Refusal Skills

Refusal skills involve verbal and nonverbal communications aimed at refusing offers for substances. Refusal skills were first studied and applied by behavioral psychologists. Over time, refusal skills training has been incorporated into various programs and interventions aimed at substance use prevention, treatment, relapse prevention, and recovery.

Refusal skills are important because people at risk for substance use often encounter or seek environments where substances are readily available. In addition, people at risk for substance use often find themselves within social groups where substance use is a widely accepted behavior. Therefore, a person with at least some desire not to use substances will be less likely to use alcohol and other drugs if he or she effectively refuses offers for substance use. Yet effective refusal of substances can be complex. As such, refusal skills must often be taught, learned, and practiced explicitly.

In practical terms, counselors are well positioned to teach refusal skills to clients who aim to prevent or stop substance use. Yet refusal skills might be taught and practiced within peer networks. The process of learning and practicing refusal skills involves brain-storming high-risk situations (i.e., situations in which it is likely the person will use alcohol or other drugs), learning skills, practicing through role-playing, and practicing in real-world situations.

To introduce refusal skills training, the counselor asks the client to brainstorm his or her personal high-risk situations. The counselor then asks the client to select one concrete situation. The client is encouraged to specify precise elements of the situation. Who might he or she be with? Where will he or she be? How strong will the temptation to use be? How confident will the client be in his or her ability to refuse the offer?

Once a concrete situation has been identified, the counselor teaches explicit refusal skills. Specifically, effective refusals must first include the act of saying no clearly and firmly to offers to use mind-altering substances. In addition, if the refusing person does not want to be offered alcohol and other drugs in the future, he or she might also firmly state this desire. This request must communicate a strong commitment to avoid substance use. Also, effective messages must be delivered with adequate volume and nonverbal communications. Specifically, it is suggested that the refusing person maintain consistent eye contact and straight posture while refusing. To follow a firm refusal, the refusing person might use other tactics such as switching topics, humor, walking away, or suggesting alternative activities.

After explicit refusal skills have been taught and discussed, the next step is to facilitate role-playing exercises to practice refusal skills. The counselor should introduce the role play by explaining that the exercise will be based on the concrete high-risk situations discussed earlier. Then the counselor should play the client (the person being offered substances) and the client should play the person offering substances. In this arrangement, the counselor can first model effective refusal skills. Then the client and the counselor reverse roles so the client practices effective refusal skills in the role of him- or herself (the person being offered alcohol or other drugs). Following the role-play, the counselor should facilitate a discussion and provide coaching on the client's newly acquired skills.

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