Tag Archives: addiction

“What to do with a client that may have addiction issues” Part 3 Help the addict/executive build a plan for recovery

Posted on October 21, 2011 by Michael

Executive Coaching and the Recovering Executive
“What to do with a client that may have addiction issues”
Part 3
Help the addict/executive build a plan for recovery

Getting commitment from the client
After the first meeting and the story session, as homework assignment I hand out the New Client Questionnaire. I use one adapted from Jeffrey Auerbach’s book “Personal and Executive Coaching, The Complete Guide for Mental Health Professionals” . I like Dr Auerbach’s up front questions about the client’s goals for coaching: here are some examples.
1. What do you want to be certain to obtain from this coaching relationship?
2. What two steps could you take, immediately, that would help you move forward?
3. Are you ready to be coached?
4. Are you willing to stop or change my behaviors that are interfering with your progress in recovery

By introducing the client to Dr Auerbach’s questionnaire, they are able to begin to focus on what they want, which is the first concrete layer of the foundation of their recovery plan.

How does a coaching client build a plan for recovery?
In this phase I use the Grow Model, to further develop the client’s Recovery Plan. The Grow Model was developed by James Manktelow in 2005.

GROW is an acronym for:
1. Goals, establishing goals through the use of various instruments
2. Reality compare the reality of the situation
3. Options, explore the client’s options
4. Wrap up or Write the Recovery Plan (Donahue, 2007 & Manktelow, 2005)

The client has set the first few Goals, by completing Auerbach’s New Client Questionnaire.
Confronting Reality- Motivational interviewing and using the results from the Cognitive Distortions Survey are very important in this process. Discuss what is happening that makes the client not achieve their goals in the past. Break down the instances and ask:

1) When does this happen?
2) What effect does it have on you or others?
3) What is really stopping you?
4) Do you know anyone who has achieved their recovery goal?
5) What can you learn from them?

Discuss Options:
Brainstorm with the client on their options. Ask -don’t tell the client- about their options, this empowers them to ensure their choices. You can ask:

1. How can you move toward the goal?
2. What has worked in the past?
3. What could you do as a first step?
4. What else could you do?
5. What would happen if you did nothing?

Writing the Recovery Plan
In the next week, I encourage the client to begin to develop their recovery plan. Most often the client needs to be exposed to role models with long term recovery, people in their therapy groups, people in the 12 step meeting rooms, sober friends, or their sponsor. It is important for the coaching client to hear their stories and recognize the path they have taken on the road to recovery. I invite the coaching client to speak with these people to gather recovery plan information. Then we discuss what are their Recovery Plan goals are and why they are important?

1. First, we date the plan (Plans are meant to evolve and change, it is important for the client to see their progress)
2. Have the client name the change(s) they want to make (e.g. stay in college, avoid self-cutting, stay away from drugs and control over spending).
3. Where does this goal (stay away from drugs) fit in with their personal priorities at the moment?
4. What obstacles do they expect to meet?
5. How will they overcome them?
6. How committed are they to their Recovery Plan goals?

In developing a recovery plan a client will often ask the recovery coach for advice. During this process, I using motivational interviewing techniques, allowing the client to judge how appropriate the coach’s suggestions are for them. I offer not one, but a cluster of options which will allow the client to choose the suitable options for their recovery plan. For example a client often asks “What do you think I should do?”

I can respond by saying “Well, I see possibly three things you could do,
1. you can swear off alcohol completely starting today,
2. you can see if alcohol is a gateway drug or a trigger leading to your sexual acting-out by choosing not to drink when you are on a business trip,
3. you can continue drinking and acting out sexually with partners other than your spouse.”
Offering several solutions allows the client to see the options more clearly and decide which one or more options he/she has. Clients may bite off too much to chew, offer the client the opportunity to minimize the plan a bit so goals can be achieved. Lastly, establish some timelines.

Throughout coaching relationships, a client may regress to the beginning phases of this plan. Consistently, a coach must ask the difficult questions, reminding the client of their commitment, over and over again: “How committed are you to your recovery goals and your recovery plan? What do you want to achieve? What is really stopping you?”

During the creation of the Recovery Plan, the addict is looking “in”. This inward focus is very natural for the addict. Most addicts are so self centered that they have never looked outside of themselves to see “anything” less likely the consequences of their being buzzed for the last fifteen years. It is important to allow the addict to look in and then, to look out to see the consequences of his/her addiction.
In keeping with this concept, this third question:

Is there any collateral damage resulting from the addiction?
is usually asked when the ‘topic’ of collateral damage comes up. It will come up in the form of their teenager exploding at them, saying “You are never here!” or a co-worker appearing defensive during a meeting with the coaching client. Allowing the client to see consequences is the most important tool for the coach to use yet, the timing of this stage is never within our control. I assure you, the addict will see the consequences of their behavior, as coaches, we just have to wait for the opportunity or the ‘learning moment’

When the addict recognizes the consequences that are a result of their addiction(s), it is time to add onto their recovery plan, the coach invites the addict to look around at his/her surroundings, and ask:
What is the collateral damage resulting from your addiction?

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

Posted on October 18, 2011 by Michael

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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Executive Coaching and the Recovering Executive “What to do with a client that may have addiction issues”

Posted on October 15, 2011 by Michael

This is a reprint in six parts of a webinar presented at the Global Coaching Conference on Oct 12.
I am Melissa Killeen, I have been a Recovery Coach for about 5 years. In this specialized field of recovery coaching, I work mostly with executives, entrepreneurs and family business owners that are recovering from addiction. I have two degrees in Organizational Dynamics and Executive Coaching from the University of Pennsylvania, in Philadelphia, PA. I have used my years of training there to develop my book on recovery coaching, which will be published early in 2012.

This seminar will focus on coaching the executive that may have unrecognized addiction issues. Have you ever coached a distracted, uncontainable or procrastinating client? Why aren’t the things that usually work for a client not working for this specific client? Sometimes a client’s behavior is blamed on a boss, or perhaps client never completes their homework assignments because of family issues or perhaps the executive has a bottle in their bottom drawer. As a recovery coach, I hear these ‘reasons’ and a red flag goes up. Maybe the possibility that this client is an addict is something to consider.

What would be the clues? What kinds of things, either ways of behaviors, body language, talking traits, or other signs are evident?

In this presentation I will attempt to expand on these questions. I will cover the following:

1. Identify IF the addict exists
2. Help the addict/executive/coaching client build a plan for recovery
3. If the above has been accomplished, look around the coaching client at his/her surroundings. Is there collateral damage from the addiction?
4. Acknowledging change, conflict and collateral damage
5. Effectively dealing with change, conflict and collateral damage

Prior to starting, let me explain some of my techniques and terminology. When I use the term “addict” I am discussing the alcoholic, the drug addict, the sex addict, the gambler, the over eater, the compulsive spender, anyone that has a compulsive need to adjust their perceptions of reality with a mind altering behavior, or substance. It is easier and simpler to use the word ‘addict’ to describe all of these types of people. Also, I want to further describe the recovering individual. A person in recovery could have one week or twenty years, however, for those individuals in recovery, it is an accepted fact that the addict has just one day, today. I would prefer to work with a client that has some good clean time in recovery, but alas, that is not always possible. So, I will use mouth swab alcohol tests, I will cut hair for analysis and request to have the client take HIV and STD tests and I will request to see the test results. I search hotel rooms, offices and homes, popping up suspended ceilings, emptying dresser drawers, sticking my fingers into jars of hand cream, and emptying aspirin bottles looking for contraband. Why do I do this? Because it works, I have swabbed people that swear they haven’t taken a drink in 10 days, hair tests come back for drugs the person has never used, I have found pot, pills, coke, booze, pornography, cash, just about anything. I will do everything to ensure my client is doing their best at honesty as well as recovery. I know this may seem odd, but in my ‘niche’ of coaching, we see it as saving a life, as much as getting a good return on investment. In order to do this, it takes asking some very difficult questions

I. Identify IF the addict exists
The hardest thing that I have to deal with in recovery coaching is denial in the addict. Usually the denial has been perfected over many years. However, when they finally recognize they are an addict, dealing with the denial was nothing compared to helping them pick up the pieces and rebuild their life. Motivational Interviewing techniques help me to unlock the years of denial, and let the client pick up the pieces he/she chooses to pick up, in order to rebuild their lives.

To begin with the first meeting, as in all executive coaching contracts, an assessment is the first order of business. I use LIFO , Life Orientations Survey, but other recovery coaches may use MBTI, Enneagrams or Disc, whatever works for you. To identify characteristics of an addict, I go one step further. In the interviewing process, either before or after the behavioral or personality assessment, I ask the addict to tell me their story. Everything, from age 1 to the present time, including the first time they used or were abused. I request the story be written before our next meeting, I ask the client to read it to me as well as to forward me a written copy for my files. This story telling process was suggested by Carl Jung to Bill Wilson in 1932, when Bill W was first beginning AA. This concept has been around and working for quite a few years. Telling of one’s story builds trust. As the client reads his/her story I take notes. My familiarity with a multitude of addictions, I compile a series of questions to ask after I hear their story.

Some of my clients come directly from an extended stay at a treatment center, so the assessment for drugs/alcohol/compulsive behaviors and adverse childhood experiences has been made and I am usually privy (with client authorization) to the results. However, if I have been hired by an Employee Assistance Program, or been contracted directly by the client, after hearing their story, I will start with a series of questions. Depending on their answers, I branch out in several directions, drawing from the following assessments:
1. 12-questions from AA, 40 questions SLAA, and/or 20 questions from NA
2. Cognitive distortions survey
3. Annis, Schober and Kelly Interview
4. ACE- Adverse Childhood Experiences
During these questions, I decide whether I will give the entire assessment to the individual or just ask a few clarifying questions from the assessments.

In all assessments, I find there is a bit of overlap between addictions, life experiences and accompanied disorders, this is commonly called co-occurring disorders. One of the most frequent co-occurring disorders is ADD/ADHD. Coaching adults with ADD/ADHD has come into the forefront of life coaching recently. Let me take a moment here to define that I am NOT a coach for adults with ADD/ADHD. If ADD/ADHD presents itself as the most important problem for a client, not addiction, I suggest the individual seek help from a specialist. Often adults with ADD/ADHD will mask, or self medicate with drugs, alcohol or other compulsive behaviors to alleviate the pain of dealing with ADD/ADHD.
So, you might ask, how do I differentiate between addiction and ADD/ADHD?
I ask:
“Do you mask, or self medicate with drugs, alcohol or other compulsive behaviors to alleviate the pain of dealing with:
1. Physical and mental health problems
2. Work and financial difficulties.
3. Emotional difficulties
4. Disorganization and forgetfulness
The client’s answer to these straight forward questions will lead me further to my conclusions about the existence of any addiction.

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