Addiction Assessment in Psychology
Neurolinguistic Programming, or NLP, is an approach to communication, self-development, and psychotherapy that targets how people:
- communicate externally and internally
- process, store, and recall information
- alter their communication to achieve the results and goals they want
NLP can be effectively applied to overcoming an addiction. In fact, NLP is a great fit for people experiencing drug or alcohol problems. Practitioners believe human beings have an extraordinary capacity for flexibility, and there is nothing that happens mentally or spiritually they cannot learn to handle. The focus is on how an individual formulates the thoughts and beliefs that help effect and maintain change.
So, how is addiction assessed in the NLP system? How can mental health clinicians take a step back from standardized assessments and look at the human behind the addiction?
We explore more here. In this article, Dr. Walton introduces the assessment process she typically uses with a client. Then, we invite your questions about NLP assessment of addiction at the end.
The Assessment Process with an Addicted Client
After building rapport, completing a detailed assessment is the next critical step. As you will see, an assessment process based on NLP strategies is different from traditional or standardized tests. The goal is to understand the problem from the client’s point of view and to identify an effective path moving forward.
The four NLP strategies which comprise the assessment are as follows:
- Outcome Specification – A nine-question summary used to identify and specify the client’s goal.
- Logical Levels – A strategy used to organize thinking, gather information, and communicate. This strategy helps the counselor understand more clearly what makes a client “tick.”
- Positive Intent – Every behavior has a positive intent even negative behavior. Once the positive intent is identified, healthier options can be explored.
- Meta Model Questions – Most people tend to speak in shorthand. Meta Model Questions address what is not said.
Now, let’s see what the assessment looks like in a hypothetical case.
HYPOTETHICAL CASE OF PROBLEMATIC INTERNET USE
Tyrell is a 40-year old man with a wife and three small sons. Over the past year, he has spent an increasing amount of time at the computer. He surfs the web for hours every evening reading the news, participating in financial chat rooms, and playing video games. HIs wife complains about how much time he spends on the computer and how little time he spends with her and the kids. She is sure that he is looking at porn websites and has demanded he get professional help.
Tyrell admits to spending more time on the computer. However, because he really is not visiting porn sites or participating in sex chat rooms, he sees no reason to stop. Tyrell says his wife just doesn’t understand. Even though he cherishes his time at the computer, Tyrell admits his computer use is creating problems and something must change given his wife’s concerns.
In the initial session, I built rapport with Tyrell. Then moved to the assessment process.
Outcome Specification Questions and Tyrell’s Responses
1. What do you want?
TYRELL: I want a happy family and time for myself.
2. How will you know when you have reached the goal?
TYRELL: When my wife and I no longer argue about the amount of time I spend at the computer and when my kids no longer bug me to play with them.
3. Where will the goal be relevant and/or irrelevant?
TYRELL: The goal is relevant at home. Our family is not happy right now.
4. What stops you from pursuing the goal wholeheartedly?
TYRELL: The internet is my only hobby, I don’t play golf and I don’t like sports. It is a way for me to unwind from all the stresses of the day.
5. What personal resources could you use if you were to achieve this goal?
TYRELL: I am flexible and I love my family.
6. What additional resources will you need to achieve the goal?
TYRELL: New ways to relax and the desire to do things with my boys.
7. How might the pursuit of the goal affect important people in your life? Is there any risk associated with achieving this goal?
TYRELL: The goal positively affects my family. The only risk is my blood pressure rising.
8. What daily actions can you take to achieve your goal? What is the first step?
TYRELL: Well, I could spend less time on the computer and more time doing things with the boys. If I were to make such a change, the first step would be to learn about their activities and explore what I could get involved in with them.
9. Given everything you have considered to this point, is achieving the goal worth it?
When looking for reasons why change does not occur, it is helpful to determine exactly where blocks are located and where best to intervene. So, I guided Tyrell through the Logical Levels Exercise, which helps me understand more clearly what makes him “tick.” Here are questions and Tyrell’s responses.
Logical Levels Questions and Tyrell’s Responses
- Tyrell: Environment = Daily from 8pm until midnight in the den.
- Tyrell: Behavior = Spend time at the computer.
- Tyrell: Capabilities = I am at home and what I do is basically free. I also know how to use a computer and it is fun for me to learn.
- Tyrell: Beliefs = “I am not hurting anyone,” “I am not partying,” and “I am not looking at porn or on participating in sex chat rooms.”
- Tyrell: Identity = I am a loving husband and father.
One option was to intervene at the Environment Level and suggest that Tyrell spend less time on the computer or to include his family in his Internet use with educational sites and games. Instead, I chose to focus on the Belief Level and his words “I am not hurting anyone.” The belief needs to be questioned – he is hurting his wife and children. By intervening at this Level, the Capabilities, Behavior, and Environment Levels may change as well.
As mentioned previously, every behavior has a positive intent even negative behavior. Tyrell identifies the positive intent of his behavior as a way to relax and have fun. During this time, Tyrell can set aside the problems of the day and learn new information.
Meta Model Questions
During the Assessment phase, I ask questions to identify and transform problematic vagueness that occurred during the Outcome Specification and Logical Level exercises. For example:
- Tyrell said, “She demanded that I get help or else.”
I asked, “What might happen if you didn’t follow her request?”
- Tyrell said, “She doesn’t understand.”
I asked, “Your wife doesn’t understand what?
- Tyrell said, “I need to relax and get away from all the stresses of the day.
I asked, “All of the stresses?”
- Tyrell said, “She thinks I am watching porn.”
I asked, “Why would your wife think that?”
After building rapport with Tyrell and using Meta Model questions to clarify his responses to the Outcome Specification and the Logical Levels exercises, I had a clear understanding of the issues and could determine a plan for future sessions.
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