The Bruges Model does not require abstinence as a mandatory condition of treatment. Harm reduction is organically built into the SF approach: the client themselves chooses the goal (abstinence or controlled use), and the therapist works with the goal the client has chosen. This is a fundamental divergence from traditional programs such as the "12 Steps". The criteria of success are defined by the client, not by the program.
Step-by-step guide
- Present both options without preference: "Some choose full abstinence, others — to learn to drink differently. What suits you?"
- With the choice of controlled use — specify: how much, how often, in which situations
- Define success criteria agreed with the client
- Regularly review the realism of the goal on the basis of the diary
- If needed — provide information about medical risks, non-directively
When to use
- When setting therapeutic goals at the start of the work
- When the client rejects abstinence as a goal
- When reviewing the contract — if the chosen goal turned out to be unrealistic
- To reduce shame and increase readiness to seek help
Key phrases
What is your goal — full abstinence or learning to manage use?
What does "controlled use" look like for you, concretely?
Follow-up questions
What will be a sign for you that this is working?
If this goal turns out to be harder than you thought — how will we notice that?
What do you want to change in your life in connection with this?
Alternative phrasings
There are people for whom controlled use works. There are those for whom full sobriety is better. Let us inquire what suits you.
What does your past experience say about which path is realistic for you?
Warnings
- ⚠️ In severe physical dependence — inform about the medical risks of controlled use, do not replace clinical assessment with the principle of autonomy
- ⚠️ Do not replace clinical assessment with the principle of autonomy in clear medical danger
- ⚠️ Review the goal if the chosen variant is not working — without judgment
Source: De Shazer & Isebaert, 2003; Isebaert, 2016; González Suitt et al. 2019; Franklin, 2021
Materials are informational and educational and summarize publicly available scientific sources. They are not medical or psychological advice, are not intended for self-diagnosis or self-treatment, and do not replace consultation with a qualified professional.