At one time addiction treatment was equated with detox, and alcoholics and addicts who had “dried out” or “cleaned up” were sent back to their daily lives with no further care. Today, a drug rehab program incorporates addiction therapy as well as medically assisted or social detoxification, so that people with a substance abuse problem can make lasting, meaningful changes in their lives. The focus of addiction therapy should be placed not only on the individual, but on the members of that individual’s family unit. Effective therapy must address the sources of addiction and the triggers for substance abuse in all aspects of the client’s life.
Finding an Addiction Therapist
If you need treatment for drug or alcohol addiction, you may be referred to an addiction therapist by your doctor, a family member, a case manager, a court representative, your employer or by the drug rehabilitation center where you seek treatment. Many professionals are qualified to perform addiction therapy at some level, including:
Licensed clinical social workers
Family or marriage counselors
Pastors or other spiritual advisors
Therapy may take place at a rehabilitation center, an outpatient recovery clinic, a community center or a private therapist’s office and may involve the individual, the individual and his or her partner, or the entire family.
The therapist you choose should have educational credentials and licensing status required by the state where you live. Most importantly, you should have confidence that the professional you’re working with will provide a safe, neutral, nonjudgmental environment where you can share the experiences and emotions that have contributed to your substance abuse. Although a therapist can provide support and encouragement for a client who’s struggling to cope with addiction, he or she must ultimately remain objective and refrain from making positive or negative judgments about your actions.
Approaches to Addiction Therapy
Addiction therapy draws from several different schools of thought, and no single approach to treatment will be effective for everyone. Trends in addiction treatment come and go, but three of the most popular therapeutic models have stood the test of time:
Cognitive Behavioral Therapy+
Cognitive Behavioral Therapy, or CBT, has been a popular approach to addiction treatment for decades. CBT approaches addiction as a learned behavior that can be “unlearned” by modifying self-defeating thoughts or behaviors. According to the University of Connecticut School of Medicine, CBT for substance abuse involves identifying the triggers and consequences of addictive behavior, then changing the client’s actions and emotions through techniques like repeated practice and positive reinforcement.
Dialectical Behavior Therapy+
Since the 1970s, dialectical behavior therapy, or DBT, has been used to help chronically suicidal individuals lead meaningful, manageable lives. More recently, this integrative therapy has been applied to treating substance abuse and mental health disorders such as bipolar and borderline personality disorder. Addiction Science & Clinical Practice states that the use of DBT in substance abuse treatment focuses on increasing the client’s motivation to change, strengthening the client’s sense of competence, reducing addictive behaviors, decreasing cravings and reinforcing life-affirming behaviors.
Unlike older approaches to addiction treatment, which placed the therapist in a confrontational relationship to the client, motivational interviewing (MI) is a supportive, client-centered modality. The client and therapist establish a collaborative relationship, which is used to help the client form a sense of self-sufficiency and enhance her motivation to change. The client is placed in a position of independence and autonomy and is empowered to make positive improvements in her own life. A study of the efficacy of MI published in Alcohol and Alcoholism indicated that this therapeutic approach is an effective way to help alcoholics regain control over their lives.
Individual Versus Group Therapy
A multi-disciplinary drug rehab program should include individual therapy sessions between the client and the therapist, as well as group therapy sessions that engage multiple clients in treatment. The goals of individual addiction therapy may encompass the following:
Assessing the client’s readiness to change
Building coping skills to manage high-risk situations
Dealing with intense emotions
Enhancing personal motivation
Identifying destructive thoughts or behaviors that stand in the way of the client’s recovery goals
Group therapy sessions may have similar goals, but in the group environment, clients can learn from each other as well as from their therapist. Group therapy can provide support for clients who are struggling to find motivation, help new patients learn how to manage cravings and reassure clients that they aren’t alone in their thoughts or feelings. A group therapy session may take place as part of a drug rehabilitation program, or it may be conducted by a community-based organization like Alcoholics Anonymous. After you graduate from drug rehab, group therapy will continue to be a vital part of maintaining your sobriety as you reintegrate into the community.
Therapy for Co-Occurring Disorders
The Genetic Science Learning Center at the University of Utah has studied the relationship between substance abuse and mental illness. The center reports that:
10 percent of people in the general population have a substance use disorder
27 percent of those diagnosed with a depressive disorder abuse drugs or alcohol
46 percent of people diagnosed with schizophrenia suffer from substance abuse
61 percent of people with bipolar I disorder suffer from addiction
Addiction therapy may center not only on drug or alcohol dependence, but on co-occurring disorders that make you vulnerable to substance abuse. Common co-occurring conditions include:
Many people who enter addiction therapy have a mental health condition that has gone undiagnosed or undertreated for years. At the beginning of any therapeutic relationship, the therapist should evaluate you for signs and symptoms of co-occurring disorders and develop a treatment plan that addresses your specific needs. Both individual and group therapy are key components of Dual Diagnosis treatment, providing the support and personal reinforcement you need to maintain your mental health while abstaining from drugs and alcohol.
Therapy for Partners and Families
Addiction therapy acknowledges the fact that substance abuse rarely occurs in isolation. If you or a loved one is drinking or using drugs destructively, your home environment may play a big part in your addictive behavior. A family can contribute to the problem by enabling the addict or by inadvertently triggering the addict’s substance abuse. At the same time, partners and children can be profoundly hurt by an addict’s behavior, suffering physical, emotional or financial damage as a result of chemical dependence.
The most comprehensive drug rehabilitation programs offer family counseling for those who are closest to the addict or alcoholic. In some residential treatment centers, family members are invited to participate in “family days” where they can spend time with their loved one while learning about the causes of addiction. At other facilities, spouses or children may be offered individual counseling and may be encouraged to participate in self-help groups like Al-Anon. Addiction therapy can provide a wealth of benefits to family members, such as:
Creating an atmosphere that promotes long-term recovery at home
Identifying dysfunctional relationship patterns that contribute to substance abuse
Helping children learn to avoid substance abuse and create healthy relationships at home or school
Helping spouses and partners identify patterns of enabling or codependency that may perpetuate the addiction
Relapse Prevention Therapy
Relapse prevention is so important to recovery that it’s sometimes considered to be a subset of addiction therapy. As with any chronic medical condition, relapsing from the treatment plan is an ever-present risk for addicts and alcoholics. Learning how to lead a drug-free life in a stressful, unpredictable world is a challenge that every recovering addict must face. A relapse prevention therapy session or class may cover:
Strategies for managing negative or positive emotions that can trigger drug use
Handling the occasional lapse so that it doesn’t become a major relapse
Learning life skills to help you handle day-to-day stressors, like dealing with finances or handling relationship conflicts
Identifying self-affirming relationships and activities that support a sober life
After graduating from a rehab program, relapse prevention therapy should continue through outpatient aftercare. Whether you participate in a 12-step program, attend counseling at a rehab clinic, join a life skills class or attend vocational counseling, relapse prevention will be an ongoing part of your life. With the help of a supportive therapist, it’s possible to learn how to build a productive, rewarding life while avoiding the pitfalls of addiction.
In many cases, the addict or alcoholic isn’t the one who actively seeks addiction therapy. It may be you or another member of your household who gets the addict into rehab by intervening in her self-destructive behavior. At any stage of the treatment process, a knowledgeable therapist or interventionist can be a valuable ally in your efforts to achieve health, stability and sobriety in your home. Contact us for information on how to arrange an effective, life-changing intervention for someone you care about.