Counselors in the field of substance abuse (alcohol and other drug) treatment are continually faced with developing client-specific intervention strategies that (a) meet the immediate needs of the client, (b) encourage active and continued participation in treatment, (c) enhance client decision-making skills, and (d) provide measurable outcomes. Service providers are increasingly challenged to prove that the treatment they provide is effective and efficient. With few exceptions, treatment models have centered around the twelve step self-help philosophy, with treatment outcomes tied to helping clients abstain from all mood-altering substances, attend self-help group meetings, work on the twelve steps, maintain employment, and, in general, assess various indicators that suggest an improvement in the quality of life of the client.
In addition to twelve step involvement and improved quality of life indicators, research has focused on coping skills, cue exposure, and expectations and beliefs as reasons why some people are able to abstain from drinking alcohol. Billings and Moos (1983) found that recovered alcoholics and a control group of nonalcoholics tend to use active-cognitive and behavioral coping responses, whereas relapsed persons tend to avoid all alcohol-related situations as their primary coping response. Litman, Eiser, Rawson, and Oppenheim (1979) found that nonrelapse was related