Tag Archives: recovery coaching

“What to do with a client that may have addiction issues” Part 5 – Acknowledging change, conflict and collateral damage.

Posted on October 31, 2011 by Michael

Executive Coaching and the Recovering Executive
“What to do with a client that may have addiction issues”
Part 5
Acknowledging change, conflict and collateral damage. Working with the client on moving forward on their recovery plan, keeping in mind that every day the client must work on repairing whatever collateral damages has been caused by the addiction.

Character defects, broken relationships, aggression, co-dependency, enmeshment, manipulation, enabling, all are characteristics of addiction. In facing character defects, I use my ‘ally’ in recovery coaching; the 12-steps. Namely steps four through ten:
• Moral inventory of ourselves.
• Admit the exact nature of our wrongs.
• Be entirely ready to remove all these defects of character.
• Be willing to make amends to persons we have harmed
• Make amends wherever possible, except when to do so would injure others.
• When we are wrong promptly admit it.

Embracing change without out relapsing
The 12 steps are not the only tools for a recovery coach to use. When it comes to the wide range of changes that can occur in a client’s recovery lives, anything that shifts the status quo – negative or positive – is known to exacerbate feelings of insecurity, vulnerability and other emotions. For many addicts, their feelings are at an unconscious or subconscious level, because for many years they have altered these feelings with a substance. The coaching client may just feel uncomfortable, upset or off-balance, but have no idea on how to verbalize these feelings. It is often very hard for them to identify feelings of insecurity, fear, vulnerability or any other emotions.
Acknowledge change, and acknowledge that change creates conflict
Change of any sort, precipitates interpersonal conflicts that may flow from these unrecognized fears and emotions. Gaining increased awareness of what is happening for our client doesn’t stop their ability to resist it. Sometimes these related emotions overwhelm our clients and contribute to the eruption of unnecessary conflict, chaos or even relapse. Here is a story about a client I had that was working through her own change:

I had a client, a smart doctor in private practice with four years of recovery under her belt. She was willing to look at the collateral damage her addiction had caused in her practice. Let’s call her Grace. Grace was a strong, controlling person as assessed by her LIFO survey. She also concentrated on building a team around her, and was very focused on the well being of the employees and other doctors in her practice.

For years, during her addiction, Grace ran her practice like a bully, forcing her ideas on everyone, and not asking for opinions. After her all, it was her practice. Now, she sees that this behavior didn’t work so well. She now avoids conflict at all costs; because she does not want to return to her controlling behaviors from the past. She is unable to strike a happy medium. We discussed what a happy medium would like. In this discussion, Grace saw that she still had to be the leader, but did not know how to be a sober leader.

So we worked on embracing conflict in a positive way. Some of the questions I asked were:
• What about you, what surrounding you is changing?
• What about it are you resisting or unsettled about?
• What does your reaction to this change tell you about how you feel in this situation?
• How would you describe the emotions you are experiencing at these times?
• If you haven’t mentioned a fear of some sort, what fear(s) if any, do you have about these changes?
• In what ways may you be taking out your unsettled thoughts and feelings on others?
• What is important to you, in this particular situation?
• How would you rather be and be seen during these times of change?
• In what ways can you manage the change that aligns with the recovery image of yourself?

Grace comes into conflict continuously with the Director of Operations for the practice, who is also her son. She wants him to take more of the managerial aspects of the practice, but she doesn’t necessarily think he is doing it the way she wants him to run the practice. So in breaking down typical conflicts with her son I ask these questions:
• What do you know about the way you habitually respond to your son that you would like to change?
• How have these habits helped you in the past?
• How have these habits not helped you?
• In your last dispute, what reaction of yours was the most counterproductive?
• What could you have said or done differently that would be more in keeping with how you prefer to interact? Or more in keeping with your recovery plan?
• What kept you from responding that way?
• What do you want to learn about to be able to respond in positive ways when you are in conflict?
• What may you need to learn that will help you cope more effectively in your adjustment to change?

I asked Grace to keep a copy of the answers to these questions on hand, and review them before every meeting with her son. Grace also recognized that her son had adopted her controlling behavior of presenting to the staff. She blamed herself for teaching her son this dysfunctional way of communicating. She requested I give a workshop on the Eight Essentials Steps of Conflict Resolution to the top tier group of doctors and administrators of the practice to disseminate the correct approach to looking at conflict as an ally instead of an adversary.

“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?

Posted in Addiction Recovery Posts | Tagged addiction, alcoholism, MKRecoveryCoaching.com, recovery, recovery coaching, recovery plan | Comments Off

“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.

Posted in Addiction Recovery Posts | Tagged addiction, alcoholism, cognitive disorder, drug addition, EATING DISORDER, executive coaching, recovery coaching, Sex Addiction, stage of change | Comments Off