Organizing the Addiction Counseling Process Part 2

In this installment, I would explore a very basic question; “Just what can we expect to accomplish in the life of a homeless addict during their stay at a rescue mission program?”   The answer comes from recognizing some basic needs that need to be addressed so those we work can develop productive, satisfying sober lives.

The answer comes from recognizing some basic needs that need to be addressed so those we work can develop productive, satisfying sober lives.   The goal of a written recovery plan is to set down these goals, in order of priority, and then develop a strategy for working through them while in the program.   This plan, then, becomes the basic road map for the counseling process with the individual.   Weekly one-on-one sessions should always begin with revisiting the written plan and discovering what progress has been made toward accomplishing its jointly agreed upon goals

A. Help Addicts to Overcome Denial – Twelve Step groups recognize that recovery does not begin until the addict accepts the reality of his or her personal state of powerlessness.   We need to assist clients to move beyond an intellectual acknowledgement that alcohol and/or drugs are the cause of their problems. They need a deep inner knowing that they are completely and absolutely powerlessness over their “drug of choice.” Powerlessness means, essentially that the user cannot predict the out come of even the most limited using experiences. Until this happens, “recovery” will remain and intellectual exercise without ever getting into the heart.   They will always have the illusion of “controlled use” and the option to return to it when the inevitable pain that is an integral aspect of recovery begins.   The term “hitting bottom” is often used to describe the experience of surrender to the reality of the addict’s sense of personal powerlessness.   A peer-centered First Step therapy group strategy can be used to bring the bottom up to the addict.

B. Help Clients to Establish a Personal Program of “Self-Care” — We need to help them to answer the question “What must I do to maintain a growing personal program of recovery and spiritual growth?”   Personal self-care includes learning the disciplines of the Christian list, along with fellowship with other recovering people, avoiding negative relationships, learning not to “stuff” feelings, practicing “rigorous honesty,” hygiene, exercise, etc.   This is an important issue because shame is a major factor in addiction.   Often the addict’s shame-based self concept says, “I don’t deserve to be taking care of.”   Instead, our goal is to help him understand that, because of what Christ has done, we indeed are loved made worthy of care.

C. Help Them to Become Integrated into a Supportive Community- Establishing accountability, fellowship, and hope through both support groups (recovering community) and the church (spiritual community).   It is critical that we have definite strategies for moving our clients into the local church.   This is where an on-going relationship with a Christian support group can be a great help.

D. Help Clients to Gain Necessary “Life Skills” — These may include:

  • Ability to handle and reduce feelings of stress
  • Decision making skills
  • Ability to assert oneself
  • Parenting skills
  • Financial and other planning skills
  • Physical maintenance skills (nutrition and physical hygiene)
  • Ability to delay gratification
  • Ability to access community resources
  • Ability to identify and reduce negative feelings (e.g. guilt, resentment, hate and fear)
  • Understanding of the basic spiritual principles of Christian discipleship (i.e. prayer, Bible study, fellowship, etc.)
  • Basic relationship skills; honesty, healthy expression of feelings, self-awareness, detachment and other codependency issues
  • Vocational skills – basic education, healthy work attitudes, marketable skills, job search skills, etc.
  • Getting medical help for drug related and other physical problems.   Whenever possible, each client should receive a medical screening before beginning a recovery program.
  • Addressing psychological problems. The term “dual diagnosis” is often used to describe individual who has genuine problems with mental illness combined with an addiction to drugs and/or alcohol.
  • Developing adequate living arrangements (housing and food, etc.) once the client has completed the recovery program.

Rarely are all of these services provided at the mission itself. Therefore, it is very important to develop a network of trusted referral resources.   With referrals be sure to develop a system of feedback to the mission from the referral agency about what services are being rendered to the mission’s clients.   Using a formal “Release of Information” form is usually necessary. When using outside support groups, a card may be signed by the group’s leader to document the mission client’s attendance.


For downloadable forms and other helpful information for creating recovery plans, see the Guide to Effective Rescue Mission Recovery Programs.


  For the rest of this series go to the  Organizing the Counseling Process Index


Organizing the Addiction Counseling Process Part 1

In the past thirty years of my work, I have had the opportunity to visit many facilities that help the homeless.   When I see a man in a recovery program I like to ask, “How is he doing?”   I usually just get a pat answer like, “Well, he’s been with us for six months.”   The problem with this answer, of course is that a sober, healthy lifestyle is not automatically picked up just by hanging around the mission for a certain length of time.

The only way to really know is by keeping accurate written records that show how we are meeting the individual needs of the people in our programs.   A formal needs assessment process is needed.   The information that is gathered provides the foundation for a written recovery plan (or discipleship plan).   The purpose of such a plan is to help program people think through their options, to identify their own needs, and to determine which specific actions they must take to get their needs met.   To ensure maximum “buy in,” the plan should be developed with lots of input from counselees themselves.

An effective recovery plan describes how the resources of the mission plus appropriate community resources are to be (or have been) used to meet the unique needs of each individual during his or her time in the program.   This is done by scheduling in-hourse resources, such as books, tapes, videos, a work program, recreational activities, one-on-one counseling, support groups, classes, etc. and using outside resources like agencies that provide various services, other Christian organizations and so forth.   While we may start with the most pressing needs, a good recovery plans moves step-by-step toward the ultimate goal of equipping program participants to live the life that God wants them to live

There are five elements that are necessary to have an effective plan

A. Identify and prioritize the client’s problems.   Everyone who walks through our doors has unique needs.   Generally speaking, we could say they need to know the Lord, they need to be sober, etc.   For some of these issues we need regularly scheduled classes, worship, work therapy, and so forth in which all program members participate.   But there also needs to be a weekly one-on-one session with a staff member who can help each one with the various personal problems that need can only be dealt with on an individual basis.

B. Set goals for recovery that are attainable within the context of the program.   For the best chance of success, it is important to develop realistic goals.   Make sure they are challenging and make sure they are attainable within your program.   This can only be accomplished when a formal assessment has been conducted to identify   resources and expertise that is available to clients; both in-house and externally.

C. Develop measurable objectives that lead to accomplishing the goals.   Good objectives can include assignments, activities, action projects, etc. — but they must be something that can be measured.   Specific habits to be developed, people to call, appointments to make, tests to take, books to read, amends to specific people are all good objectives.   Setting dates and describing the exact circumstances of conditions that demonstrate the objectives have been accomplished makes them truly measurable.

D. Establish a timeline for when   the various objectives are to be met.     Don’t say “sometime in the next three months you will read this book.”   Instead say, “this book will be read by the end of the week” or by this specific date.

E. Assign a staff member to assist   the individual to meet his or her objectives.   Every program member needs one primary staff person who is responsible for overseeing his or her progress in the program; whether it be a counselor, chaplain, or case manager.   Someone has to meet with the individual at least weekly to review progress in the program and to coordinate the meeting of program goals and objectives with other staff members, outside referrals, family members, and anyone else who will be involved with helping the person.

A written, regularly updated written recovery plan can be one of the best ways to motivate people in the change process.   A regular, weekly review allows rescue mission program participants to evaluate their options, to see progress and establish “benchmarks” for measuring their personal growth.   The best way to ensure that this happens is to adopt a set of policies that embody an approach to counseling that will be used by all mission staff members who counsel program residents.

In   future installments, we will discuss some methods of gathering data in order to identify and prioritize the problems faced by counselees.   We will also look at the details of creating and updating the recovery plan.   For downloadable forms and other helpful information for creating recovery plans, see the Guide to Effective Rescue Mission Recovery Programs.


  For the rest of this series go to the Organizing the Counseling Process Index

Theology of Christian Recovery

The primary distinctives that differentiate Christian Recovery from other approaches to life change lie in our approach to spirituality. Here are some of the major theological tenants of the Christian approach to recovery.

    1. Recovery is truly Christian only if God is part of it. This God is not just a nebulous “Higher Power”, but rather is the Creator of the Universe Who has revealed Himself in the Bible. Additionally, this God is a loving God, who showed His love by sending His Son, Jesus Christ, into this fallen world to save us. (John 3:16)
    2. The Word of God is the authoritative rule and guide for our recovery. We believe there is, indeed, some objective TRUTH in this world and that it is revealed in the Holy Scriptures. (Hebrews 4:12)
    3. There is a real devil. He is a real entity, who though the power of deception, is fighting for the minds of men. Truth is therefore the ultimate weapon in the spiritual warfare of Christian recovery. (John 8:31-32)
    4. Sin is deceptive, powerful and addictive. As Christian author, Keith Miller states, sin (or the “control disease”) is the root of all addictions and compulsive disorders. (Romans 7:15-25)
    5. There is a Redeemer. Jesus Christ has won the victory over sin, death, and the devil by His death on the cross. (1 John 3:8b) Therefore, the message of the Gospel brings forgiveness and the power to experience real change in our lives through God’s power. (Romans 1:16)
    6. This is a fallen world Not only are external things warped, perverse, confused, and corrupt, believers in recovery must still contend with their own fallen natures, as well. (Romans 7:21)
    7. All human beings need spiritual rebirth. Because spiritual death is a reality, we must assume that everyone needs to experience new life from God. (John 3:3)
    8. There is a significant difference between guilt and “toxic shame”. Guilt is a response of the conscience to specific sinful actions. On the other hand, destructive (or “toxic”) shame is an inner sense of being unlovable, unredeemable, hopeless, irreparably flawed, incomplete, and worthless. Everyone who struggles with a compulsive disorder experiences this to some degree. The Gospel provides the answer for both of these dilemmas. Confession and forgiveness are God’s way to overcome guilt. And, growing in relationship to Him and other healthy people enables us to accept ourselves as loved and lovable. (1 John 4:9)
    9. There is a definite difference between the terms “drunkard” and “alcoholic.” According to the Bible, drunkenness is a moral condition. On the other hand, alcoholism is a therapeutic condition. What separates the addict from the non-addict is not how often they drink or how much they drink, but what happens when they do drink – the loss of control (or powerlessness). Once an individual becomes addicted, he can never be a social drinker. (Ephesians 5:18)
    10. God works in processes. “Recovery” is not a one time, once-and- for-all thing – it is a process (Romans 12:2). Recovery is not just “fixing” ourselves, but rather it is gaining the “tools” to succeed in working out what God has already put within (sanctification). (Philippians 2:12,13)
    11. God works through His Spirit. The word Greek word “paraclete” is used in the scriptures to refer to the Holy Spirit. This term means “counselor” or “personal tutor.” To succeed in recovery, believers must learn to respond to God’s Spirit and walk in His will for their lives. (John 16:13-15)
    12. God works through people There is no more isolated and lonely person than the addict. John Bradshaw says, “The deepest wound of toxic shame is the inability to develop meaningful, intimate, human relations.” The message of Christian Recovery is that God’s grace is experienced as a process which involves intensely honest and nurturing relationships with other people. They serve as agents of His grace to unravel our woundedness and reshape our thinking. (Hebrews 10:23-25)
    13. Christian recovery is “intensive discipleship.” “Putting the cork in the bottle” (not using drugs or alcohol) is no guarantee of any lasting change in an individual’s life. What addicts need is a systematic commitment to an ongoing process of personal growth. Christian recovery means gaining new tools that enable us to live a new sober life and to remove all the “stumbling blocks” to a life of Christian victory. (2 Peter 1:5-11) We might also consider “recovery” as another word for what that Bible refers to as “sanctification”.
    14. Repentance is more than simply confessing our sins to God. We all must own up to our own sin if we are to experience forgiveness. (1 John 1:9) Still an additional step is necessary — repentance. The Greek word for repentance is “metanouia” which implies a complete change of mind. New thinking comes from new attitudes that have been formed by new perspectives. (Acts 3:19)
    15. “Rigorous honesty” is essential for true spirituality. Jesus declares that the truth will set us free (John 8:32) So, we must make a commitment to “walk in the light”. (1 John 1:5-9)
    16. There is a “therapeutic value” to talk. Self-revelation in a safe environment is a tremendously healing experience. Support groups provide an environment that promotes this process. (James 5:16)
    17. “Grace flows freely through unclogged conduits.” Christian workers cannot bring people to a place they have not come to themselves. Therefore, if we want to reach out to hurting people, we must be in the process of dealing with our own issues first. (1 Cor. 11:31; 2 Cor. 4:1-2)


You may also want to hear the audio work entitled Spiritual Foundations for Recovery