Substance abuse problems occur along a continuum rather as a dichotomy. The treatment selected for each should be individualized to meet his or her individual needs and goals.

What implications might these ideas have for the following client?

Bob, who is in his early 20s, is arrested for driving under the influence of alcohol. Because this is his second arrest, he is ordered to participate in DUI classes and alcohol treatment. The counselor who assesses his situation refers him to a 28 day inpatient treatment program and recommends that he attend meetings of alcoholics anonymous or obtain a recovery coach.

Bob begins this program because he knows there is no hope of getting his driver's license back. He needs the license for his work as an electrician. After a few days in the program, however, he drops out, saying that he does not feel he belongs there. He has never experienced physical signs of addiction to alcohol and does not believe his life is out of control. The treatment providers and other patients press him to recognize and verbalize that he has an issue with alcohol, but he refuses to do so. He says he will drive without his license if necessary and will try to avoid drinking and driving in the future.