Word Choice and Positive Outcomes

Word Choice and Positive Outcomes

Words matter. Our beliefs about substance abuse and compulsive behavior problems—and the potential for change—are built into the words we use to speak about them. Maybe more importantly in this case is that words are reflective of culture beliefs, and the conveyors of those beliefs and attitudes.

And beliefs inform behavior. One study found that treatment providers who referred to patients as “addicts” had significantly more negative attitudes towards them when compared to treatment providers who referred to patients as having “substance use disorders.”

Words are an attitude, a belief, and have an impact. The leading barrier to treatment entry by people abusing substances is fear of stigma. Stigma is conveyed by word choice. “I’m glad you’re hear Mr. Smith, and it’s important that you’ve recognized you are an alcoholic” Ouch! “I thought I was just drinking too much in the evening! Maybe this isn’t the place for me..maybe they are going to view me a certain way..maybe I’ll do this on my own”. Words matter, because they convey meaning and attitude, and they set up barriers and roadblocks.

The fortunate inverse of this is that words are hugely powerful mediators of positive change as well. Some of our most successful treatments (e.g. Motivational Interviewing) are predicated on use of language by the therapist that is non-confrontational, respectful, conveys a sense of collaboration, and demonstrates empathy and understanding of the other person. All with words!

Additionally, this approach places a lot of emphasis on facilitating certain language from the client, called “change talk”, that has been demonstrated to predict positive change. So our language matters, and the language of the person we are trying to help matters.

  • Kelley Backous

    That is a powerful statement. I believe that all behavior is purposeful along with all words chosen shows our character, feelings and thruths to or about a particular person or subject. Therefore, a lot can be detected or understood by looking and listening to a person rather being the one to do the talking all the time.

  • What I thought of when I read this is about REBT. I love the idea of helping the client identify beliefs that are destructive for them or keeping them stuck. But the idea of labeling them “irrational beliefs” just doesn’t sit right with me. I keep thinking about how we end up believing what we do, in growing up what we formulated as truth made sense to us, and consequently as we saw our world through these lenses it confirmed our beliefs. It seems a bit harsh to call them irrational. I have been trying to think of a better way to label these perceptions (irrational beliefs) in a way that the client can look at them objectively and choose whether they want to change their old perception to a newer and more healthy one. I hope this makes sense, or maybe I am just being too sensitive to call them irrational, but to me it just seems a bit judgmental to label them that…

    • Carrie Wilkens

      Not too sensitive at all!  “Perceptions” is a good alternative to “irrational”…which I agree is loaded with as much negative meaning/assumptions/judgement as the word “addict” can be. While it is not the intention of CBT strategies to use the word “irrational” as a negative…we cannot escape the fact that some words pick up cultural meanings and value judgement.    I have heard many people say, “I’m being irrational” (or labeling others as irrational) when they are actually having strong emotions that they don’t understand or cannot label.  Labeling something as irrational whitewashes the experience down to something that sounds like a negative judgement and may prevent people from digging deeper and understanding the nuances of their feelings or experience.
      I like the idea of letting people choose which of the “perceptions” of themselves and the world contribute to healthy/constructive experiences and which move them to unhealthy/destructive experiences.

    • Kathy Lang

      You are right. I facilitate an online mtg. for families and friends at SMARTRecovery.org We use the term unhelpful — to encourage the person to see their belief as unhelpful rather than irrational.