One of the most challenging things an individual, group, or organisation can do is to look at itself and how it operates. For the substance use field, this means asking: how do you engage and work with this client group?
The overarching response to substance use has always been to use labels – addiction, dependent, sick, ill or diseased – that appear to be supported by strong scientific research. But have we stopped to think what messages these labels are sending to the service user? Do they offer a get-out clause, or a justification for them to continue their relationship with a substance with total impunity?
As professionals we may not agree with the idea that the client is sick, or that he or she is dependent on their substance – or that they are unable to regulate their behaviour and actions because they have no control.
Services may have inherited a way of working, validated by many in the scientific community, that the substance user is in some shape or form sick. We have also created an even broader context called the bio, psycho, social model, affirmingthat the client is affected by their substance use at a biological, psychological and social level. But could we be missing out the fundamental issue of why they came to the service?
What if the service user is not sick, diseased, or addicted; could this pave the way to look at their behaviour from a different angle? An example, backed up by pharmacology, would be that drug use is very pleasurable and that is why they keep returning. While being fed messages – that they are dependent, have no control over what they do, have a sickness, and are simply a product of their addiction – the client may always be able to justify carrying on using.
The Resonance Factor, the approach used by Janus Solutions – which we will investigate further in two more articles in DDN – offers a counterpoint to the established treatment approach in that it allows the client to own their love of substance use. They explore their relationship with their substance and the behaviours that they act out to maintain this relationship.
This process is then underpinned by deconstructing justifications for continuing their use, taking them to a place of ownership and choice. Of course this is a challenging process for the service user and, as with most forms of transformation, requires the individual to go through a level of discomfort. But when our labels provide them with appropriate justifications for their past and future actions, we have to ask ourselves – is this supporting the client, or are we becoming a part of their collusion?