Drug Rehab: A Therapist’s Perspective

Drug Rehab: A Therapist’s Perspective

Drug Rehab: A Therapist’s Perspective

When entering a drug rehab program, addicts are first introduced to a therapist who becomes their support and counselor throughout the treatment process. A bond forms between the primary therapist and addict enhanced by the amount of time spent together in treatment as well as disclosure of intimate details to the therapist. The addict becomes vulnerable, allowing the therapist to help him or her change thoughts, patterns and behaviors related to drug addiction.

Admission to Drug Rehab

An addict enters addiction treatment because of various reasons. Whether it is legal issues, family influence, health concerns or recognizing the need for help, admitting to a residential treatment program is not an easy decision. An addict is filled with a tremendous amount of anxiety, stress, fear, and depression upon entering drug treatment. His or her brain is flooded with raw emotions after completing an alcohol and/or drug detox. A qualified therapist is aware of this emotional sensitivity and knows that some of the addict’s angst will be displaced on them.

Understanding displacement ,the misdirection of emotions, a therapist is taught to not take an addict’s intense emotions personally. A therapist is trained to do the initial session including obtaining psychosocial information, reviewing treatment rules and expectations, and encouraging treatment success while offering:

  • Unconditional positive regard
  • Validation of emotions
  • Supportive listening

After the initial session, the therapist has established rapport with the addict. The development of the relationship allows the therapist to have direct communication, challenging and confronting the addict during the counseling process.


In a comprehensive drug rehab, an addict will attend individual therapy sessions, group therapy, family therapy, educational lectures and inhouse Alcoholics Anonymous and/or Narcotics Anonymous (AA/NA) meetings. A quality drug rehab has a multidisciplinary team of doctors, nurses, therapists, and certified behavioral techs who all monitor and assist with treatment planning for the addict.

  • Individual Therapy – The primary therapist will conduct individual therapy with an addict regarding underlying issues that have led to his or her addiction, work towards beginning to resolve any problems created by substance abuse, and explore healthier ways of coping with feelings.
  • Family Therapy- The primary therapist will work with immediate family members in the addict’s life including their wife, children and parents depending on whom the addict is most involved with. The therapist will explore with family members how the addict’s addiction has impacted them and how to embrace family recovery. Family therapy sessions begin repairing relationships that have been damaged by addiction.
  • Group Therapy- During group therapy, the therapist will create an environment that helps the addicts connectwith one another through identification with stories, feelings and struggles. The therapist and group members also confront and challenge addiction related thoughts and behaviors during group therapy.
  • Educational Lectures- Daily educational lectures are offered on various topics. The primary therapist and other members of the treatment multidisciplinary team will provide lectures.  Some of these topics include: Anger management, relapse prevention, healthy relationships, mood management, spirituality, life skills and 12 step introductions.
  • AA/NA Meetings- Alcoholics Anonymous and Narcotics Anonymous is a 12 step recovery based meeting to help those who suffer from alcohol and drug addiction. A comprehensive drug rehab will offer in-house AA/NA meetings. This helps the addict become familiar with the program curriculum and make the transition to outside support groups smooth.

Individual and group therapy are complimentary components to Alcoholics Anonymous and/or Narcotics Anonymous and should not be used as a replacement for the programs. The responsibility of the therapist is to help the addict with changing patterns of behavior related to addiction and begin the process of recoverywhile in a drug rehab.

Relationship between Therapist and Client

Therapists and addicts will form a bond throughout the process of addiction treatment. This relationship is marked by all the same dynamics as a non-therapeutic relationship, although therapists in a drug rehab are not actual friends. A therapeutic relationship should include:

  • Healthy boundaries in the relationship dynamic. This is taught through therapist modeling behaviors and assertive communication with the addict.
  • Encouragement for recovery changes needed to get clean and sober.
  • Guidance and teaching the addict how to manage life without the use of drugs.
  • Challenge/confront unhealthy behavior patterns found in addiction.
  • Reframing negative thoughts related to self-esteem, self-worth, relationships, etc.
  • Relapse prevention techniques are explored specific to the addict’s situation.

In active addiction, many relationships are formed that are inconsistent, abusive and unhealthy. The new therapeutic relationship is extremely structured and at first, the addict may not trust it. Trust needs to be built first with the addict before he or she allows the therapist to help. Trust takes time and consistency. Having a qualified therapist who understands this dynamic is essential to the therapy process.

Aftercare and Discharge Plan

After 4-6 weeks in a drug rehab, both the therapist and addict have become part of the recovery process. A shift takes place in the therapeutic relationship when the discharge plan needs to be made. The therapist encourages outside support groups, private individual and/or family counseling, and continued fellowship within the 12 step program. Discharge planning with the therapist should include:

  • Decision for a half-way house, sober living or returning home.
  • Decision for continued care in intensive outpatient program or partial hospitalization program.
  • Private, individual and/or family counseling appointments made.
  • Psychiatric follow up appointment (if dual diagnosis is present).
  • 12 step meeting list around the area and contact with a temporary sponsor.

Therapists are happy to receive updates from addicts in recovery who have completed a drug rehab program at their facility. Substance abuse counselors want their clients to be successful but are trained to understand that relapse may be part of the process in recovery. The staff at a drug rehab center is a resource of support through the addict’s recovery process.