A full evaluation of a potential addiction generally requires a thorough evaluation, but I’ll often use a tool in the first session that will quickly give the person some measuring sticks to help begin to explore their use in more detail. It’s really a quick screening tool, but it almost always opens the door for opportunity to explore their behavior in more detail.
They’re easy to remember, because they all begin with the letter “C”:
People without an abuse problem always have control over the amount they drink or use; if they say they're going to have 2 drinks, that's all they ever have.
People with a problem will often go over a self-imposed limit, often with consequences (see #2 below). This is often a "Russian-roulette" pattern: you can stay under a limit for many months, and then "boom", you go over (and you're not happy about it).
People without an abuse problem rarely will experience negative consequences. If they do, they will make an adjustment in their behavior or lifestyle and the consequence won't occur again.
People with an abuse problem, when experiencing a negative consequence, will often make an adjustment, which is short-lived. In fact their attempts to make adjustments often fail, and consequences continue and often get worse.
Consequences can be related to:
- physical health
- legal situations
- emotional well-being (feelings of guilt, remorse, lowered self-esteem, depression)
- anger management
- family conflicts
- interpersonal conflicts
- job performance
The "Three C's" is not just a handy screening tool. It's a great way for my clients to begin to explore some of the specific issues related to their substance abuse behavior and to help them make their own mind up about the issue.