
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and utilizing the case conceptualization and other strategies that require a thoughtful, empathic, and pragmatic approach
