Guided self-change

Domain II · Behavioural & cognitive · Mark Sobell, Linda Sobell · 1993

What it is

GSC is a brief, time-limited outpatient treatment that combines motivational interviewing (MI), cognitive-behavioural problem solving and relapse-prevention ideas. Mark and Linda Sobell first built it for problem drinkers who are not severely dependent. It has since been tested with people who use…

Format

• Format
• Individual: one assessment plus four sessions, usually weekly. The handouts do not give the length of individual sessions; 50–60 minutes is a reasonable default.

Questions to explore with your client

• What drew you to it, and what are you hoping it will change?
• Is there physical contact? Was it explained beforehand, and do you feel free to say no or stop at any point?
• Does it involve any substance, plant preparation, remedy or supplement? Has your doctor or prescriber been told, especially about any medication you take?
• Is it a group, retreat or community? How do they respond if someone wants to leave or raises a concern?
• How do you and the practitioner understand what is happening, in spiritual or cultural terms? Is that a source of comfort, worry, or both?
• Who runs it, and what training or registration do they hold?
• What actually happens in a session or meeting, and how often?
• What does it cost, and is there pressure to commit to more?
• How do you feel afterwards, in the hours and days that follow?
• Does it fit with, or clash with, the work we do here?

What practitioners of it watch for

• The ratio of your talking to theirs.
• Arguing for one side; your job is to reflect both.
• Leaders who are under-prepared fall back on lecturing.
• The client brushing off past successes; reflect them and stay with them.
• Members who seem uneasy about confidentiality; deal with it before going on.

When to involve someone else

• New or worsening physical symptoms, or advice to stop or change prescribed medication: involve the client's doctor or prescriber.
• Signs of coercion, isolation from family and friends, escalating costs or secrecy: discuss openly and consider safeguarding.
• A crisis or thoughts of suicide: follow your crisis protocol. In the US, call or text 988; in the UK and Ireland, Samaritans on 116 123.

Drawn automatically from the guide's own sections. Stay curious: neither endorse nor dismiss what the client values, and check anything that matters against the full guide and its sources. Not medical advice.