Denial is one of the most challenging defense mechanisms used by individuals with addictions. This term has been familiar to the substance abuse treatment nomenclature for many decades. It applies when a substance abuser denies the existence or severity of his or her problem. Treatment for clients in denial is typically challenging. In these cases, the focus of intervention is on helping the client acknowledge the problem. The only way treatment will be successful is if the client recognizes the existence or extent of the substance abuse.
The contemporary perspective is that denial occurs in the “pre-contemplative” stage of the change process (Prochaska, DiClemente,