Suggestions for therapists

As a therapist working with an individual client, how do you lead the client through these steps? Here are some suggestions.

I suggest incorporating the Steps within each session, with a portion of the session devoted to reading and discussing a specific Step. For instance, the last 15 minutes of the session could be assigned to reading and discussing a Step. Of course, 15 minutes are often not going to be enough for a given Step. This is just a point of departure, for instance you can allow more time in the following session to continue the discussion.

If your client likes to do homework, they can read the specific Step ahead of the session where you read it together. In this case, the session might be starting with the Step. But it’s if your client doesn’t want to do homework, you can still work on the Step together in session.

So, we’re talking about going one Step at a time, one per session. It does not have to be rigid. That is, it is quite possible that you will take breaks in between discussing Steps, to process issues that become highly charged.

In any given session:

After you read the Step together, I would start with a very general question, such as: What does this bring up for you? 

Based on trial and error with your client, you word the question so that it is an invitation for them to share whatever comes up for them. The points below can be prompts to help the client say more:

  • How they understand this Step (or what they don’t understand),
  • What are the similarities and differences with the traditional Twelve Steps (if the client is involved with a Twelve-Step group)
  • How this Step relates to the way they explore things in therapy with you
  • How they relate to this Step (or don’t relate to it)

Generally speaking, think of this as something similar to what we do to absorb food: we chew on it. Processing helps the client assimilate the Step, in their own words, in their own context.

Once the client has absorbed the meaning of the Step, you can further consolidate this learning by focusing on how they are going to apply the Step: Generally speaking? What are they specifically going to do this week? Today? Or: what is in the way of applying it?

A larger context

As the therapist, you keep an eye on how the client is making sense of the process as a whole, not just any individual Step.

You will probably find it useful to intersperse the discussion of individual Steps with some sessions in which you discuss some of the core ideas. In particular, as you go through Steps 4-10, it may be good to draw your client’s attention to the process of mindful change.

Please feel free to share your experience as a therapist through the feedback form.