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Why You Need Therapy in Addiction Treatment

March 6, 2017

In addiction – especially addiction to opiate drugs that comes with intensive physical and psychological withdrawal symptoms – the focus is often primarily on physical dependence. A critical part of addiction and recovery, it is true that intensive medical and psychiatric care is needed during the detox process. It can be uncomfortable and all-consuming to deal with ever-intensifying symptoms, and for many people who are considering entering treatment, their primary concern is this initial part of their treatment program.

It is important to note, however, that managing withdrawal symptoms is not the beginning and end of treatment for addiction. It is the first step in a very long process that includes a range of different types of therapies that should begin during the first 30-120 days of recovery but extend well into the first year and beyond. Here’s what you need to know.


Detox is about stabilizing physically in recovery. Medication and medical care can be determined on a case-by-case basis. Depending on the drug of choice, the existence or not of co-occurring mental health disorders and physical ailments, and the person’s history of drug treatment attempts, the specifics will vary widely.

During this period, all therapeutic intervention is focused on stabilization. Support in managing cravings and the intense emotional ups and downs that come with detox as well as the provision of strong, positive support are critical during these first weeks.

Because withdrawal symptoms can be intense, it is imperative that no one undergo the detox process alone. Many will simply relapse in order to abate the symptoms, making professional therapeutic support the key to making it all the way through detox to sobriety.

Support during Transition

During the transition from active addiction to a healthy recovery, it is necessary to take advantage of a wide range of different therapies in order to have all the skills necessary to not only function healthfully but also avoid relapse. Therapy can provide everything from individualized support to a community of supportive individuals to assistance in developing much-needed skills to thrive in life. For example, therapy offers:

  • Emotional support in the process of transition (e.g., Cognitive Behavioral Therapy, support groups, etc.)
  • Relationship assistance and positive communication skills (e.g., family or couples counseling)
  • Therapeutic treatment for co-occurring mental health disorders (e.g., exposure therapy, CBT, EMDR, etc.)
  • Alternative therapies that support a well-rounded treatment program (e.g., art therapies, animal-assisted therapies, sports and adventure therapies, etc.)
  • Support for lowering stress and creating positive lifestyle changes (e.g., nutritional therapy, yoga, acupuncture, tai chi, etc.)
  • Assistance finding safe, sober housing, if necessary
  • Job skills support, employment assistance, and life coach support to identify and achieve career goals

Each person’s needs will be different, so a unique combination of these therapies will be effective in helping someone to transition from active addiction into active recovery.

Timing and Intensity

Just as different therapies and treatments will be effective for different people, the timing and intensity of therapeutic intervention will ebb and flow during the course of treatment. That is, during the initial phase of recovery, or the first 30-120 days, intensive therapeutic intervention of up to five hours a day or more is often appropriate. This provides time for clients to fully immerse themselves in their new, healthy way of life and get the support they need every day to turn their plans into action.

Once stable, it may be appropriate to change therapies as the original therapeutic goals are reached and/or to decrease the number of hours spent in active therapy. For example, someone in inpatient drug rehab may undergo up to eight hours a day of therapeutic support and treatment and then transition to an outpatient program that provides them with five hours a day of therapy during the week. Later, they may decrease the number of hours by half, going every other day.

The idea is that a slow, stepdown process is most effective, ensuring that clients always have the option to step up their sessions again if necessary and making sure they have everything they need to continue living in sobriety.

Addiction Is More than Physical Dependence

It would be much simpler if addiction could be treated effectively with nothing more than a detox program. However, addiction is so much more than just a physical dependence, which is little more than the body’s natural response to repetitive exposure to a substance – something that can happen with medications with no abuse potential. Addiction requires a psychological component, usually defined by:

  • Intense cravings for the drug of choice
  • An inability to focus on anything or anyone else when without the drug or when the supply of the drug is threatened
  • Feeling agitated or anxious when without the substance of choice
  • Willing to sacrifice health, safety of others, relationships, and goals in pursuit of getting and staying high

This psychological dependence lasts long after the physical dependence has been addressed and can create complications in recovery at any time. The only effective way to address the problem is to actively engage with research-based therapies and continue to remain actively engaged for the long-term.

What do you, or your loved one, need to effectively put a substance use disorder in the past? What therapies will help you and your family to live a long, balanced life in sobriety?

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