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Stage Three: Advice & Menu of Options

The final stage of implementing these motivational tactics involves the giving of advice and alternative options by which the person may move forwards. This is the final stage, because it is vital that you avoid giving any advice until the person indicates that they are ready to be receptive to this. In other words, your drinker will have already indicated that they accept that they at least might have a problem, by the time you use these tactics.

If you deliver advice before the person has indicated a willingness to listen, then your advice will do worse than fall on deaf ears. It is only likely to push the drinker further into denial - to listen to your advice before they have reached their own conclusion that they might have a problem, would be to accept that they do have a problem before they have done so! Remember the theme that people have to come to their own conclusions; they have to believe that they have reached these conclusions by themselves. You must not force this, and you must not rush it. Bide your time and use the techniques above - Feedback, Responsibility, Empathy and Self-efficacy. In time, your drinker will hopefully reveal to you that the idea that they might have a problem with alcohol is starting to reach consciousness. It is only at this point that you can start to give advice, and you must give it in such a way that you do not push the drinker back into denial once again. You will achieve this through your style, and by the use of a 'Menu of Options'.

In the examples of conversation above, the nearest the drinker got to accepting that he/she might have a problem was to state:

Drinker: No, not really - well, I know I'm drinking a bit too much, but I can't see that's anything to do with it.'

The helper replied: 'May be you're right'.

I suggested the conversation should be left here, hopefully with the words 'May be' ringing in the drinker's mind.

Alternatively it may continue:

Drinker: ‘Why, do you think I’m drinking too much?’
Helper: ‘Well looking from the outside, it does seem to be the cause of a few problems you’re having. I mean I might be wrong. What do you think?’
Drinker: ‘I’m not sure.’
Helper: ‘I can say that you haven’t looked very well to me for quite some time now. Do you feel ill?’
Drinker: ‘I’m feeling worn out the whole time.’
Helper: ‘Is there anything you’d like me to do?’
Drinker: ‘What can you do – what is there to do?’
Helper: ‘Well may be we should try to find out if drinking has got anything to do with this or not – may be it has, may be it hasn’t’.
Drinker: ‘And how are we going to do that?’
Helper: ‘If I find out some information, I could leave it with you to have a look at.’
Drinker: ‘And how’s that going to help?’
Helper: ‘I don’t know; could it do any harm?’
Drinker: ‘I suppose not.’

Within the next day or so (not rushed) you should then leave some independently written informational materials for the drinker to browse. Personally, I suggest that you leave a copy of 'How To Enjoy Life without Alcohol: Routes to a Healthier Existence' for the drinker to read, as well as other self-help materials. Don't expect immediate results, and don't expect the person to read it immediately. Leave it for them, and don't follow up. Wait for them to bring it up in conversation.

When and if your drinker does raise the issue, whether in a positive or a negative light, you should be prepared to suggest a number of options for a meaningful way forward. Things will probably still be at the phase of change of the drinker's thinking whereby you will have to approach it from the angle of 'let's ascertain whether you have a problem or not'.

Your options here will include:

  1. Visiting the GP to have a blood test taken to see if there is any sign of damage due to drinking. (Ask the GP to perform gamma-glutaryl-transferase (GGT) and mean cell volume (MCV) tests, as well as routine liver function tests (LFTs).) See if the GP will agree to send the results direct to your drinker’s address.
  2. Making a self-referral to your local NHS Community Drug and Alcohol Team for an assessment.
  3. Make an appointment with a counsellor for a more general look at the problems in the person’s life, and an impression on whether alcohol is causing or exacerbating
    these.

    (Contact details for local counsellors and NHS alcohol services are available from the www.dryoutnow.com ‘Get Free Advice’ page.)

    OR/AND suggest to your drinker that he/she uses one of the following DryOutNow.com related services:
  4. Confidential telephone advice from Alcoholism Help on 0845 555 444
  5. The email advice page to type a question for the doctor at www.dryoutnow.com (click on Get Free Advice when you arrive at the home page).
  6. The self-assessment page for physical dependency to alcohol in the ‘Do I Need Detox’ section of the www.dryoutnow.com site.

The important point here is that the drinker makes the decision about which one of these routes to follow - your role is merely to give advice as to the possible options. If you leave only one option, then this has effectively become your decision and not the drinker's. If your drinker is not ready to approach any of these options at this time, do not force the issue; but you will be on safer ground by now than before if you choose to bring the issue up again yourself at some point in the future. The drinker has by now clearly started to contemplate that there might be a problem. You have also introduced a number of means by which he/she can establish INDEPENDENTLY whether or not this is the case. And this is also a central point - you must not take on the role of the professional helper. I do not say this out of any sense of ego or protecting my own role or that of my colleagues. I say this because, if handled in the right way, the professional role has many advantages over your own in terms of moving the person on - purely because the drinker is more likely to believe that the professional's advice is independent of any ulterior motive. When you are emotionally involved with someone you are trying to help, that person will often have a tendency to think that you are trying to do this for yourself on some level - to ease your own burden. Equally, as they are emotionally involved with you and they are aware that their behaviour impacts on you in various ways, it is more difficult for your drinker to admit to you that they may be responsible for the difficulties you are experiencing, than it is to admit this to someone independent who they perceive as non-judgmental. All good workers in the field will try to demonstrate 'unconditional positive regard' for their alcoholic patients. And it is much easier for them to do it than it is for you, for the simple reason that they are not at the receiving end of the drinker's behaviour on a regular basis.

 

 



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