Drug addiction is a complex disease that typically requires a sophisticated approach when it comes to treatment. People might use several therapy options to find sobriety. Learning more about these therapies and how they may help someone battling addiction can guide people in determining which treatment might work best for them.
Therapy works in three primary ways to aid people who are working to overcome addiction, according to the National Institute on Drug Abuse (NIDA).
Cognitive behavioral therapy (CBT) was initially created to help people with alcohol use disorder reduce their risk of relapse. The strategies operate on the principle that the development of substance abuse and other negative behaviors is something that people learn. By learning how to identify and change such behaviors, the person can stop abusing drugs and engaging in other issues that often co-occur with a substance use disorder, according to the NIDA.
Clients learn how to improve their self-control and coping skills. This can help them to reduce the strength of their cravings and lower their risk of experiencing a relapse.
Community reinforcement approach with vouchers allows people to earn incentives for abstaining from drugs and following through with the other elements of their treatment. Urine screenings may be used to ensure the person is not using any drugs or alcohol.
This therapy is intensive. It focuses on helping people with the vocation, recreational and social practices, and coping skills, according to the California Evidence-Based Clearinghouse for Child Welfare. This allows people to work on several things at once to help them manage their addiction.
The Matrix Model is primarily used to help people who have an addiction to stimulants. This therapy essentially gives people the framework to achieve abstinence from cocaine, methamphetamines, and other stimulant drugs.
Throughout the therapy, urine testing is done to monitor the client’s process. This therapy can help clients to learn more about addiction, get direction to help them achieve sobriety, learn about relapse, and get support from their therapist, says NIDA.
Family therapy will involve providing therapy for the client and their closest loved ones. This allows everyone to work on their issues as a unit. This type of therapy emphasizes helping people to learn how to communicate better so that current issues can be resolved and future ones can be prevented.
Contingency management (CM) therapy works on the principle that if a client’s behavior is rewarded or reinforced, they are more likely to repeat it, according to an article in the Psychiatric Times. This is true whether the behavior is good or bad, so throughout the therapy, the client will work on adopting good behaviors and be rewarded when they do good things.
Motivational enhancement therapy (MET) and motivational interviewing (MI) help people to determine what they want more than their substance of choice. How the therapy is performed will depend on the exact substance a person is trying to recover from. This therapy may be done alone, or the therapist may have the client bring a loved one to help them be accountable for their goals.
Twelve-step therapy is a program where clients progress through the 12 steps to achieve and maintain their sobriety. In 2013, a national survey determined that this therapy was used in about 74 percent of facilities that treat drug and alcohol addiction, according to the National Survey of Substance Abuse Treatment Services. While peer support groups like Alcoholics Anonymous use the 12-step model for recovery, 12-step therapy is run by a professional therapist.
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It is estimated that in 2014, about 22.5 million people (ages 12 and older) needed to undergo treatment for a substance use disorder, NIDA reports. During this same year, only 4.2 million people received treatment.
People who have a substance use disorder should not hesitate to seek treatment. It may take experimentation to determine which type of therapy a person responds to the best. Those going through treatment should be patient and work with the professionals at the facility to create a tailored program that meets their needs.
It is a good idea to evaluate the program and the therapies it offers. Make sure the facility is reputable and that the people who provide the therapy have the proper education and licensing for it if these are necessary.
Therapy options are often targeted at specific substance use disorders. Cognitive behavioral therapy can be used for any substance use disorder since it can be flexible. It has been shown to be particularly useful for alcohol use disorders, according to research published in Addiction.
This therapy might also be used when someone has a dual diagnosis of a substance use disorder and another mental illness, such as major depression. CBT can help people to foster their abstinence while also putting sufficient focus on co-occurring problems.
Voucher-based incentives in contingency management are commonly used to help people with opioid addiction. It has been shown to improve abstinence and retention following detox from opioids, according to research published in the Journal of Consulting and Clinical Psychology.
Motivational interviewing may help people with marijuana and alcohol addiction. Compared to a delayed treatment control group, marijuana-dependent adults who engaged in this type of therapy experienced a significant reduction in their marijuana use, according to research published in the Journal of Consulting and Clinical Psychology.
Motivational approaches for alcohol use disorder have a strong scientific backing showing that it can have durable and significant effects, according to research published in Addiction. However, it is important that the therapy occurs on a long-term basis. Stopping this therapy prematurely could put clients at risk for a relapse. Exactly how long it should last will depend on the specific needs of the client.
Family therapies are commonly used for all substance use disorders, but they can be particularly helpful for teens and young adults. Including family members in the recovery process can help to build a support system for the client. This may also help to reduce attrition.
There are numerous approaches to using family therapy to treat addiction. The techniques involved that help to promote greater efficacy including putting equal focus on skills training, family therapy sessions, and communication training.
Those who attend an addiction treatment program may engage in several types of therapy. The type of therapy that will be most effective depends on the specific needs of the individual.
At the outset of treatment and as it progresses, clients will work with staff members to determine which types of therapy are best for their case and that point in their recovery. They should also continue therapy once they complete their treatment program to reduce their risk of a relapse.
(January 2018) Treatment Approaches for Drug Addiction. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction
Cognitive-Behavioral Therapy. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral
Community Reinforcement + Vouchers Approach. California Evidence-Based Clearinghouse for Child Welfare. from http://www.cebc4cw.org/program/community-reinforcement-vouchers-approach/detailed
The Matrix Model (Stimulants). National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral-3
(February 2012) Contingency Management in Addiction Treatment. Psychiatric Times. from http://www.psychiatrictimes.com/addiction/contingency-management-addiction-treatment
(2013) Data on Substance Abuse Treatment Facilities. National Survey of Substance Abuse Treatment Services. from https://www.samhsa.gov/data/sites/default/files/2013_N-SSATS_National_Survey_of_Substance_Abuse_Treatment_Services/2013_N-SSATS_National_Survey_of_Substance_Abuse_Treatment_Services.pdf
(March 2002) Mesa Grande: A Methodological Analysis of Clinical Trials of Treatments for Alcohol Use Disorders. Addiction. from https://www.ncbi.nlm.nih.gov/pubmed/11964100/
(October 1997) Effects of Adding Behavioral Treatment to Opioid Detoxification with Buprenorphine. Journal of Consulting and Clinical Psychology. from https://www.ncbi.nlm.nih.gov/pubmed/9337499/
(October 2000) Comparison of Extended Versus Brief Treatments for Marijuana Use. Journal of Consulting and Clinical Psychology. from https://www.ncbi.nlm.nih.gov/pubmed/11068976/
(December 2001) The Use of Brief Interventions Adapted from Motivational Interviewing Across Behavioral Domains: A Systematic Review. Addiction. from https://www.ncbi.nlm.nih.gov/pubmed/11784466/
(October 2001) Treatment Outcomes for Adolescent Substance Abuse at 4- and 7-Month Assessments. Journal of Consulting and Clinical Psychology. from https://www.ncbi.nlm.nih.gov/pubmed/11680557/