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The Drug and Alcohol Forum



Ed Jacobs, Ph.D.
Associate Professor
West Virginia University


Anne Smith, Ed.D.
Associate Professor
Alabama A&M University


This article describes a multi-sensory approach to drug and alcohol counseling. A brief explanation is given to encourage counselors to be more active and concrete in their counseling. Case examples are given using different sensory modalities such as props, movement, and writing.

After completing the article, participants will:

  • Be able to define the concept of Impact Therapy
  • Recognize that a multi-sensory approach requires the counselor to be more direct and active in the therapeutic relationship.

Listening is not enough! Counselors who listen politely as clients tell their stories most often are not being helpful. In this article we present a new and dynamic approach, Impact Therapy, that was created by one of the authors (Jacobs, 1994). Impact Therapy is a multi-sensory, active approach to counseling that makes counseling interactive and concrete. It is especially helpful with drug and alcohol clients since it uses more than the traditional "talk-listen" approach to counseling. Impact Therapy encourages the use of props, writing, drawing, and movement in order to make counseling more dynamic and impactful (Jacobs, 1992).

Having trained and taught D&A counseling for over 12 years, it is clear that counselors need to be more direct and active. Impact Therapy advocates that counselors are responsible for trying to make each session meaningful and this is best accomplished by using a multi-sensory approach rather than a reflective listening approach. A multi-sensory approach uses seeing, doing, and experiencing in addition to talking and listening. In the remainder of this article we present two props and a number of examples of how to use them.


Joe, an alcoholic who is in denial, has come to the second session with his wife, Beth. Joe thinks she lacks understanding of his need to go to the bar each evening for a few beers and pool. The counselor interrupts Joe’s story by handing Joe a large beer bottle (a 3 foot tall, plastic beer bottle that you can buy at a novelty shop).

Counselor: Joe, take this bottle and hug it. Beth, move over here near Joe. Now Joe, I want you to keep hugging the bottle and also hug your wife.

Joe: I can’t.

Beth: That’s it exactly. You like the bottle better than me!!

Counselor: Joe, here’s what is clear to me. Alcohol is causing all kinds of problems in your marriage and you can’t see it. What are you doing now – holding your wife or holding your alcohol?

Joe: The alcohol.

Counselor: That’s why you need treatment. Alcohol has become more important than anything else. If you had heart disease, you would get that treated. Joe, this is no different!

The value of using the beer bottle as a prop allows the counselor to confront Joe’s denial in a way that is experiential which tends to have more impact than words.


Beth complains about Joe’s anger being uncontrollable. The counselor wants to get Joe to see how drinking affects his anger.

Counselor: Joe, let me show you what happens to you when you drink (gets a 12 inch cord and the 3 foot beer bottle). If this cord represents your anger fuse, according to both you and Beth, it is long when you are not drinking (counselor holds up the cord above the opening to the beer bottle). When you drink, look what happens to your fuse (counselor slowly lowers the cord into the bottle until the cord disappears). If you drink, you get angry. It is as simple as that and if you want to quit fighting, you are going to have to stop drinking. You both have said that you got along real well when you were not drinking.

Joe: I didn’t realize that was happening.


In their third session the counselor has asked Joe to close his eyes as Beth writes on a whiteboard a list of the different things she would like to have happen to make the marriage better.

Counselor: Joe, keep your eyes closed. I want you to take this large beer bottle and put it up in front of your face. Now open your eyes.

Joe: Why am I doing this?

Counselor: Because I want you to read Beth’s list now.

Joe: I can’t see through the bottle.

Counselor: You’re right, Joe. You can’t see through the bottle. You have got to see the list if you want your marriage to work. If you keep drinking you will never be able to pay enough attention to your wife’s needs and your wife is more than likely going to leave.


Shana has been in recovery for 18 months. She is a 33 year old, single parent of a 5 year old son, Derrick. Shana started drinking heavily in her early 20’s.

Shana: I just can’t forgive myself for all the terrible things I did to Derrick.

Counselor: You’ve mentioned the guilt a number of times and I think it’s time we do something about this (counselor pulls out an old audio cassette tape and hands it to Shana). I want you to think of this tape as your guilt tape that you play every day. Put the tape up to your ear. Does it make you feel good to listen to this tape?

Shana: No, it makes me feel bad.

Counselor: That’s right. What we have got to do is get you to make a new tape (counselor exchanges the old tape with a new one that is still in the wrapper).

Shana: (Stares at the new tape) You’re right. I do listen to that guilt tape all the time. It’s all I know. I don’t have any idea what to put on the new tape.

Counselor: I know you don’t and I can help you. (The counselor spends the remainder of the session focusing on Shana’s self-talk that causes her guilt. The tapes help make this more concrete.)


Shana has been talking about feeling stuck and not getting on with her life. The counselor decides to do something experiential.

Counselor: Shana, I want you to stand up. I want you to think of moving toward the door as going forward in your life. I am going to take your arm and provide resistance. As you go forward, you will feel held back. As we do this, see if you can get in touch with what is holding you back in your life. (Shana extends her arm back and the counselor takes her arm with both hands.) Okay. On the count of 3, try to go forward. 1, 2, 3 (Shana pulls hard but does not persist. Shana starts to cry.) What are you thinking?

Shana: Lots of things went through my mind.

Counselor: Like what?

Shana: I don’t deserve to be happy! Also, I am afraid to take risks because I fear that if it would not work out, I may drink. That’s why I turned down the promotion and also why I didn’t go out with Jackson.

Counselor: I think we now have a better understanding of why your life is not going forward. (The counselor spends the remainder of the time on these new insights.)

In each of these examples, the multi-sensory approach of using the beer bottle, the fuse, the whiteboard, and the pulling helped to make the counseling more concrete and impactful. Even though the examples are very briefly presented, we hope you get a sense of what we mean by using a multi-sensory approach. In these examples we demonstrated how counselors need to do more than just listen. The purpose of this article was to encourage you to be more active and creative during every counseling session. The most important thing to remember is that people learn in many different ways and your ability to help your clients will increase as you incorporate more learning modalities.


Jacobs, E. (1992). Creative Counseling Techniques: an Illustrated Guide. Odessa, FL: Psychological Assessment Resources.

Jacobs, E. (1994) Impact Therapy. Odessa, FL: Psychological Assessment Resources.


(Record Answers for JACOBS/SMITH Test on Answer Sheet)

1. Impact Therapy is a _______________ approach to counseling.

a. confrontive
b. intuitive
c. multi-sensory
d. multi-faceted

2. According to Impact Therapy, responsibility for making a session meaningful belongs to

a. the client
b. the family
c. AA
d. the counselor

3. The beer bottle was used with Joe as a means to ____________.

a. remind Joe of how big his problem is
b. make counseling more concrete
c. to divert Joe’s attention
d. to add comic relief to a tense session

4. Old and new audio tapes can be useful for

a. focusing the client on self-talk
b. relaxation
c. music therapy
d. recording the session

5. Clients learn best when the counselor

a. relies on listening skill predominantly
b. uses different learning modalities
c. is multi-linguistic
d. is forceful