“What to do with a client that may have addiction issues” Part 2 – Cognitive Distortions, Stages of Change and ACE Assessments

Cognitive Distortions

As I interview the client, I keep in mind their language, way of talking and their perceptions. I listen for Cognitive Distortions in their conversations. Dr David Burns, author of “Feeling Good” has a list of Cognitive Distortions that comes into service here, as it can identify certain key phrases that reveal the cognitive distortions that are characteristic of an addict . I am sure you have heard these types of cognitive distortions in past interviews

1) They didn’t show up on time, they’re completely unreliable! This is an example of All or Nothing thinking, a cognitive distortion
2) I’ll never get that promotion/ My boss always tries to swindle me out of my commission. This is an example of Over-generalization
3) I forgot to send that email! My boss won’t ever trust me again, then I won’t get that raise, we will loose the house to foreclosure and my wife will leave me. This is an example of Catastrophizing, which is seeing things as dramatically more or less important than they actually are.

Identifying the Stage of Change

My next series of assessment questions include the Annis, Schober & Kelly interview questions, to identify the stage of change the client is in . This series of interview questions are drawn from the Identifying the Stage of Change research by James Prochaska, John Norcross and Carlo DiClemente. There are six questions in this interview and the questions start out very simply:

1. Did you drink during the last 30 days? YES or NO
2. Are you considering quitting or reducing drinking in the next 30 days? YES or NO
3. Did you knowingly attempt at least once, to quit or reduce your drinking during in the past 30 days? YES or NO

At this point in my assessment work, I have to decide whether I can help this person or not. I call the Annis, Schober & Kelly assessment the “knowing when to hold them or knowing when to fold them” assessment. If in completing this assessment, the coaching client does not present that they are in the Preparation Stage or the Contemplation Stage of change, I cannot help them. I have to regretfully say I cannot help them and why.

Adverse Childhood Experiences

The last series of questions are from the ACE survey (Adverse Childhood Experiences) which are highly personal questions . In the executive coaching world these are not questions an executive coach would ever ask, but for a recovery coach, these are important questions. However, I still have to tread very lightly on these queries. I preface the questions with a warning that I will be getting very ‘close’ to the client with the next series of queries, and if he/she chooses not to continue with answering these questions, we can move on.
Some examples are:

1. Did a parent or other adult in the household swear at you, insult you, put you down or humiliate you?
2. Did a parent or other adult in the household push, grab, slap, or throw something at you?
3. Did you often or very often feel that no one in your family looked out for each other, no one feels close to each other, or no one supports each other?


The ACE questionnaire is important in identifying behavioral addictions, primarily eating disorders or compulsive sexual behaviors, so I use it specifically for queries that may identify these addictions.

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