Addiction is a problem that continues to grow in the United States at nearly exponential rates. To combat the rise in overdose and addiction, researchers, clinicians, and scientists are constantly working on new ways to address the disease. Today, medications and psychotherapeutic options are available to people who need help with a substance use disorder.
Addiction therapy is a tool on the front line of the addiction epidemic and it comes in many varieties, some more effective than others—depending on the severity of the addiction.
Learn more about what addiction therapy is, the different methods involved, and how it can help you achieve lifelong sobriety.
What Is Addiction Therapy?
Alcohol and drug addiction therapy can describe a wide range of interventions that treat substance use disorder or address a pattern of drug abuse. Some therapy options address addiction directly and provide coping mechanisms to help you deal with cravings and triggers without relapsing. In many cases, these therapies are centered on helping you form relapse prevention strategies with which you can safeguard your sobriety.
Other therapies can be focused on underlying issues that may contribute to or worsen a substance use disorder. For instance, trauma is often associated with alcoholism. To treat alcoholism in someone who has experienced trauma, it may be necessary to use therapy options that specifically address disorders like post-traumatic stress like eye movement desensitization and reprocessing (EMDR therapy).
Addiction therapy can also be split into two other categories: evidence-based treatments and alternative therapies. Evidence-based interventions are supported by research and, while alternative therapies have some apparent success in clinical settings, they haven’t been verified through studies. Treatment plans should be grounded in evidence-based studies, but there may a time and a place for alternative treatments in certain situations.
Why Is Addiction Therapy Necessary?
Addiction is a chronic disease that affects the brain in complex ways that contribute to compulsive and uncontrollable use. Unfortunately, the media’s portrayals of addiction often show characters going through detox and then never having much of an issue with addiction again. In reality, you may have to deal with cravings and triggers for years after your last dose. It’s not just a matter of biology, there are a variety of factors that contribute to addiction.
Generally, your reward center, also known as your limbic system, is the epicenter of a substance use disorder. It’s designed to link and regulate parts of the brain that are involved in feeling pleasure, in order to motivate us to repeat certain activities. Normally, activities like warm social interaction, good food, and a comfortable bed trigger this pleasure response. Our reward center teaches our brain to repeat activities necessary for our survival. However, psychoactive drugs and alcohol can also trigger the limbic system to respond with intense feelings of pleasure. This produces a deep-seated desire to continue using.
During active addiction, your brain has learned to seek drugs to relieve stress, pain, anxiety, and just to feel good. Even when you know that a drug can be harmful, it’s incredibly difficult to resist. Alcohol and drug addiction therapy can help you re-write the effects of drugs in your brain, learn to cope with negative feelings, and learn to avoid and deal with cravings.
Addiction therapy can also address root problems that may have contributed to your initial drug use. For instance, substance use disorders have a significant rate of comorbidity with other mental disorders, especially depression and anxiety. In some cases, substance abuse begins as a way of self-medicating to relieve negative symptoms of a mental disorder. Drug and alcohol addiction therapy can address these issues to remove the need to self-medicate and prevent mental disorders from triggering an eventual relapse.
How Does Addiction Therapy Work?
There are many addiction therapy options to consider, but they all have the same general goal. Drug and alcohol addiction therapy should increase your ability to cope with negative emotions, thoughts, and circumstances in healthy ways without the use of drugs or alcohol. Even after you complete a medical detox program, you will still have cravings that pull you back toward substance use and relapse. Long after your body has been purged of your last dose, your brain will still seek the rewarding response of drugs or alcohol.
Drug and alcohol addiction therapy options will seek to give you the tools you need to cope with cravings and stressors or address underlying issues that contribute to or worsen addiction. Some therapies can be applied to multiple issues at once. For instance, cognitive behavioral therapy addresses the way your thinking influences behavior. This can be applied to both a substance use disorder and other mental health issues like anxiety and depression. Other therapy options are aimed at addressing a specific issue. For instance, EMDR therapy is designed to help people reprocess past traumas. Still, addressing specific issues like trauma can be vital to your overall goal of abstinence.
The Cognitive Behavioral Model
Cognitive behavioral therapy (CBT) is an evidence-based treatment method that is commonly used to treat substance use disorders and other behavioral issues. In fact, it is the most commonly recommended treatment options for addiction. The cognitive-behavioral model involves changing behavior by addressing and correcting problematic thinking. According to the cognitive behavioral model, relapse doesn’t start when a person begins to use drugs or alcohol again. It starts much earlier than that—when a person uses poor coping skills to respond to negative emotions, stress, or cravings.
In many cases, addiction starts when a person who is stressed, depressed, or has a mental disorder uses drinking or drugs as a form of self-medication. And this negative coping mechanism leads to addiction. In recovery, negative coping mechanisms can lead to relapse and, in the cognitive behavioral model, high-risk situations are the main dividing point between sobriety and relapse.
CBT works in several different ways, including:
- Identifying high-risk situations. High-risk situations are any time where a person in recovery experiences some kind of stimulus that causes cravings and the desire to use an addictive substance. High-risk situations can come from outside influences like the stresses that come from your job, but it also comes from inborn influences like feelings of depression that you experience when you come home from work to an empty apartment. High-risk situations can be regular and recurring like having cravings around the same time every day. But they can also appear randomly, like a photo of someone smoking that triggers a craving.
- Developing strategies to avoid known high-risk scenarios. High-risk situations are the easiest to deal with when they are avoided altogether. If you know that you feel depressed when you return home from work, you may be able to avoid that high-risk situation by becoming going to the gym or picking up a hobby to go to during that time in your schedule, replacing a known high-risk situation with a positive and healthy experience.
- Develop coping strategies to deal with high-risk situations. It’s impossible to completely avoid all high-risk situations, especially the kinds that can happen without warning. For that reason, it’s important to develop positive coping strategies to employ when you experience unexpected cravings, stress, or other negative emotions that could otherwise lead to relapse.
- Increasing self-efficacy. In addiction treatment and relapse prevention, self-efficacy refers to a person’s mastery over their behavior. In other words, self-efficacy is your belief that you can effectively resist cravings and cope with high-risk situations. Building positive coping strategies can increase self-efficacy which helps to prevent relapse.
According to the cognitive behavioral model, your thinking, when presented with a high-stress situation can lead you down two possible paths. Effective coping skills lead to increased self-efficacy and increased self-efficacy helps to safeguard your sobriety. Ineffective coping skills lead to a decrease in self-efficacy and then to a lapse in which you use again.
“Cognitive behavioral therapy can help you better recognize your own personal high-risk situations, learn effective coping skills, and increase your self-efficacy.”
Other Types of Behavioral Therapy
Behavioral therapy is the gold standard for addiction treatment but it is a broad term that describes therapies with a focus on how learned behaviors are influenced by internal and environmental factors. For instance, how does your thinking in a particular circumstance influence your behavior? In many cases, behavioral therapy involves learning to change your thought process to produce different behaviors. Behavioral therapies can be used to treat obsessive-compulsive disorder, depression, anxiety, insomnia, and anorexia as well as substance use. Since addiction has a wide range of factors and behavioral therapies have a wide range of applications, it has become a mainstay in addiction treatment centers.
However, not everyone responds to CBT and some may benefit from additional therapy options alongside CBT. Some behavioral therapies are designed to address more specific needs like family therapy. Here are some of the other common behavioral therapy options and how they are applied.
Family therapy is an important part of addiction treatment for many people in recovery. Addiction is often referred to as a family disease because of the way it can affect the people around the person who is addicted and has a significant impact on the mental health, finances, and even physical health of an entire family. Family members can also feed into substance use disorders without knowing it through enabling.
Behavioral therapy involving family members is a key way to accomplish several factors in treatment, including:
- Helping family members to understand the difference between enabling and non-enabling behavior
- Allowing the addict to see how their actions affect the people in their lives
- Giving all members of the family a platform with which they can communicate their feelings and grievances
- Building a support structure for clients that will be returning home after treatment
Family life can be a significant environmental factor in the initial causes of addiction. People who make it through treatment, only to re-enter negative, triggering family environments will struggle to maintain sobriety. Family therapy may be able to address these issues and get to the root of addiction in the family. Family therapy can follow the cognitive behavioral model, but there are other models like the family disease model and the family systems model. Several techniques may be combined in multidimensional family therapy, which is designed to address the relationships between thought, emotions, behavior, and environmental factors.
Motivational interviewing (MI) is a behavioral therapy that typically involves one-on-one sessions with a therapist with the goal of increasing a client’s readiness to change. According to the transtheoretical model, people approach addiction treatment at varying levels of readiness to change, including:
- Precontemplation – Not ready to change. This is when a client is not ready to change or doesn’t see a need to make a change.
- Contemplation – Getting ready to change. This is when a client sees the need for a change and they start to look at the potential benefits of making a change.
- Preparation – Ready for a change. People in this stage plan to take action in the near future or may take small steps toward change, like signing up for treatment.
- Action – At this point, the client will begin to take steps in making a behavioral change and begin to acquire new healthy behaviors.
- Maintenance – After a change has been made, the maintenance stage is when the client employs relapse prevention strategies to maintain sobriety.
Motivational interviewing is a non-judgmental and non-confrontational conversation between a client and a therapist. The goal of MI is to increase the client’s awareness of the problems addiction has caused, the consequences they have already experienced, and the risks that they may face if addiction continues.