Denial is one of the most challenging defense mechanisms used by individuals with addictions. This term has been familiar to the substance abuse treatment nomenclature for many decades. It applies when a substance abuser denies the existence or severity of his or her problem. Treatment for clients in denial is typically challenging. In these cases, the focus of intervention is on helping the client acknowledge the problem. The only way treatment will be successful is if the client recognizes the existence or extent of the substance abuse.

The contemporary perspective is that denial occurs in the “pre-contemplative” stage of the change process (Prochaska, DiClemente, & Norcross, 1992). The denial of clients in this stage is not confronted as it was in older forms of treatment. It is viewed as a necessary beginning on the journey to sobriety. Addressing the denial requires encouraging the client to identify the ill effects as well as the perceived benefits of his or her substance abuse. The client in this stage will attempt to work toward finding internal motivation to change based on the insight gained about the effects of his or her use pattern.

Use the module readings and the Argosy University online library resources to research denial used as a defense mechanism.

Download and review the case study.

Respond to the following:

• How is the use of denial by the substance-abusing client evident in the case?
• What other ways might substance-abusing individuals display denial?
• What approaches could you use to work with the client in the case study?