Therapy plays an important role in addiction treatment programs as well as ongoing care. Types of therapies include biofeedback, cognitive-behavioral therapy, dialectical behavior therapy, experiential therapy, faith-based therapy, family therapy, holistic therapy, medication-assisted treatment, and motivational enhancement therapy. The therapy uses psychotherapeutic processes to address physical and emotional dependency on psychoactive substances, modifies the attitude and behaviors related to drug use and increases healthy life skills. These psychotherapeutic processes along with supervised medication-assisted treatment are the most effective at breaking the cycle of drug addiction.
Getting a patient sober is the first big step, however, keeping a patient sober is an even longer and more difficult process. Ongoing therapy plays a critical role in helping people who have struggled with a substance use disorder stay on the right track, to maintain their new drug-free lifestyle and to lower the chances of relapse.
Specialized addiction therapists work with patients in different therapy settings to address the underlying psychological addiction to drugs or alcohol as well as set measurable and achievable short-term goals to empower the patient through their progress. Eventually, the patient and the therapist can develop long-term goals that can solidify a healthy life and future.
There are a wide variety of treatment and therapy options that can cater to the unique needs of each individual and circumstance as well as more general facilities and programs for basic demographics and recovery needs. It is important to review the depth of your needs and addiction as well as consider the range of treatment and therapy options to ensure the process of treatment and recovery as comfortable and effective as possible. Some forms of treatment and therapy use spiritual or religious methods, while others will use non-religious, scientific and evidence-based methods. Often times, however, programs incorporate a combination of approaches to provide the most quality treatment.
Everyone has their own unique path to recovery; the most commonly used therapies to treat addiction include:
Biofeedback therapy analyzes functions of the body and provides feedback to medical professionals. They then teach the patient how to gain control of their body and mind during treatment. The goal of biofeedback therapy is to guide the patient how to react to physical and emotional situations and stimulants in a healthy and appropriate manner. Biofeedback therapy first tracks functions of the body including heart rate, skin temperature, blood pressure, sweating, muscle contractions and breathing rate by placing electrodes or sensors on the skin along certain points of the body and then displays the feedback to the medical professional and the patient. The medical professionals can then analyze the information and teach the patient techniques to gain control of their stress, anxiety, breathing and thought patterns etc. Repetition of healthy coping and reaction techniques can break the destructive cycle of addiction as well as can help treat a variety of disorders such as attention deficit hyperactivity disorder, depression, anxiety disorders, chronic pain, migraine headaches, generalized seizures and high blood pressure. For addiction treatment, the therapist will teach the patient how to control their reactions to withdrawals and cravings.
Cognitive-behavioral therapy (CBT)
Cognitive-behavioral therapy, or CBT, focuses on developing positive thoughts and thought patterns into personal coping strategies as well as identifying, understanding and modifying negative ‘automatic thoughts’ and thought patterns. An automatic thought is an involuntary impulse reaction to a trigger that the body and mind develop as a means of protecting itself. Automatic thoughts and reactions can be productive or destructive, from believing anything is possible to believing everything will go wrong because something bad happened once. The body and mind quickly become accustomed to these patterns and for many, it is difficult to change alone. In times of stress when the mind is vulnerable, it can create feelings of self-doubt, fear, anxiety and other misconceptions which commonly lead to self-medication by drinking or abusing drugs. It is especially important to be aware of and able to control potentially destructive thoughts and emotions in treatment and recovery to prevent relapse and other harmful behavior. CBT will treat co-occurring disorders including anxiety, attention deficit disorder (ADD), bipolar disorder, obsessive compulsive disorder (OCD), eating disorders and post-traumatic stress disorder (PTSD).
Dialectical behavior therapy (DBT)
Similar to cognitive-behavioral therapy, dialectical behavior therapy, or DBT, focuses on working with the patient to develop healthy techniques to deal with stressful situations. DBT includes four strategies for achieving their goals: mindfulness, distress tolerance, interpersonal effectiveness and emotion regulation. Theses are ways patients can seek out peer support groups that have a similar interest in maintaining sobriety, getting rid of triggers, and skills training.
- Mindfulness involves being aware of oneself, surroundings and actively being in the moment
- Distress tolerance involves learning how to deal with difficult and traumatic situations to the best of one’s ability by being optimistic, engaging in relaxing activities, self-talk or self-soothing and meditation
- Interpersonal effectiveness involves knowing how to express oneself in a healthy way including how to say “no” to someone and how to ask someone for something while maintaining their respect as well as your self-respect
- Emotion regulation includes being aware of your emotions, their triggers and also learning how to change those emotions and letting go of emotional suffering.
Experiential therapy is focused on active experiences for the body and mind. The patients can use the scenarios to experience the expression of emotion and understand how emotion affects one’s behaviors. The goal of experiential therapy is to teach the patient how to cope and live without turning to drugs. Recovering addicts may often feel uncomfortable talking to therapists in a traditional and clinical setting, experiential therapies give patients the unique opportunity to receive treatment in an environment where they feel as comfortable as possible. Common experiential activities include:
- Drama/ theater therapy
- Rock climbing
- Music therapy
- Wilderness therapy
- Recreation therapy
- Adventure therapy
- Creative writing
- Animal-assisted therapy
For many people, religion is a beloved and vital part of every facet of their lives, including addiction recovery. It is important for psychiatrists and clinical psychologists to be sensitive to the correlation between one’s faith and their overall wellbeing. An important factor of faith-based therapy involves getting the patient more and more involved in their religious or spiritual community as they progress through the program. Faith-based therapy offers strong mental and emotional support along with addressing the medical issues treatment programs by focusing on spirituality and community activities.
Holistic therapy programs offer non-medical recovery methods that do not require medication and are often used along with more mainstream treatments. Holistic therapies such as yoga, tai chi, meditation, exercise, acupuncture and massage therapy are introduced to encourage a healthy mental and physical lifestyle that can replace the drug lifestyle. These activities along with professional counseling are used to strengthen resistance to cravings and reduce the appeal of drugs and alcohol by promoting physical fitness and increasing self-confidence.
- Nutritional Therapy – A healthy diet is the foundation for a healthy body and mind and is vital in addiction recovery. It is important for recovering addicts to get the proper daily nutrition they need to nourish their body and mind through recovery.
- Exercise and Recreational Therapy – Daily exercise is good for the body and mind as well as is an excellent way to develop a healthy routine and relieve stress. Being active is an important part of many holistic treatment programs and can include swimming, yoga, rock-climbing, canoeing, horseback riding or hiking.
Meditation – Mental strength and clarity are valuable for recovering addicts to combat cravings and conflicting impulses. Holistic therapy programs often offer guided meditation, yoga and tai chi as reflective and therapeutic practices to help residents reinforce the positive thoughts and tools they have learned.
Massage and Acupuncture – Massage is used to relieve stress and relax the body while acupuncture is used to help relieve pain.
Motivational enhancement therapy (MET)
Motivational enhancement therapy, or MET, is an intervention and counseling approach specifically designed to evoke internally motivated change. MET is often combined with other forms of counseling such as a variation of the 12-Step treatment method and cognitive-behavioral therapy.
After an initial assessment session, the patient attends four individual treatment sessions that are customized to fit the needs of each individual. MET therapists then work with patients to help change their thoughts and behaviors related to drug use. Early sessions focus on evaluating information from the initial assessment and setting goals for the future. Later sessions provide the patient with perspective and positive reinforcement for staying sober. MET can help treat addiction and co-occurring disorders simultaneously to prevent relapse.
It is essential to have a plan for continuing care to provide the addict with a consistent sense of community. Support groups emphasize the importance of accountability and offer ongoing peer support and include:
12-step programs are anonymous and help addicts remain sober with a rigorous step by step plan and highly involved group support with a huge focus on spirituality. The program usually includes being assigned a sponsor as a new member and even sponsoring someone in the future. 12-step programs are derived from Alcoholics Anonymous.
AA meetings involve group sessions in which patients can discuss the impact of alcohol on their lives through personal experiences. These meetings can take place in a religious center and are guided by a trained specialist.
Based on the AA model, NA provides a supportive group setting for people who are struggling with drug addiction with many spiritual undertones.
Founded in 1994, SMART Recovery offers a 4-point program that includes motivation, coping mechanisms, thought management and balance. Tools include a change plan worksheet, brainstorming sessions, unconditional self-acceptance, and a decision-making worksheet.