Psychological Counseling

The Action Plan is the set of actions that the patient and the counsellor have agreed will be done in between one session and another. The Action Plan relates to the overall plan and to the Target Behaviour(s) discussed in the session, but it is an account of some more detailed steps that the patient will be taking in between one session and another

Using praise

By ambivalence we mean ‘having strong feelings in opposing directions’. For example, a patient with harmful drinking may realise that his drinking has started creating problems in his life and he should change; and at the same time he may also have a strong desire to continue drinking. Helping a patient to resolve such opposing feelings is a very important step in developing his ‘motivation to change’.

Ambivalent feeling about change

Acronym for Alcohol Use Disorders (AUD)

Acronym for Counselling for Alcohol Problems

The change plan is the overall plan outlining

• What the changes are that the patient wants to achieve in counselling (e.g. to completely stop drinking) , outlining
• What his main reasons are for wanting to change • What steps he wants to take to achieve this change
• Who can help him achieve this, and how
• How he will know if the plan is working
• What could interfere with the plan
• How these things could be dealt with

A patient’s statements which show that they are in favour of change are termed ‘change talk’. It helps patients to change their behaviour if they hear themselves stating that they want to do this. If we can encourage the patient to make ‘change statements’ or to generate ‘change talk’, it is more likely that they will go on to change.

Coping Skills are skills that our patients use to deal with (or cope with) challenging situations. These situations could include having an urge to drink, or feeling some negative emotion, or being pressurised to drink alcohol when it is not wanted.

General Counselling Skils in attached manual. 

Persistent sadness and loss of interest with reduced sleep/appetite, guilt feelings, feelings of hopelessness, etc.

A single sheet of paper in the form of a diary, on which a patient monitors his drinking over a specific period (usually a week, sometimes longer), in a systematic fashion, collecting information about precisely how much is consumed, when, where, and with whom.

Hearing voices or seeing visions even when one is alone.

Part of the Action Plan, Homework Tasks are specific tasks that we agree with the patient (and his SO) that he will undertake in between sessions, and tell us about during his next session, such as ‘fill out the drinking diary’, or ‘go to the college and get information about the course that we have discussed’, etc.

Part of the Action Plan, Homework Tasks are specific tasks that we agree with the patient (and his SO) that he will undertake in between sessions, and tell us about during his next session, such as ‘fill out the drinking diary’, or ‘go to the college and get information about the course that we have discussed’, etc.

The strength of an individual’s motivation for and movement towards a specific goal (in this case, changing their drinking behaviour.

We let a patient know how and why his drinking may be harmful, and how it may be related to any problems or issues that he may have told us about, during the assessment.

When a patient has a lapse, if he stops drinking, or drinking uncontrollably, quite speedily, then the lapse remains as a lapse. But if he continues drinking in this way, then his lapse turns into a relapse. Relapse is not just an event of drinking alcohol again but is a process which starts with thoughts about drinking alcohol, goes on to actual drinking, and then continues so that the patient is drinking at increasing quantity and frequency.

A patient’s statements which argue against any change in drinking behaviour are called ‘sustain talk’. The more that patients hear themselves saying that they don’t want to change, the less likely it is that they will change.

The Target Behaviour is the thing (or set of things) that we are working on during a counselling session. As in the examples in the text, “Typically, these include targets related to drinking (e.g. not drinking at all over the past week, or drinking on only some days and to a pre-agreed level) and those related to other things (e.g. not seeing friends who put pressure on the patient to drink; or dealing with conflict at work or at home in a different way, which does not involve drinking)”