In early rehab when the client is thinking about using, what is an appropriate initial intervention?

• A. Offer to go for a walk
• B. Ignore the cravings
• C. Demand a written commitment immediately
• D. Discuss consequences of relapse and ask if they are ready to change

Answer: (D)

When someone in early rehab is thinking about using, the best first move is to engage them in a collaborative, reflective conversation that explores what relapse would mean and where they are in the change process. Discussing the consequences of relapse helps the person see the potential impact on goals, health, and relationships, which can spark motivation to change. Asking about readiness to change respects their autonomy and invites them to consider what step they feel ready to take, rather than forcing a commitment. This approach aligns with motivational interviewing principles: it reduces defensiveness, addresses ambivalence, and sets up a conversation that can lead to a tailored plan when the person is ready.

While offering a walk is supportive, it doesn’t directly address motivation or readiness. Ignoring cravings can miss a critical opportunity to teach coping strategies. Demanding a written commitment is premature and may provoke resistance.