Fostering Client Autonomy in Addiction Rehabilitative Practice: The Role of Therapeutic “Presence”

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Addiction is a pathology that progressively and insidiously undermines one’s autonomy—manifested, among other ways, in the experience of a sense of alienation from oneself and others. Therefore, in seeking to overcome addiction, the rehabilitative journey must facilitate the fostering of autonomy. Here, in as much as autonomy is a socially embedded capacity, so must the therapeutic process—within this context, the client–counselor relationship—be grounded in an attentiveness to and facilitation of autonomy’s dialogical antecedents. One such means of achieving this is through the counselor attending to and expressing their “presence,” in which they are engaged in a “person-to-person” therapeutic alliance underpinned by a collaborative dynamic. Here, the healthy interpersonal dyad between client and counselor can provide an environment through which the client may more fully recognize their autonomous resources and exercise such resources in a way that enables them to embark on the rehabilitative journey, and, attendant to this, autonomous living.

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