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Treatment Plan for Alcohol Dependent Patients with Poor Insight

Most patients entering treatment do not have the volition to change their addiction problems. Substance abusers often have characteristics of denial, rationalization, projection, defensive-ness, manipulation, and resistance. Furthermore, because these responses can block successful treatment, clinicians and interventions often focus on them. The clinician’s task is to elicit and enhance motivation. Addiction stems from an addictive personality. Alcoholics must learn how to spot the resistance to change associated with addictive thinking and how to use this evidence to achieve abstinence and ongoing stable recovery. A strategy of aggressive confrontation is likely to evoke strong resistance and outright denial. Researchers recommend using empathy, not authority and power. The clinician’s style influences the alcoholic’s motivation. Research suggests that the more clinicians use adversarial, confrontational techniques with alcoholics, the less likely such clients are to change.