This is not uncommon. Shame is one of the most powerful drivers of substance use — and also one of the most powerful barriers to recovery. When people feel judged, they become defended. When they feel safe, they become honest. The counselling relationship, built on genuine warmth and non-judgement, can become one of the few spaces where honesty is possible.

With Donna, I worked hard in the early sessions simply to build trust. I was not there to assess her or report on her — others held that role. My role was to be alongside her as she made sense of her situation. MI places a high value on this: the therapeutic relationship is not incidental. It is the foundation on which everything else is built.

What emerged over time was a woman of considerable resourcefulness who had, for complex reasons rooted in her own childhood, never quite been able to believe she was capable of the life she wanted. Her own experience of being parented had been chaotic and unpredictable. She had no template for the kind of consistent, attuned parenting she aspired to.

Rather than focusing on deficits, MI directs attention toward values and strengths. I asked Donna what kind of mum she wanted to be remembered as. She thought for a long time. "One who showed up," she said. "One who was actually there." We returned to that phrase many times over the following months.

Slowly, Donna began to link her substance use not just to external consequences, but to the internal gap between who she was and who she wanted to be. That connection — between behaviour and identity — is where the most durable motivation for change tends to live.

At the point of writing, Donna's children have returned to her care under a support plan. She continues in treatment. The work is not finished. But she is showing up — and she knows it.

All identifying details have been changed. "Donna" is a composite, created to illustrate therapeutic themes around parenting and substance use.