The Model isn’t the Focus: Your Client Is
I had a supervision session recently with a candidate who is doing good work. He is thoughtful, he cares about his clients, and he is trying hard to do CSAT work the “right” way. But partway through our conversation, I heard something I hear often from newer clinicians in this field. He was stuck on the workbook. Stuck on the assessment. Stuck on which exercise came next in the sequence. And in the process, he had lost sight of the actual human being sitting across from him.
A Tool is Only as Good as the Hand That Wields It
This is an easy trap to fall into, especially when you are early in your career and a structured model gives you something solid to hold onto. The CSAT task model and workbook exist for good reason. They are excellent tools! But a tool is only as good as the hand that wields it, and the moment you become married to the tool instead of the client, you are no longer doing therapy. You are administering a curriculum.
I told him to picture a seven iron. It is a great club. But if I hand you a seven iron and tell you it is the only club you are allowed to use for the entire round of golf, you are going to hit some very bad shots. Sometimes you need a driver. Sometimes you need a putter. The club has to match the shot in front of you, not the other way around.
The same is true with our clients. Every couple’s therapy model I know of, EFT, Gottman, and others, will plainly tell you their approach does not work while someone is an active addict. That is not a flaw in those models. It is simply a reminder that no single framework covers every situation. If you are married to one methodology, you will eventually cause harm, because you will keep reaching for the same tool regardless of what the moment actually requires.
Conceptualize First
So what is the alternative? Conceptualize the client first. Understand their story, their goals, and where they actually are in their process. Ask yourself what they need right now, this month, this session, in order to move toward the next area of growth. Only then do you choose the methodology, the theory, or the exercise that serves that goal. The workbook, the SDI, the courtship inventory, the sobriety challenges worksheet, all of it is in service of the client’s goals. None of it is the goal itself.
Don’t Mistake the Workbook for the Word
Let’s me emphasize this important point. Completing the workbooks is not the goal! A complete workbook does not mean someone “recovered”. It’s an amazing tool to help clients recovery. Don’t get fixated on the tool, loosing sight of your client.
See the Whole Client, Not Just as Addiction
This also points to something bigger: CSAT work is not separate from the rest of a client’s life. The addiction did not appear in isolation. It grew out of everything else the client has not yet learned to cope with. Our job is to see the full picture, not just the piece labeled “sex addiction.” That means staying flexible enough to bring in whatever approach actually meets the client where they are, even if it did not come from our specific training. Remember, in sex addiction, sex is a poor solution for a greater dis-ease or discomfort. What helps the client better understand the deeper issue?
Trust Your Clinical Judgment
Trust your conceptualization. Trust your clinical judgment. The model works for you. You do not work for the model.