Addiction Treatment providers should clients as people, not as stomachs…

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If there’s one thing I’ve studied consistently over the years, it’s leadership. I’ve been able to lead people towards their goals pretty much all of my life. Not only have I been successful as a leader professionally, but I’ve also formally studied the concepts behind leadership psychology and if there’s one thing of which I’m certain, it’s that people perform at their best when they work from a place of meaning and competence. That is, if a person finds value within the work that needs doing and if that person believes she know how to do the work well, that person will perform at a high level. I am certain of that; so much so that I base everything I do on that belief, whether it’s lead a team or lead a treatment program.

Recently, I was asked about Contingency Management (CM) as a means of addiction treatment. The reality is that, while incentives and consequences are almost always a fact of life, programs based upon Contingency Management basically see people as animals who respond to sticks and carrots. CM is based upon transactional forms of leadership and may be able to gain compliance, but they hardly ever develop true commitment. Really, to get commitment, program leaders (whether they are counselors, therapists, or psychologists) must allow “clients” to define their own treatment goals (other than simply either using or not using a substance) and the means through which they attain those goals. CM sees people as little more than stomachs that must be filled; they really aren’t treated as intelligent and capable people.

I realize that CM has its uses and its adherents who strongly believe in its efficacy. But in all my years of studying and practicing leadership, I have no doubt that people perform at their when they are allowed to be people who are actively engaged within their own forming their own destinies. All too often “leaders” really haven’t learned enough about leadership theory, especially within the addiction treatment domain, and are mostly concerned with others adhering to the reality those limited leaders create. I just don’t see how transactional forms of leadership such as CM can develop people into the best version of themselves….



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