The Different Types of Therapy That Can Help With Addiction
The National Institute on Drug Abuse (NIDA) has explored many of the different types of therapy that can help with addiction based on data that has been collected for the past 40 years. These principles are engineered improve the odds of success in treatment by ending (or moderating) drug use, lowering the risk of relapse, and allowing the person with addiction to rebuild or restart their lives. These principles include assertions such as:
- Addiction is a problem encompassing many facets, but one that can be treated effectively.
- Treatment should be directed a treating the individual person rather than to their drug(s) of choice.
- Treatment can be helpful even if the client is required to obtain treatment involuntarily. (Eventually however, the client’s voluntary participation in treatment will have an impact on their recovery.)
- Medications can play an important role in of drug abuse or the mental health aspects underlying substance use.
- Psychotherapy and group therapy are commons forms of treatment that are highly utilized and represent the best in available treatment options for drug abuse.
This final notion is an important one. Many agree that Psychotherapy and behavioral therapies are essential elements to treat substance use, but with so many options, it can be challenging to know what forms of treatment are available, how they differ, and which is best for the individual. It should also be mentioned that the researchers do not believe that there is any one approach that is appropriate for every person. It is important to understand psychotherapy vs counseling when attempting to find the right program for yourself or someone you love.
Types of Addiction Treatment Therapies
Addiction treatment therapies include (but are not limited to) the following:
- Psychotherapy and Behavioral Therapy
- Cognitive-Behavioral Therapy (CBT)
- Contingency Management
- Rational Emotive Behavior Therapy (REBT)
- Community Reinforcement and Family Training (CRAFT)
- Person-Centered Therapy
Psychotherapy and Behavioral Therapy
Psychotherapy and behavioral therapy is focused on obtaining goals directly related to the present life of the client and examine the underlying causes of the addiction. These therapeutic styles will work to examine behaviors that are unhealthy and undesirable while identifying the situations in place that support their continued presence. In the example of substance use, the addictive behavior is can often continue unchecked because of the role the substance plays in creating feelings of euphoria, calming the body, eliminating pain, and others. These physiological responses to drugs create reinforcement necessary to fuel continued addiction. Even when negative consequences occur because of the drug use, the person still craves the physiological effects despite the risk of the consequence.
Contingency management is one the many different types of therapy that can help with addiction. This type of behavioral therapy used in the treatment of substance use, especially for alcohol, stimulants, opioids, marijuana, and nicotine. In this approach, the client is given a tangible, wanted reward for accomplishing their desired behaviors. Commonly, the desired behavior is abstinence from substances, and the reward helps to build new behaviors.
Like many of the different types of therapy that can help with addiction, Cognitive-behavioral therapy (CBT) uses behavioral therapies as a base, but it also assigns equal importance to thoughts and feelings. CBT is grounded in the idea that negative thinking patterns lead to unwanted feelings and behaviors,. This often leads to problematic behaviors which then can lead to unwanted feelings and negative thinking. This relationship between thoughts, feelings, and behaviors is at the core of CBT. In CBT, a therapist will act as a coach and as a teammate to assess and understand the systems in place inside the addict’s mind that lead to the thoughts, feelings, and behaviors. The therapist then queries the addict to identify which of these issues he wants to address. In the case of substance use problems, the therapist would go beyond the behavioral therapy principles of trying to learn the source of reinforcement. In such a case, the therapist would seek to understanding the thoughts and feelings that lead to the use as well as the thoughts and feelings that occur following the use. The therapist will look for something called “cognitive distortions” that feed into these behaviors. Cognitive distortions are essentially flawed ways of thinking that, while they may sound rational at the time, they are irrational and illogical. For example, someone with an “all or nothing” cognitive distortion will think that their life is falling apart if it is not perfect. Since perfection cannot be obtained, they will be overly negative, hopeless, and depressed. Then, they learn that drug use can cover these feelings and allow for avoidance.
Rational Emotive Behavior Therapy (REBT) is a type of therapy that was formed during the same time as CBT. Due to its many similarities, it has since been absorbed into CBT. Like CBT, REBT places less emphasis on the behaviors and more on the views of the individual. Instead of focusing on the thoughts, REBT focuses on the beliefs of the client. REBT views flawed, unrealistic beliefs as the center of psychological issues. Common themes of irrational beliefs are:
- People in my life MUST love me and treat me fairly.
- I MUST perform perfectly well.
- I MUST get what I want at all times.
- I MUST avoid the things that are too hard.
To combat these faulty beliefs, a therapist using REBT inside of the CBT framework will use the ABC Model. This system works to communicate the notion that it is not the situation that creates the consequence; it is the belief about the situation that creates the consequence. In the case of substance use, someone would say that being offered the substance leads to the use. REBT would say that being offered the substance (A) leads to the belief that the substance would resolve a problem (B), and this would end in use (C).
Person-centered (or Humanistic) therapy arose as opposition to the views of psychoanalytic thought that believed all people are motivated by greed, power, sex, and aggression. Person-centered therapy believes that all people have an innate goodness in them that wants to emerge. This is considered to be among the most effective of the different types of therapy that can help with addiction.
- A supportive environment.
- Unconditional positive regard.
- Understanding from the therapist.
In this form of treatment, the therapist is more of passive participant in therapy than in behavioral therapy or CBT, and the work is done by the client.
All of the therapies mentioned before are primarily focused on working to effect change by only working with the individual. This attention to the person using the substance or in recovery is crucial for enduring success, but it can have some limits. Since the addict does not exist in a vacuum as they are part of wider family and community settings, there are important outside influences, especially the setting in which treatment is being administered. These settings can either aid recovery or serve as a hindrance based on the established routines, reinforcements, and communication styles. Because of this, many therapies will acknowledge and address the influence of the family and the addict’s community to increase the rates of success for the client. The treatment styles that focus on the client and their surroundings equally are referred to as family-based or community-based therapies. Family/community-based treatments examine the push and pull forces being placed on the person with the substance use disorder. These might include:
- The need for individuality as well as the need for togetherness.
- Relationship triangles where the client will be influenced by other relationships as much as they will influence others.
- The history of substance abuse in the family through a multi-generational assessment to identify past mental health or substance history occurring in family members.
All of this information will aid in building a thorough treatment plan and many family/community-based treatment styles exist, not the least of which is a sober living community.