Addiction is a complicated disease that requires a complex solution to overcome effectively. Addiction may come with various underlying causes and consequences. To effectively treat a substance use disorder, treatment has to address issues that are both, directly and indirectly, related to addiction. When you first enter a drug and alcohol addiction treatment program, you will begin with an intake and assessment process that identifies your specific needs. You will also sit down with your therapist to create a treatment plan that’s tailored to your specific needs. Your plan might include any number of a large variety of therapy options.
Addiction therapy is designed to address medical, psychological, social, legal, and financial problems that might threaten your sobriety. Some therapy options might address a wide range of issues like cognitive behavioral therapy. Others are designed to specifically target one issue, like eye movement desensitization and reprocessing (EMDR therapy, which is designed to focus on addressing trauma.
Addiction therapies are separated into two major groups: evidence-based therapies and alternative therapies. Evidence-based therapies have been studied scientifically and proven to be significantly effective. Examples include behavioral therapies, 12-step programs, and pharmacotherapies. Effective treatment plans will have evidence-based treatment options as their foundation. Traditional therapies are often used in clinical settings, but they haven’t been studied or proven in scientific studies to be effective. While they may be a significant help for some people, traditional therapies should only be supplemental to evidence-based approaches in any given treatment plan.
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Behavioral therapies are often recommended in addiction treatment. They are useful in increasing motivation, encouraging a continued commitment to treatment, and explore how internal thoughts can affect behaviors. One of the most commonly used therapies in addiction treatment is cognitive behavioral therapy, a treatment option that is instrumental in helping form relapse prevention strategies. The cognitive behavioral model in addiction treatment is based on the understanding that relapse doesn’t begin with the use of a drug or alcohol after gaining sobriety. Using the substance again is actually the result of a long process that begins in the mind.
According to the cognitive-behavioral model, a relapse starts with a response to high-risk situations or scenarios that pose a threat to a person’s sobriety. A high-risk situation could be inborn, like an emotional trigger to coming home to an empty house, or it can come from outside yourself, like someone offering you a beer.
When you are faced with triggers that could lead to a relapse, your coping response can make or break your success in recovery. An ineffective coping response can lead to a decrease in self-efficacy, which is your belief in your own ability to achieve goals. An increase in self-efficacy leads to a decreased probability of a relapse. Conversely, ineffective coping can lead to a decrease in self-efficacy and increases the likelihood of a relapse.
Addiction treatment needs to be tailored to individual needs, but CBT is a common therapy option. CBT can address a variety of issues in treatment and can be applied to a host of needs. Therapy works in several ways, including:
Since a relapse often starts with a high-risk situation, it’s important to learn how to identify and prepare for it. Learning to recognize situations that would likely result in feelings or triggers that test your resolve can help you avoid them altogether. For instance, if you feel inborn emotional triggers when you come home from work to an empty house, try going straight to the gym after work to relieve stress.
The best way to avoid a relapse in any given situation is to avoid high-risk situations completely. Learning what types of parties to avoid, which streets not to drive down, and the types of friends that might encourage you to use can help you limit your exposure to triggers. In CBT, you can learn strategies to identify and avoid those situations.
Of course, some high-risk situations can arise out of nowhere, and you can’t avoid every trigger. In those cases, recognizing them can help you know when to implement your relapse prevention strategies.
Self-efficacy is what allows you to resist relapse when you are faced with triggers and emotional downtime. CBT is designed to build up you self-efficacy so that when all your defenses fail, you can withstand the urge to use again. Self-efficacy is important to prevent relapse, but it’s also vital to other positive goals you may have in your recovery like starting a career, providing for your family, and being there for your friends.
Behavioral therapies can help with a broad range of issues in addiction treatment. Behavioral approaches are generally designed to address the way thinking can affect behavior in either a positive or negative way. For that reason, these therapies are used to increase motivation, advance a client’s readiness to make a change, provides incentives to remain in treatment, and increase life skills to handle stress and environmental triggers. Behavioral therapies are instrumental in addressing psychological and social issues in treatment and help bolster your relapse prevention strategies for after treatment.
Here are some of the most common behavioral therapies and how they can be used in addiction treatment:
Addiction is often called a family disease because of how it can affect an entire family unit. Substance use disorders can be traced back to problems that involve the whole family, especially when adolescents are involved.
For that reason, family behavior therapy (FBT) is an excellent tool in addressing both a substance use disorder and co-occurring problems like childhood trauma, conduct disorders, depression, family conflict, and even unemployment. FBT involves a client and their significant others like parents, partners, and children.
Therapists can teach families new skills, behavioral techniques, and how to cope with stressors positively
Contingency management is common behavioral therapy, and it’s often incorporated into other therapy options. It involves offering rewards to reinforce positive behavior like completing objectives, sobriety milestones, or remaining in treatment. Rewards are tangible and allow clients to see clear benefits for positive actions. However, rewards can be small and still prove effective. For instance, sobriety chips in Alcoholics Anonymous are an example of contingency management techniques.
Motivational enhancement therapy (MET) is designed to help clients increase their motivation to change. Not everyone enters treatment realizing that their substance use has become a problem. Sometimes they attend to appease family members or because of a court order. MET helps clients see the consequences drugs or drinking has caused and how making a change could benefit their lives.
Marlatt, A. G., Ph.D., Palmer, R. S., & Larimer, M. E., Ph.D. (1999). Relapse Prevention – National Institutes of Health. Retrieved from https://pubs.niaaa.nih.gov/publications/arh23-2/151-160.pdf
National Institute on Drug Abuse. (2018, January). Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-0
National Institute on Drug Abuse. (2018, January). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine). Retrieved from National Institute on Drug Abuse. (2018, January). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine). Retrieved