The structure of this chapter is as follows. The meaning given to the term ‘basic work’ is first defined and the significance of the therapeutic relationship discussed. Some guiding principles to provide a frame within which the therapy will be conducted are outlined, and the likely content of the basic therapeutic work is considered, with emphasis on a person-specific approach. Attention is then given to such issues as how the effort to achieve sobriety is to be made worthwhile, for the patient, how to deal positively with relapse, basic work with the family, and matters relating to the duration and termination of treatment. A note is given on basic approaches in the generalist setting. The chapter is rounded off with a summary which identifies 12 core elements fundamental to the treatment process.

What is meant by ‘basic work’?

Special techniques, such as various psychotherapies, cognitive and behavioural therapy or the use of drugs, can all make contributions to an individual's treatment programme (see Chapter 19). It is these approaches which offer the conventional headings for discussion, while the undramatic basics of the helping process tend to be passed by, or dismissed as the background to the application of specialized techniques. It is, however, vital that attention should be given to the subtle and important range of happenings which occur whenever patient and therapist interact – the what, when and how of what is felt and said and done between them.