Our clinical counsellors play a vital role in our residents’ therapeutic journey. They are pillars of support for our residents as they progress through their therapy. Inspired by the expertise of a level 4 substance use clinical counsellor at Portage, this article explores the techniques used to accompany residents throughout their therapy.

Plan of care

As soon as residents arrive at Portage, a plan of care is designed for them; this is the first step in accompanying them through their therapy. The counsellor and resident work together to develop a customized plan that sets out the resident’s objectives and aligns their treatment with their specific needs and any issues they wish to address during their therapy. The plan is designed to be flexible and is reviewed every 4 to 6 weeks based on the resident’s progress.

Therapeutic alliance

The term therapeutic alliance refers to the bond of trust that develops between resident and counsellor. Trust is vital in building a secure environment where the resident feels heard, understood, and supported. Trust encourages open, honest communication and allows residents to discuss their experiences and challenges without fear of being judged. This is a vital part of accompanying residents through their recovery process by giving them the support they need to confidently address the more sensitive aspects of their substance use dependency.

Listening, a pillar of the therapeutic process

Active listening

Active listening is an important component of the therapeutic alliance. The counsellor must be fully present and receptive to what the resident is saying. To show he understands what is being said, the counsellor can use verbal and non-verbal language such as nodding his head, eye contact, and summarizing. This approach reinforces the resident’s feeling of being heard and valued, which creates an environment that is conducive to openness and sharing profound personal experiences.

Emphatic listening

Emphatic listening goes one step further than active listening by seeking to truly understand residents’ experiences and emotions, without judging them. The clinical counsellor must put himself in the residents’ shoes in order to feel their struggles, their sorrows and their achievements. Emphatic listening validates the residents’ experiences and reinforces their feeling of being understood; it can also alleviate the feelings of shame and isolation that often accompany substance use.

Silent listening

This listening technique uses silence as a technique during group therapy. It can be an efficient means of encouraging residents to reflect and express themselves more fully. Silent listening creates an environment in which residents can take some time to gather their thoughts, identify their emotions and share their reflections at their own pace.

Emotion-focused therapy

Emotional validation

Emotional validation goes beyond simple listening to recognize and accept a resident’s emotions without minimizing or disputing them. This process is crucial to offering genuine emotional support; it tells residents their feelings are legitimate and important.

For example, if a resident expresses sadness and regret about the relationships that were damaged as a result of his substance use, the counsellor could respond as follows: ʺI understand that you feel sadness and regret about the impact of your substance use on your relationships. It’s a natural and legitimate reaction. How can we work together to start mending those relationships?ʺ This response not only validates the resident’s feelings; it also provides proactive and empathetic support.

Reflection of feelings

In this method, the counsellor verbalizes and mirrors the emotions expressed by the residents. For example, if a resident expresses feeling of guilt about his prior substance use, the counsellor could respond as follows: ʺI see you feel guilty about your substance use. In your opinion, where do those feelings come from? ʺ

This is a good example of using reflection of feelings to further explore a person’s emotions. By recognizing the resident’s feelings of guilt and inviting them to reflect on their source, the counsellor is not only validating the resident’s emotional experience, but also encouraging them to examine their feelings.

The techniques presented in this article are only some of the many approaches used by our expert clinical counsellors. Other techniques, such as supervising therapeutic communities, as well as organizing and facilitating cultural activities, enhance and diversify their array of therapeutic methods. These complementary methods highlight the wealth of approaches our counsellors use to respond to the specific needs of each resident.

Are you interested in becoming a clinical counsellor? Are you a good listener? Would you like to help our residents overcome their addictions and enjoy a healthy, positive life?