Behavioral therapy plays an important role in addiction treatment. Therapy occurs in individual, group, and family settings and supports different aspects of addiction recovery.
Behavioral therapy or psychotherapy also addresses the individual needs of people in treatment as well as those of their family members.
The Role Of Therapy In Addiction Treatment
The role of therapy in addiction treatment is to help clients look into their past to uncover the root causes of addiction and give them tools for relapse prevention.
Therapy helps clients:
- Recognize behaviors and attitudes that aren’t helpful
- Modify those behaviors and attitudes that have contributed to substance abuse
- Uncover and process trauma or emotional wounds that have led to addiction
- Learn how to cope with stress and stressful situations in a healthy way
- Recognize and deal with triggers that might lead to a relapse
- Deal with cravings in a way that doesn’t lead to relapse
- Benefit from medication-assisted treatment (MAT)
While there are many other effective treatment approaches that providers use in treatment plans, behavioral therapy is the cornerstone of addiction health care.
Behavioral Therapies For Addiction
Different therapeutic modalities address different aspects of a client’s individual needs in addiction treatment.
Cognitive Behavioral Therapy (CBT)
Cognitive Behavioral Therapy is a type of therapy used for many different psychological problems and assumes that those problems are based, at least in part, on unhelpful behavior or thought patterns.
By helping people recognize and address thought patterns that contributed to their substance use in the first place, CBT allows clients to choose new, healthy beliefs, leading to more positive behavior.
Contingency Management (CM)
Contingency Management is a therapeutic approach in which clients receive positive reinforcement in the form of rewards for completing a series of tasks or helpful behaviors.
Rewarded actions may include:
- Remaining drug-free (verified through negative drug tests over a period of time)
- Attending counseling
- Participating in group therapy
- Taking medications as prescribed
Rewards typically consist of vouchers for retail goods or services or other prizes. The idea is to replace substance use with healthy behaviors to achieve rewards.
Motivational Interviewing (MI)
Sometimes associated with strengths-based treatment programs, Motivational Interviewing derives treatment goals from a person’s desire to change.
MI draws out of clients their own reasons and motivations for leaving addiction behind and empowers them to achieve that change.
Motivational Enhancement Therapy (MET)
MET is a therapeutic approach that utilizes MI as a tool in the process of addressing a person’s apathy toward changing drug and alcohol use.
Therapy sessions are used to increase (or enhance) clients’ motivation and help them set achievable goals.
Family therapy is an important component of drug and alcohol treatment programs. Providers may couple it with family support groups and education about addiction.
Family therapy helps clients and their families address anger, resolve emotional wounds, and re-establish healthy relationships.
Twelve-Step Facilitation (TSF)
TSF is based on the 12-step model and encourages clients to become involved in 12-step recovery groups such as Alcoholics Anonymous.
The 12-step model has been helping people overcome substance abuse for many decades, and some treatment providers model their programs after it.
Therapies For Dual Diagnosis Treatment
Dual diagnosis, or co-occurring disorders, is a term used to describe the presence of a substance use disorder along with another mental illness.
Therapists use some of the modalities above to treat dual diagnosis, but there are others. Treatment providers often use group therapy and group settings for this form of treatment.
Dual diagnosis treatment also includes approaches for specific mental health issues like post-traumatic stress disorder (PTSD).
Therapeutic Communities (TC)
Often used in long-term residential treatment settings, therapeutic communities utilize the support of peers in addressing co-occurring disorders.
These communities help people develop healthy behaviors, values, and attitudes in managing their conditions.
Dialectical Behavior Therapy (DBT)
This addiction therapy teaches clients skills that enable them to reduce self-destructive behaviors and control difficult or intense emotions.
With an additional focus on improving relationships, Dialectical Behavior Therapy helps clients be attentive to and accepting of what is going on, including their emotions, using the skills of mindfulness and acceptance.
Eye Movement Desensitization And Reprocessing (EMDR) Therapy
Treatment providers often use Eye Movement Desensitization And Reprocessing Therapy to address PTSD. Combat veterans sometimes experience severe PTSD, which can lead them to drug use or alcohol addiction.
EMDR is a psychotherapy that enables people to access and process traumatic memories in a way that helps them resolve the severe emotions related to those memories.
While commonly used as a standalone treatment for PTSD, therapists may use it in conjunction with other types of treatment for substance use disorders.
Medication-Assisted Treatment (MAT) In Conjunction With Therapy
Medication-Assisted Treatment is a medical approach that a treatment center may use in conjunction with the behavioral therapies mentioned above.
Studies have shown MAT to be an effective addiction treatment for alcohol use disorder and opioid use disorder.
MAT works by blocking the receptors that opioids or alcohol activate, reducing withdrawal symptoms and lessening the intensity of drug cravings.
Medications used for opioid treatment include:
Medications used for alcohol treatment include:
Naloxone is a medication that reverses an opioid overdose, saving people from potentially fatal consequences if administered quickly enough.
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- American Psychological Association (APA) — What is Cognitive Behavioral Therapy?
- Columbia University Irving Medical Center — Motivational Enhancement Therapy
- Motivational Interviewing Network of Trainers — Understanding Motivational Interviewing
- National Institute on Drug Abuse (NIDA) — Drugs, Brains, and Behavior: The Science of Addiction - Treatment and Recovery
- National Institute of Mental Health (NIMH) — Substance Use and Co-Occurring Mental Disorders
- The Psychiatrist — Contingency management: what it is and why psychiatrists should want to use it