An intro to NLP for clinicians
Are you looking for more on how Neuro Linguistic Programming (NLP) can be used in the treatment of addiction? Here, we briefly review the NLP model, introduce the Stages of Change model, and present an initial session with a hypothetical client experiencing problematic Internet use.
Continue reading to learn more, and join us for some Q&A in the comments section at the end of the page. We welcome your questions and try to provide personal and prompt answers.
What is Neurolinguistic Programming?
NLP examines the basic dynamics between the thinking processes (neuro) and the words (linguistic) we use, as well as how their interaction affects behavior (programming).
NLP targets how people:
- communicate externally and internally
- process, store, and recall information
- alter communication to achieve desired results and goals
Practitioners believe human beings have an extraordinary capacity for flexibility, and there is nothing that happens mentally or spiritually they cannot learn to handle. The focus is on how a person formulates his or her thoughts and beliefs; those which maintain behavior and those which create change.
Counselors need to understand a client’s willingness to change as they counsel, as well. The Stages of Change model, which I introduce next, assesses willingness.
The Stages of Change Model
The Change Model applies to a broad range of behaviors such as weight loss, injury prevention, and alcohol and drug problems. Proponents of the model believe people don’t change in a single step; rather, they progress through different stages at their own rate. Therefore, expecting clients’ behavior to shift by telling them to attend “x” number of A.A. meetings in a certain time period, may not be effective.
Generally speaking, assessing a client’s willingness initially and throughout the course of counseling makes sense. James Prochaska and Carlo DiClemente describe the stages as follows:
Stage 1: Pre-Contemplation – The client recognizes the cost of addiction; but, doesn’t see it as significant compared to the benefits.
- Characteristics – Client has a lack of interest in change with no plan or intention to change.
- Client is unaware.
Stage 2: Contemplation – The client is aware of problems associated with the behavior. However, he or she remains ambivalent about whether or not change is worthwhile.
- Characteristics – Client explores the potential to change, desires change but lacks confidence and commitment. He or she has the intention to change at some unspecified time in the future.
- Client is aware and open to change.
Between Stage 2 and 3: The client makes a decision. He or she concludes the negatives of the behavior outweigh the positives and makes a commitment to change the behavior. This decision represents an event rather than a part of the process.
Stage 3: Preparation – The client accepts responsibility to change his or her behavior, to evaluate, and to select techniques for change.
- Characteristics – Client develops a plan to make needed changes. This builds confidence and results in a commitment to change within a month.
- Client is willing and anticipates the benefits of change.
Stage 4: Action – The client engages in self-directed behavioral change efforts. He or she gains new insights and develops new skills.
- Characteristics – Client consciously chooses new behaviors. Client learns to overcome tendencies toward unwanted behavior; and engages in change actions for less than six months.
- Client enthusiastically embraces change and gains momentum.
Stage 5: Maintenance – The client masters the ability to sustain new behavior with minimal effort and establishes new behavioral patterns and self-control.
- Characteristics – Client remains alert to high-risk situations. He or she maintains a focus on relapse prevention and behavioral change that is sustained for six months.
- Client perseveres and consolidates change efforts.
Stage 6: Termination – The client adopts a new self-image consistent with his or her desired behavior and lifestyle. The client does not react to temptation in any situation.
- Characteristics – Confidence, enjoyment of self-control, and appreciation of a happier life.
- Client creates a relapse prevention plan which evolves into the pursuit of a meaningful and healthy lifestyle. As such, relapse into a former way of life becomes almost unthinkable.
Relapse can occur at any Stage of Change
However, relapse to a prior stage can occur anywhere during the process. Someone in the Action Stage may move back to the Contemplation or Pre-Contemplation Stage. Therefore, the counselor must continuously evaluate the client’s willingness.
4 stages of the initial session using NLP for addiction
Now, let’s take a look at a first session and focus on the following four elements:
1. Rapport – People like people who are like themselves.
- As a client attempts to access information, he or she uses a primary sensory representational system: visual, auditory, or kinesthetic. The language, words and phrases a client uses indicates a preferred representational system and are known as predicate phrases. In other words, if the client’s primary representational system is visual, the client will use words like “I see” or “I imagine.”
- One way an NLP Practioner improves communication with a client is to observe eye cues and listen to predicate phrases.
- Based on information learned, the Practioner uses predicate phrases that match the client’s identified representational system. The Practioner also matches the client’s, physiology, tonality, breathing, chunk size, and experience.
2. Assessments – Clients are often unclear about what they want.
- The Stages of Change Model explores a client’s willingness to change.
- The Outcome Specification is a nine-question summary used to identify the client’s goal and his or her dedication to it.
- NLP Practioners believe every behavior has a Positive Intent, even negative behavior. Once identified, healthier options can be explored.
- The Logical Levels strategy is used to organize thinking, gather information, and communicate. This exercise helps establish an understanding of what makes a person “tick.” The levels are as follows:
…………………..–Environment – refers to what is around us.
…………………..–Behavior – refers to what we are doing.
…………………..–Capability – refers to what we are able to do.
…………………..–Belief – refers to what we think we can or should do.
…………………..–Identity – refers to who we think we are.
3. Meta Model Questions – Most people have a tendency to speak in shorthand and Meta Model questions address what is not being said.
4. Moving Forward – Once the assessment procedure is complete, the counselor is ready to develop a plan of action. I include the client in the decision-making process because it leads to greater involvement.
Now, I will apply the elements in a hypothetical case.
Hypothetical case with a problematic internet user
Peter is a 56-year old CEO of a successful high tech company in Silicon Valley, CA. He and his wife, Jennie, are married with adult children. Over the past year, he has been spending an increasing amount of time at the computer. He surfs the web for hours every evening: reads the news, participates in financial chat rooms, and plays video games. Jennie complains repeatedly about the amount of time he spends on the computer. In fact, she insisted that he make an appointment with me, an Addictions Counselor with NLP training.
Peter admits he spends more time at the computer than he previously did. However, he doesn’t view it as a problem. As he sees it, he is not looking at porn or participating in sex chat rooms and, therefore has no reason to stop spending his free time surfing the web. He enjoys “vegging out” at the computer with a glass of wine, for hours at a time. While he says Jennie just doesn’t understand, he readily admits his computer use has become a bit compulsive and creates a problem for their relationship. This is not okay with him.
In the initial session, I wanted to quickly build rapport with Peter because he is less than enthusiastic about coming to see me. In answering my questions, he looked up-to the left and to the right-which led me to think his primary representational system was visual. Therefore, I used predicate phrases such as “looks like,” “envision,” and “picture.” I also matched the pace and tone of his voice. During the conversation, we found a shared interest in baseball. Soon, we chatted easily and moved effortlessly into the reason for the appointment.
In regard to the Stages of Change Model, I determined Peter was in the Contemplation Stage. He acknowledges his wife’s concerns and is aware he spends a lot of time on the computer. However, he is unsure he wants to change the behavior.
According to Peter, the positive intent of the behavior is to relax and spend time at an enjoyable pastime. It’s quiet, which means he has a chance to set aside the problems of the day and learn new information. I conduct the Outcome Specification Exercise to further explore Peter’s perception of the situation.
The outcome specification exercise and Peter’s responses
1. What do you want?
PETER: I want Jennie to be happy.
2. How will you know when you have reached the goal?
PETER: When we no longer fight about how much time I spend on the computer or how much time we spend together.
3. Where will the goal be relevant and/or irrelevant?
PETER: The goal is relevant because my wife will be happier and when she is happier our relationship improves.
4. What stops you from pursuing the goal wholeheartedly?
PETER: I don’t play golf and the internet is my only outlet. It is a way to relax from the stresses of the day. I need that.
5. What personal resources could you use if you were to achieve this goal?
PETER: I have a strong will and solid entrepreneurial skills that serve me well.
6. What additional resources will you need to achieve the goal?
PETER: A new and fulfilling pastime, as well as, other ways to relax.
7. How might the pursuit of the goal affect important people in your life? Is there any risk associated with achieving this goal?
PETER: The goal will positively affect Jennie and the rest of the family. The only risk is that my stress level and blood pressure will probably rise.
8. What daily actions can you take in order to achieve your goal? What is the first step?
PETER: Well, I could spend less time on the computer. We could web-surf together. Finally, I could do more things with Jennie and the family. I haven’t spent much time with them, lately.
If I make a change, the first step is to find a new pastime, a pastime that interests me as much as being on the computer does.
9. Given everything you have considered to this point, is achieving the goal worth it?
PETER: Well, the goal of making my wife happy is certainly worth achieving and if it means using the internet less, so be it. I can find something else.
According to the Stages of Change Model, Peter made a decision at this point. He concluded his wife’s unhappiness outweighs his pleasure at using the computer. He chose to change and makes a commitment to do so. When looking for reasons why change does not occur, it can be helpful to determine exactly where a block is located and where best to intervene. So, I take Peter through the Logical Levels Exercise. His responses are as follows.
The logical levels exercise and Peter’s responses
- Peter: Environment – Daily from about 8 PM until 3 AM in my home office.
- Peter: Behavior – I am at my computer with a glass of wine.
- Peter: Capabilities – I am at home and not partying, what I do is basically free; and I can relax for a while.
- Peter: Beliefs – “I am not hurting anyone,” “I am not partying,” and “I am not looking at porn or on sex chat rooms.” “I need to relax and get away from the stresses of the day.”
- Peter: Identity – I am a loving husband and a successful entrepreneur who needs to relax.
One option was to intervene at the Environment Level and suggest that he spend less time on the computer or to include his wife in his Internet pursuits. Instead, I chose to focus on the Belief Level and Peter’s words “I am not hurting anyone.” If his belief were, “While I am not partying or looking at porn, Jennie is upset at the amount of time I spend at the computer,” he might consider other options. I also know that by intervening at this Level, the Capabilities, Behavior, and Environment Levels will change as well.
During the Assessment phase, I ask META MODEL QUESTIONS to identify and transform problematic vagueness that may occur during the Outcome Specification and Logical Level exercises above. For example:
- Peter said “She insisted he come to see me.”
I asked “Insisted how?” - Peter said “She doesn’t understand.”
I asked “She doesn’t understand what? - Peter said “She insisted I stop.”
I asked “What might happen if you didn’t?” - Peter said “She is afraid I am watching porn.”
I asked “Why would she think that?”
After building rapport with Peter and by using the Meta Model questions, I was able to clarify his responses to the Outcome Specification and the Logical Levels exercises. This information allowed me to more clearly understanding the issues and to determine strategies for future sessions.
Do you have any questions about the NLP Approach?
If you found this description of the use of NLP approach during a first session with an addict client and believe that you or a loved one may benefit from such therapy, you can seek NLP licensed therapists in your area. For any further questions, please post them below and we’ll try to respond personally and promptly to all legitimate inquiries.
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