Why Respect Matters
We live in an increasingly confusing and complicated world. As we all learn more about the intricacies of social issues, mental health, and addiction, we begin to see that people (and their treatment) is more complex than just: person X has an Alcohol Use Disorder, Moderate. Over the last 20 years in the scientific community people have figured out that, although biology and psychology are primary drivers of mental illness and substance use disorder, the social aspect plays a significant role as well. In this article, we’d like to expand on a model of respect that promotes a better integration of the social self into a well-rounded treatment philosophy.
One of the most impactful developments in clinical psychology has been the creation of “motivational interviewing” and the “transtheoretical model” of behavior change. The framework below is used by clinicians all over the country to help people with substance use disorders enhance motivation to change unhealthy behaviors (i.e., drug use) and develop healthier behaviors. Research shows that acknowledging a patient’s culture helps build rapport and foster a sense of safety in therapy. Given that our culture and the world in which we habit affects our mind and our behavior, we think it’s important to have a concrete understanding of how to understand respect and integrate culture/community into the treatment process.
Respect: many people come from similar cultures and backgrounds, but when we differ it may be important to note that our differences around how we communicate, make eye contact, and/or frame conversations can impact the felt sense of respect between people.
Explanatory Model: most cultures have varying beliefs about drugs and/or mental illness, taking the time to understand these beliefs and how they play a role in someone’s struggles is important for rapport and enhancing motivation.
Sociocultural Context: because we live in social systems, those systems may assign more value or react with prejudice to different types of people. Understanding a person’s struggles with shame and prejudice will help increase treatment engagement.
Power: Although clinicians are doing their best to be “on the same page” it is true that clinicians have some power compared to their patients, especially when it comes to court mandated treatment. Understanding/acknowledging this dynamic will allow a more open and clear relationship.
Empathy: part of any quality therapeutic endeavor is enough empathy to allow the patient to feel “seen,” “safe,” and “soothed.”
Concerns/fear: being clear about one’s concerns is respectful, being clear about one’s fears allows people to work together to solve problems. Patients need a space to express their concerns.
Trust: trust is earned, and its reciprocal. It’s a two-way street, and (see Power) if one or both parties engages in power games then trust is lost. Open, clear, nonjudgmental communication allows trust to build.
These are just some ideas for how to have respectful clinical relationships, but these concepts apply to all parties in a treatment center. Fostering respect is what helps people heal, grow, and change. When looking for treatment, or deciding if you should stay in a particular facility, these variables are important to consider.
Remember, treatment is a very challenging process. Many people just getting sober or looking for treatment are experiencing intense emotions and are sometimes even combative. Most clinicians will understand this. It’s important that you do your best to be respectful, and that the treatment you receive operates with a framework of respect like the one mentioned here. If everyone involved focuses on building and maintaining a respectful relationship, then success is much more likely.