Types of Therapy Used in Treatment
Addiction is a complex disease that can affect many areas of a person’s life. In 2017, it was estimated that 20.7 million Americans needed treatment for substance use disorders; however, only 2.5 million received specialized substance use treatment.1
Addiction requires individualized treatments that address the symptoms and underlying causes of the disease, as well as the consequences that substance use has on different areas of a person’s life. This includes their ability to socialize, their physical and mental health, and consequences at work, home, school, or with the law.2 There are many types of therapy available to effectively treat addiction.
Different Types of Therapy
Addiction treatment commonly consists of a combination of group and individual therapy sessions that focus on teaching those in recovery the skills needed to get and stay sober as well as how to navigate various situations without turning to drugs or alcohol.2 Behavioral therapy is perhaps the most commonly utilized treatment component used during substance rehabilitation. A general behavioral therapeutic approach has been adapted into a variety of effective techniques.2 These include:
- Cognitive Behavioral Therapy (CBT). CBT can be applied in the treatment of many different types of problematic substance use.2 People treated with CBT techniques learn to recognize and change their maladaptive behaviors. CBT can help people with coping skills, with identifying risky situations and what to do about them, and with preventing relapse.2 This approach is helpful because it can be paired with other techniques. The skills learned through CBT continue to be of benefit long after the initial therapy, and it can be used to treat co-occurring mental or physical health disorders as well.2
- Contingency Management (CM). CM may also be effective in treating several types of substance use disorder—for example, alcohol, opioids, marijuana, and stimulants—and is used to encourage or reinforce sobriety.2 This method provides material rewards as motivation for desirable behaviors, such as maintaining sobriety.2 A major benefit of CM is that it can result in a reduction in the two of the biggest treatment-related issues: dropping out and relapse.2
- Motivational Interviewing (MI). MI is a method of resolving ambivalence in recovering individuals to allow them to embrace their treatment efforts to best change their problematic substance use behavior. One benefit of MI is that, despite being facilitated by a therapist, those in recovery develop their own motivation and a plan for change over the course of several sessions, which can provide them with more of a sense of control over the course of their treatment.2
- Dialectal Behavioral Therapy (DBT). DBT can be adapted for many substance abuse cases, but mainly focuses on treating severe personality disorders, such as borderline personality disorder.2 DBT works to reduce cravings, help patients avoid situations or opportunities to relapse, assist in giving up actions that reinforce substance use, and learn healthy coping skills.3
- Rational Emotive Behavior Therapy (REBT). REBT helps patients understand their own thoughts and then helps to develop better habits and thinking in more positive and rational ways and gain healthier emotions.2 The base for REBT is the idea rational thinking comes from within; external situations are not what give one the feeling of happy or unhappy.2
- Matrix Model. The Matrix Model employs a combination of various therapeutic techniques and was originally developed for the treatment of individuals with stimulant addictions.2 Against this backdrop of various of techniques, therapists focus on rewarding good behaviors and teaching patients to believe in themselves; self-esteem, dignity, and self-worth.2 The National Institute on Drug Abuse describes the Matrix Model as mostly focused on “relapse prevention, family and group therapies, drug education, and self-help participation”.2
- 12-Step Facilitation. 12-Step facilitation therapy aims to promote continued abstinence by engaging people in recovery with 12-Step peer support groups. Meetings are hosted by several different 12-Step fellowships varieties, including Alcoholics Anonymous and Narcotics Anonymous.2
Medications and Treatment
When combined with counseling and behavioral therapies to assisted in a patient’s recovery, medications play an important role in many addiction treatment protocols.2 Various medications may be used to help reduce cravings and manage withdrawal from opioids, alcohol, benzodiazepines, and other sedatives.2
Opioid agonist medications such as buprenorphine and methadone as well as antagonist therapy with naltrexone may be used to help those with an addiction to opioids.2 For those in recovery from alcohol use disorders, medications like acamprosate, disulfiram, and naltrexone can be used to decrease continued drinking behavior.2
Additional medications may be used off-label for symptomatic support during withdrawal and treatment, as well as to address any co-occurring mental or medical health issues.2
Complementing Standard Treatment Approaches
There are alternate types of therapies that can be used to complement the more standard treatment types listed above to aid recovery. Though these techniques do serve as adequate substitutes for the substance abuse treatment programs themselves, they can help promote recovery through stress management and overall wellbeing. Some of the complementary therapies are:
- Exercise. Physical activity is a great way to reduce stress and release uncomfortable emotions.2 With some substances, early abstinence can be associated with weight gain, and exercise can help to manage this as well.2
- Meditation. Recovery can be a stressful time, and meditation can have a positive impact on anxiety, depression, and overall health.5 Mindfulness meditation is one way to maximize the benefits one gets out of treatment and is a technique that can be practiced easily after treatment is completed.5
- Yoga. Yoga is another activity that comes in a variety of forms, with some gentle styles that focus on breathing and relaxation and others that are more strenuous.5 Yoga can have various benefits, including a reduction in stress or physical tension and feeling more self-aware, peaceful, stronger, or physically fit. 5
- Massage. This technique is another way to help reduce physical tension and assist in learning to relax without relying on a substance.5 Massage can become part of your self-care routine and even be used to reward yourself for small milestones in your recovery journey. Some early studies show that massage could possibly help in managing various symptoms associated with different types of substance withdrawal.5
- Equine-assisted therapy. The idea of using various therapy animals has been gaining popularity, and studies have illustrated that programs that incorporate horses into the treatment process have better outcomes for participants.6 People in these programs may stay in treatment longer and be more likely to finish treatment.6 They report that going to the stable lets them develop a persona other than that of “patient” and helps them feel accepted, valued, capable, and emotionally supported.5
Addiction affects each person differently, so it is important for treatment to be individualized as well. Just because something works for one person, doesn’t mean it works for everyone. Over time, needs will change, and so should treatment plans.
- Substance Abuse and Mental Health Services Administration. (2018). Key substance use and mental health indicators in the United States: Results from the 2017 National Survey on Drug Use and Health.
- NIH Publication. (2012). Principles of Drug Addiction Treatment; A Research-Based guide (3rd ed.).
- Dimeff, L.A., & Linehan, M.M. (2008). Dialectical behavior therapy for substance abusers. Addiction Science & Clinical Practice, 4(2), 39–47.
- Turner, M. J. (n.d.). Rational Emotive Behavior Therapy (REBT), Irrational and Rational Beliefs, and the Mental Health of Athletes. Frontier Psychology. doi: 10.3389/fpsyg.2016.01423
- Burzinski, C.A., & Zgierska, A. Substance use disorder treatment: Complementary approaches clinical tool.
- Kern-Godal, A., Brenna, I.H., Arnevik, E.A., & Ravndal, E. (2016). More than just a break from treatment: How substance use disorder patients experience the stable environment in horse-assisted therapy. Substance Abuse: Research and Treatment, 10, 99–108.