Module 7: frameworks for alcohol and other drugs work: facilitator's guide

6.3 Counselling models used in AOD work

Page last updated: 2004

The following are the most common counselling therapies used in AOD work.

  • Cognitive behavioural therapy (CBT) - where the client learns strategies to change thoughts and behaviours related to AOD use. CBT is now a dominant model of counselling in Australia.

  • Psychodynamic - where the client develops an understanding in how and why the AOD problem began, often associated with childhood and/or family issues.

  • Narrative approaches - where the client is helped to understand the story (or narrative) of their life, adopts a new perspective, and writes another script (usually metaphorically) for the future.

  • Family therapy - assumes that the whole family is involved in the development of the young person's AOD problem, and should be involved in the counselling.

  • Solution-focused counselling - where the counsellor assists the young person identify their goals. These goals are then broken down into manageable objectives and specific tasks. The counsellor helps the young person track how difficulties developed.

Overhead transparency

  • Cognitive behavioural therapy
  • Psychodynamic
  • Narrative approaches
  • Family therapy
  • Solution-focused counselling

Stages of change

In the early 1980s, James Prochaska and Carlo DiClemente (among others) developed a model to explain the process of change in the context of substance use and dependence. Based on their research of 'self-changers', the stages-of-change model forms part of a broader conceptual framework known as the Transtheoretical Model (Prochaska & DiClemente, 1982; 1986).

This model recognises that different people are in different stages of readiness for change. It is important not to assume that people are ready for or want to make an immediate or permanent behaviour change (see Diagram). By identifying a person's position in the change process, a worker can more appropriately match the intervention to the client's stage of readiness for change.Top of page

Diagram: Stages-of-change model

Text equivalent below for Diagram: Stages-of-change model
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Text version of Diagram

The diagram illustrates the stages-of-change model as an upward spiral process, involving progress through a series of stages until reaching the "lasting exit". Each loop of the spiral consists of the stages precontemplation, contemplation, preparation, action and maintenance.