Required: Hope
By Kevin Doyle, EdD
NOTE: This was published for the Hazelden Betty Ford Foundation’s monthly Recovery Advocacy Update. If you’d like to receive our advocacy emails, subscribe today.
Unconditional positive regard. Empathy. Authenticity. Active listening. Genuineness. These are among the traits or skills that are often presented as essential for a counselor (or any helping professional) to have.
I would add hope to that list. Without hope, I am not sure if any of the others matter.
A few years ago, I was listening to a counseling student talk about the concept of hope. The gist of his comments made a connection to a Christian belief system in a somewhat convoluted way, noting that God is ultimately in charge. He said something along the lines of, “I don’t believe in hope, as nothing is promised to us.”
Working in the addiction/substance use space, however, has led me to the opposite belief. Our clients and patients often come to us hopeless. Their many efforts to cut down or stop using altogether have been spectacular failures. They have been alienated from those they love the most, lost jobs, dealt with serious substance-induced medical issues, and been thrust into a largely unsympathetic criminal justice system. The cumulative effect of all of this is the snuffing out of any hope at all that things can be better.
That is where the professional comes in — to offer a sense that, yes, change is possible and a return to health and functioning can, indeed, occur.
A few years ago, I was involved in a project through the Network for the Improvement of Addiction Treatment (NIATx), a SAMHSA-funded effort to look at access to and retention in treatment for substance use disorders. Through “secret shopper” techniques—such as walk-throughs of the admissions process — participating agencies learned how hard it is to navigate the treatment system, whether it be repeatedly getting sent to voicemail when making an inquiry for treatment; long waiting lists; indifferent admissions staff; complicated regulations around payment; or downright hostility to those seeking care.
One of the most striking findings from that project had to do with how people were treated when they entered care. Usually there was a series of long, duplicative forms to sign, followed by a rigorous delineation of all the rules that someone would need to follow — with the threat of discharge if any were violated.
Imagine if we did that to cancer or diabetes patients.
What was missing in the above example were statements like, “We’re so glad you are here,” “People can get well here,” “We work with folks with these issues all the time and we can help you,” etc. In other words, rarely was an individual entering treatment for a substance use disorder presented with that essential quality of hope.
At a time when a patient is fearful, often alone, in physical withdrawal and hopeless, a little hope can go a long way.
So, let’s consider adding the quality of hope to the essential characteristics needed by counselors and helping professionals, regardless of what issues clients or patients are facing, and especially when they are dealing with issues related to their use of substances.
Kevin Doyle, EdD, is the president and CEO of the Hazelden Betty Ford Graduate School of Addiction Studies in Center City, Minn.
