Recovery-oriented psychotherapy: patient resistances and therapist dilemmas

This paper examines patient resistances, especially in early recovery, and explores some therapist's dilemmas and hazards arising from personal issues and gaps in professional training. To some extent, these vary according to the route by which the practitioner became involved in treating addiction. The vulnerabilities of the conventionally trained mental health therapist are contrasted with difficulties often seen among those whose training and primary experience base is in substance abuse treatment. Emphasis is given to the patient in denial and in early recovery and to the frustrations and power struggles common at those stages. The paper briefly addresses problems manifested by insulated treatment systems and other obstacles to open inquiry and dialogue among professionals.