An Overview of Choice Theory for Addicted Populations


A Broad Overview of Choice Theory for Addicted Populations.

    The Quality World of the addict or alcoholic contains a very vivid image of their drug of choice.  (Alcohol is a drug only in liquid form).  So whatever drug they prefer or whatever brand of beer or liquor they prefer will be vividly pictured in their Quality World.

    But this is not the only place we will find it.  Their drug of choice will also be in their Behavior System because this is the primary tool which they use on a regular basis to deal with those things that lead to their frustration and unhappiness:

  • Unwanted emotions. (anger, fear, anxiety, helplessness, stress –  all of which create depression when suppressed).
  • Unwanted situations.  (marriage, unemployment, employers, managers, problems with kids, physical health, teacher problems)
  • Unwanted people in their lives. (in-laws, spouses, enemies, family, co-workers, employer, managers, teachers)
  • Wanted people in their lives who have taken the addict/alcoholic out of their quality world. (see above)
  • As a sleep aid to get to sleep at night.
  • For physical aches and pains.
  • To feel more comfortable and acceptable around other people. (low self worth and self esteem that dissipates when they drink because they don’t care what others think  of them when using or drinking)
  • Heavy disappointments. (things that didn’t work out as expected)
  • To feel better to overcome withdrawal effects due to the lack of the drug in their system.
  • To feel pleasure which they mistakenly identify as happiness.
  • They “feel good” because the drugs/alcohol causes them to not give a damn about their frustration.

    The above listings are why people abuse alcohol or use drugs but they are not the cause of their addiction.  Their addiction is the result of the body’s bio-chemical adjusted reliance of an addictive substance that has been regularly introduced into the body.  So now, the addict/alcoholic has the concerns of their drug of choice in three places:  1.) Their Quality World, 2.)  Behavioral System, and 3.)  their Physiology.  The first two areas are contained in the mind while the last concern is, not only in their mind, but also in their entire physical, cellular being.

    Management for the addict and alcoholic will be determined upon where they are with their addiction.  If cellular chemically dependent, they will require a period of detoxification to rid the body of the toxic effects and to allow the body to readjust to normal functioning.  This is best done under medical supervision to ease the client’s physical and emotional withdrawal symptoms and to avert seizures or other physical reactions resultant from cessation as well as possibly leading to relapse or even death.  The standard time of inpatient treatment in the past was 28 days.  This period might be effective for the first two stages of addiciton.  As of late, this has been found to be ineffective compared to 90 or more days for the cellularly addicted individual.

    Those who have gone through detoxification, and those who are chemically addicted but are psychologically and sociologically addicted, would now go through the next following procedures:

There are four things that come into play while using CT with chemically dependent individuals that are not considered important, if at all, in other types of management:  Relationships, Relationships, Relationships, and Relationships  Alcoholics and addicts drink and use drugs because they are unhappy people, to start with.  All long term emotional problems are relationship problems.  Consumption of drugs or alcohol cover up unwanted emotions but create further relationship problems.  Only one thing creates happiness:  Meaningful relationships.  And the more meaningful relationships one has, the happier one will be.

    Not only is the focus of reconnecting relationships with others, but also a relationship with one’s self.  Those who are the most successful in overcoming addictions are those who have truly, genuine, loving and meaningful relationships.  You can find this to be true by watching any of the numerous Intervention TV shows.   Those who are successful are those who have genuine love from their family and friends and not just those who merely voice their love for the client.

    Reconnecting with lost relationships with the important people in the addict’s life, as well as forming new relationships, are a major component in CT’s approach to chemical dependency management.  Counselors can discover who these people are in the alcoholic’s life while in their recovery program and help them discover new ways to possibly reconnect with them.  (This can be accomplished in the W area of WDEP for those readers who are CT certified or knowledgeable).

    Next in line of management is learning ways to deal with unhappiness in healthy and effective ways rather than to self-medicate.  This will involve acquiring healthy life-skills and learning how to deal with stress and frustration other than relying on drugs or alcohol to deal with them.  Specific needs will be found by the responses from several different self-evaluation questions and plans.  A major component in recovery is How to Effectively Resolve Conflict with self and others.  In other words, teach Choice Theory and explain the Quality World, Basic Needs, and Behavior Systems along with Total Behavior in knowing what we can control and what we can’t and how they have been using them ineffectively to find happiness.

    The third area of concern will be in learning how to avoid boredom, and to acquire new ways to recreate and have fun without drugs or alcohol.  Added to this is the association with those who have been there as well as those who have never been there yet are successful and happy in life. . . real life role models and teachers.

    This is but a broad, yet simplistic, overview of the approach to managing those with chemical addictions using Choice Theory.  Emphasis will be placed on getting the client to see a need to make a change as well as wanting to re-acquire happiness and relationships in their life.  Without this, no recovery of any sort will be successful.  Unlimited and oft repeated use of self-evaluation questions are an ongoing strategy;  implementing plans for clients to get what they want in life without relying on drugs or alcohol which would only add more to their current unhappiness.  By realizing that their unhappiness is the result of their drinking/using, they will be more inclined to replace their maladaptive behaviors if what you have to show them is equal to or greater than what they are currently doing.  Contrary to popular belief, addicted people do not have to hit “rock bottom” before they get help.  Waiting for that to happen often leads to death before they reach that point.

    Those who wish to receive examples of self-evaluation questions for chemically dependent individuals may acquire them by e-mailing me at  or going to the information portal of the site.  Further information is available in my books:  “Choice Theory With Addicted Populations,” a more clinical approach that includes exercises; and “A Choice Theory Approach to Drug and Alcohol Abuse,” a more general informative book on chemical addiction.  Both can be found on or which also include reviews.  Or, you can order them from me personally via my email address and I will personally sign it for you.  There will be a shipping fee added should you purchase from my e-mail request.   My web site is

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