Discussion Questions
Chapter 2: The First Hours of Treatment
1. The chapter described several counselor qualities and behaviors that are very important
in developing a therapeutic alliance and contribute to the quality of the treatment
environment. List and discuss the qualities and behaviors that you believe are essential
for a counselor to possess. How do you compare? In other words, in reviewing the list,
what qualities do you believe you have? What qualities do you need to develop?
2. Discuss the typical needs and barriers for clients entering treatment. Using the ASAM
Placement criteria, what obstacles do you believe are most characteristic of clients who
are in need of inpatient treatment? As a counselor, what might you do to assist a client
to overcome those obstacles, so he or she would be able to fully participate and benefit
from treatment?
3. What are the three participant behaviors that family or friends are encouraged to
exhibit during an intervention? As a counselor, how would you discuss the importance
of those behaviors to intervention participants? How would you include them in a
discussion as a part of the organizing, rehearsing, and choreographing preparation for
the intervention?
4. Clients leaving detoxification facilities create a unique challenge for counselors. In what
ways can counselors engage clients who are determined to leave a treatment facility
against medical advice? What interventions might you consider in an attempt to
discourage a client from leaving AMA?
5. Not every community has all the levels of care identified by ASAM. Imagine a client
being clinically determined to need a level of care that was not available in your area.
For instance, a client needs inpatient treatment based on his/her living in a “using”
environment and having prior relapses; what would you do?