The article ‘The illusion of choice’ by Wendy Jefferson particularly interested me. I can see where Wendy is coming from and I agree with some of it. According to the Concise Oxford Dictionary there are many definitions of the word ‘choice’: ‘The act or an instance of choosing; range from which to choose and the power or opportunity to choose.’
 
I have been a qualified counsellor for 15 years and working in the field of addiction for almost 12 years as a substance misuse therapist. I see my job as an educator and facilitator of change. I believe that when a client walks through my door that is their first ‘choice’: to remain in therapy is their second ‘choice’. With regard to clients abusing alcohol, they may feel under pressure to do something about their drinking. However, they may feel that they have no choice.

Initially, because of family or social pressures, it may appear to them that they do not have a choice to do something about their substance abuse. They could be so ill that they know that they have to do something, but they may feel unable to choose. Monti et al¹ clearly states ‘[Drinkers] ignore or minimise the longer-term negative or destructive consequences of drinking.’
 
One must be very careful to avoid collusion with clients. Substance misuse clients have particular problems with accurate recall. Bryman² points out ‘…it is highly unlikely that most [people] will in fact recall events accurately over…a long space of time.’ ‘In the case of alcohol misusers this difficulty is greatly compounded due to the effects of the substance.’ (Doggart³) For the sake of accuracy it is important to evidence and not to generalise when making statements.
 
Over my many years as an addiction therapist I have never used the word ‘choice’ to my clients until their drinking has stopped. When the client is dry their awareness enables them to make a conscious decision which empowers them to remain in sobriety or not.
 
The section under ‘Further exploration’ becomes involved with philosophical issues and loses sight of the article’s point. At the beginning of the drinker’s journey there may well be an illusion of choice, but definitely not when making an informed and aware decision of whether or not 
to remain dry.

 

E Jane Doggart 
MSc MBACP (Accred) FDAP (Accred)
 

1. Monti, P.M, Abrams, D. B., Kadden, R.M. and Cooney, N.L. (1989) Treating Alcohol Dependence, The Guildford Press: New York.

2. Bryman, A. (2001) Social Research Methods, Oxford University Press: Oxford.

3. Doggart, E.J. (2006) MSc Social Research Dissertation.