| Under the Influence in Group |
| George arrives at group intoxicated. His speech is slurred, he staggers somewhat, and he laughs loudly and inappropriately. |
| Counselor response. |
| • Inserts an educational video, and instructs the group to continue on its own for the next 15 minutes. Alternatively, asks another staff member to sit in temporarily with the group. |
| • Escorts George from the group. |
| • Obtains a urine sample and conducts a Breathalyzer™ test to determine the substances consumed. |
| • Asks George in a one-on-one session how he will return home. Because George drove to the facility, the counselor tells him that he cannot drive home and that the counselor will contact police if George tries to drive. The counselor reviews with George the names of family members who can provide a ride home. The counselor follows applicable Federal, State, and local laws regarding contacts with authorities (CSAT 2004b ). |
| • Allows George to use the phone to call his wife to pick him up. Note: Some programs pay for a cab. |
| • Expresses concern about the substance use and encourages George to return to the next session where the episode will be discussed therapeutically. |
| Key point. The counselor did not engage George in a discussion about his substance use, such as why it occurred and the circumstances. Instead, the counselor immediately focused on confirming George's substance use, ensuring his safety, encouraging him to return to treatment when sober, and preserving group time for the benefit of the other clients. |
From: Chapter 7. Clinical Issues, Challenges, and Strategies in Intensive Outpatient Treatment
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