Substance Use Counselling

Our substance use counselling services for young people up to age 24 and their adult supports have now been running for over 30 years! Over those years, Impact has grown quite a bit around these core services. This growth has wholly been in service of the aims Impact started out with when it was formed by concerned citizens in 1988.

While ground-breaking research was done right under our noses at Simon Fraser University by the likes of Dr. Bruce Alexander in the 1970s (see video below), it’s taken a long time for a body of research that points to the complex bio-psycho-social-spiritual factors that contribute to substance use behaviours (and the human needs that underlie them) to work its way into practice.

To someone who has not had their life challenges get tangled up in substance use—and who sees the devastation and heartache that can often be correlated with people meeting human needs through substance use—it’s tempting to look at education, warnings and training on resisting peer pressure as a silver bullet.

We now know that the underlying factors of each episode of substance use can be unique to both the individual and their context. In other words, what helps one person to avoid concerning substance use in one situation will often not work for another person, or even the same person in another situation. 

Our counselling team continues to be an integral and critical part of everything we do. But we don’t view counselling in a vacuum. The point to our counselling shouldn’t be just to “reduce symptoms,” but to do so in the service of something better… quality of life for our clients.

Many studies on medical problems view “success” as whether or not a person died only—with no focus on quality of life. While, especially in today’s world of toxically contaminated illicit drug supplies, even one episode of substance use can be too many—the fact is we live in a society where substance use is common. Our clients have told us what they appreciate about our work is that we don’t just look at people through the lens of substance use. In fact, very little of what we end up talking about in sessions is substance use. Instead we might look at what function substance use might be playing for a person—what needs substance use is meeting for them. And might they have access to other ways of meeting those needs so that if they do continue using substances, they can do it more thoughtfully, and less out of blind need?

Even more-so, clients have told us they would rather be seen through their strengths than their struggles… how they manage to keep getting back up, rather than the things that may bring them down. So, we’ve been playing with a saying to go along with this feedback from our clients: 

“Not counselling in the community, but contributing to the community (and some counselling, if you’re curious whether it might help you better contribute).”

An approach in the so-called “third wave of cognitive behavioural therapy” is called “Acceptance and Commitment Training.” The “acceptance” part is about accepting that we will have all kinds of bad thoughts (and those thoughts have the capacity to have an effect on feelings and then on our quality of life… to the point that we may find it difficult to even value our lives anymore).

The fact is that once we have a thought, there is always the possibility… and really it is almost a certainty… that we will have that thought again. While language has some wonderful uses, the fact that we humans use language also condemns us to being able to repeat some potentially debilitating statements to ourselves… even if we weren’t the ones who came up with them in the first place. 

A statement like “I’ll never be a success” repeated over and over in someone’s mind can be soul-crushing. But what does it really mean? To assume that sentence has a clear meaning would be like saying the words “beautiful sunset” convey the experience of a beautiful sunset. So, in Acceptance and Commitment Training, the “acceptance” part is accepting we humans can be tormented by abstract thoughts to which only beings who have developed language as a tool are vulnerable.

Our counselling team can help with the “acceptance” part, but if there aren’t viable opportunities for the people our counsellors work with to “commit” to meaningful action that is in line with their values… Well, nature abhors a vacuum.

Oftentimes, our clients have been brushed (or have brushed themselves) broadly with the “at-risk” or “troubled” or “addicted” label, and it can be tough for them to get access to opportunities to participate and contribute in ways that would feel meaningful and valuable to them. Often, we notice, this can lead youth—rather than to follow their own values—to experiment with following the values they see being played out (intentionally or not) in their communities or peers or in the media. Some of these experiments can go tragically wrong very quickly and dig a very deep hole almost instantly.

So, along with counselling, we work with all our other projects to allow our clients to see not just that they can, but also how they can—not just suffer less, but feel meaningful and valuable more.