Pryor u07a1 Therapeutic Approach

Running head: THERAPEUTIC APPROACH OF ALICE GREEN 1

Therapeutic Approach of Alice Green

Christine Pryor

Capella University

Theories and Models of Addiction and Compulsive Behaviors

COUN-5260

Lawrence Pattington

February 25, 2016

THERAPEUTIC APPROACH OF ALICE GREEN 2

Therapeutic Approach of Alice Green

In the movie when a man loves a woman, Alice Green is a school counselor who is

married to a pilot and has to beautiful daughters. At first glance this family seems picture perfect

and happy, but inside tells a very different story. Alice Green has a serious drinking problem

that is slowly running her relationship with her husband, her daughters as well as her career as a

school counselor. Alice Green is the lead character in the movie and the movie showcases her

addiction to alcohol. Alice addiction began in high school and continued way into adulthood and

as time goes by the problem gets progressively worse. Alice’s behavior often appears to be

manic, since her moods can change very rapidly and can even seem bipolar. However,

according to the Diagnostic and Statistic Manual (DSM-5), Alice is not suffering from bipolar

but substance abuse disorder.

The diagnosis and Treatment plan

Diagnosing Alice Green is the first step in creating a treatment plan. Recently the DSM-

5 has been updated and the terms to treat substance abuse and substance dependency has

changed (SAMHSA, 2015). No longer do we use the terms substance abuse or substance

dependency, but we refer to the substance that is used to classify the disorder, and define them as

mild, moderate, and severe, which is determined by the number of diagnostic criteria met by

Alice. According to the DSM-5 Alice is suffering from Alcohol Use Disorder (AUD). For this

paper Alice diagnosis is Alcohol Use Disorder (AUD) 305.00 Alcohol Abuse and 303.90

Alcohol Dependency and her classification would be severe due to her meeting more than six of

the symptoms of the disorder (APA, 2013) .

In substance abuse treatment of Alice it is important to get an accurate diagnosis so that

we can develop an effective, personalized treatment plan. In order for us to get the root cause of


Alice addiction to alcohol we need to employ a number of diagnostic tools, which will include,

face-to-face interviews, interviews with family members, and may also include standardized

tests. To further ensure the treatment plan is meeting Alice’s needs and that the therapy is being

effective, we will preform assessments at the admission stage, and during the later stages of her

rehabilitation. Further, we may use standardized testing before discharge to measure how

Alice’s progress in treatment has progressed and to choose what types of aftercare services may

be beneficial both to Alice and her family.

Working with Green family the solution-focused model of therapy will be an effective

tool since it will increase the communication between Alice and Michael as well as the whole

family. Alice and Michael need to learn to communicate with one another about serious topic so

that their relationship will become stronger and so that they can begin to heal the entire family.

Solution-focused Therapy (SFT) is a short-term, strength-orientated model of therapy that helps

to identify and enhance the client’s ways of coping with many difficulties in life. SFT originated

as a family therapy model, but has recently proved that it is affected working with families that

have addiction problems (De Shazer et al., 1986).

Solution-Focused Treatment of Alice Green and family

One of the key elements in Solution-focused therapy (SFT) is how it places the focus on a

client’s present and future circumstances and goals, unlike other methods that focus on the

client’s past experiences. SFT is goal-orientated therapy therefore the symptoms or issues that

the client is bringing to counseling is not targeted (Iveson, 2002). For example, Alice Green’s

alcohol dependency would not be targeted, instead such things as coping skills, communication

etc. will be focused on.


Another key component of SFT is its ability to look at a family system as a whole, in

doing this the notion of change can occur. This concept of changing one part of a behavior

sequence will allow for the rest of the system to change (Iverson, 2002). Since SFT is a

collaborative approach the client and the counselor are partners in the treatment process. Often

the client and the counselor have conversations that are led by key questions that can pave the

way in which a client views his/her self, allowing this to occur the client can make small changed

to the problem behavior. One of the many reasons why SFT has been successful when working

with the addiction is because it proposes that the solution to a clients issues may have very little

to do with the problems that originally brought them to counseling. Using SFT with the green

family will allow Alice to be treated without focusing on the alcohol problem but to rather focus

on the goals she sets for herself.

Techniques of SFT

Initially, it is important in this type of therapy to first develop a vision for Alice future

and determine how Alice’s internal abilities will be enhanced in order for her to attain the desired

outcomes. It is important as Alice’s counselor to guide her in therapy through the process of

recognizing things that are working for her and encourage Alice to acknowledge and celebrate

her success as well as helping her explore how to continue to practice these strategies in her life

and her family’s life.

To begin treating Alice and helping her to achieve her goals we will need to ask her

specific questions that will help guide our sessions. One type of questioning that may be useful

to Alice and her goals, is coping questions. Copying questions will demonstrate to Alice the

resiliency she has deep inside here. It will also help her to better cope with the challenges that

might occur in her life as a mother, wife, and employee. Coping questions should look similar to


How do you meet you daily obligations when you are constantly facing so much difficulties? By

using these types of questions allows Alice to see that she have positive coping skills even

though she has so much adversity in her life. Coping questions are intended to help clients who

have been managing in spite of their addiction problems. Furthermore, coping questions will

bring Alice hope and self-efficacy as well as show her empathy while acknowledging her

struggles (Wormer & Davis, 2008).

Miracle questions are also a great way to help Alice envision her future, minus the

alcohol problems. The point of these types of questions is that it allows Alice to explain how

her life would look different if the drinking did not exist. This will allow Alice to identify steps

that she can take immediately towards the change. For example, Alice might describe a feeling

of ease with her husband or daughters and believe that this ease in therapy can only be felt is the

drinking problem was absent. Essentially, when Alice can imagine a scene where the present

problems does not exisit will remind Alice of the behavioral changes are possible and these

changes will allow her to see what can be done to create the changes in her lives. By imagining

a scenario where the present problem does not exist.

Finally, scaling question can be used to help Alice asses the level of hope, determination,

confidence, sadness and how much change has occurred. Scaling question are used to gage how

Alice is feeling and are very similar to motivational interviewing questions (Wormer & Davis,

2008). We simply ask Alice on a scale of 1-10 (1 being the worst and 10 being the best) how do

you feeling today? are very similar to motivational interviewing scales.

Theory of Change

Solution-focused therapists often believe that change can happen quickly, despite the

issues that may be in a client past. It is this belief that will empower Alice because of its


“conventional wisdom that says change happens slowly (Hepworth, 2006). Accompanying this

belief with rapid change is the “inherent method of focusing on the solution” (Hepworth, 2006).

This is why solution focused therapy is not a problem-focused approach to therapy. Initially,

working with Alice s a way to begin identifying problems and putting them in the proper order.

However, we must focus on the language and interaction since they are the Alice’s strengths, it is

important shows Alice that these strengths can change the undesired symptoms and behaviors.

Alice’s problems will only be the stepping-stone to finding her solutions. There are many

research studies that show that when you shit the focus from the problem to the solutions it

becomes more effecting for positive outcomes and helps motivate the client (Hepworth, 2006).

Outcomes, and Therapeutic Relationship

There are several outcomes that we can gather from using the SBT method of therapy

with the Green family. Focusing on the positive of Alice life will bring upon the change in her

behavior and provide her with coping methods to handle tough situations. It is the hope that

Alice and Michael will be able to better communicates with one another so they can support one

another through any difficult issues that may arise. Since Alice’s behaviors are changing, her

daughter will feel more secure in their mom’s ability to care for them as well.

Conceptualizing the process of change is one of SBT key concepts, therefore SFT

counselors categorize the types of clients they have counseling relationships with. Identifying

the types of client-counseling relationships has two major benefits. First, it will remind them

that both the client and the counselor are part of a team. Secondly, it will help will help the

counselor to determine which therapeutic intervention will be most successful with each client.

SFT give of us three different types of clients: the visitor, the compliment and the customer. The

visitor is usually the gambler who has no clear problem or goal and may be seeking treatment on


the advice or pushing of others. The complainants, are aware of the problem, and may be able to

set goals but have no motivation. Finally the customer, this client most counselors would like

but is very rare. Customers understand their problems and have clear goals; they are not only

responsible but are extremely motivated to change.

Conclusion

Solution-Focused Therapy is a form of therapy where changes occur rapidly. When

working with SFT and the Green family, it is important to use positive client centered interaction

so that the specific change can occur. There are many people that are in favor of the

effectiveness of solution-focused therapy, but there is also many people that citizen the approach.

One major criticism of SFT is that its quick and goal-orientated that may not allow some

counselors time to empathize with the clients they are working with. Another area that has been

critical the fact that SFT does not take into consideration past experiences, proponents of SFT

suggest that SFT counselors simply discard or ignore information deemed important by any other

approach. When working with the Green family SFT will fit nicely since Alice is struggling

with an addiction and it’s that addiction that is harming the family. It is beneficial for the

family and Alice since the alcohol addiction will not be the main focus of the therapy sessions.

Finally, the family will be worked with as a whole, Alice and Michael will be work with as a

couple and Alice will be worked with individual both in and out of rehab. All of these things

will reunite the family back together, stronger than they have ever been


References

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Pryor u07a1 Therapeutic Approach