Although addiction is a complex and chronic disease, treatment is available. Despite their circumstances and past histories, many people live happy and fulfilling lives in recovery. That said, addiction treatment typically requires a blend of various emotional and physical changes.
While everyone is different with what they need, certain interventions naturally tend to have higher success rates than others. Let’s explore the evidence-based treatment strategies you should know.
Motivational interviewing can help people who feel ambivalent about their commitment to change. Many people struggling with addiction feel torn about recovery. On the one hand, they may recognize the dangerous perils of drugs and alcohol. On the other hand, they often feel terrified and insecure about the thoughts of releasing these vices.
Motivational interviewing consists of the following tenants:
- Empathy (providing encouragement and validation for the individual’s situation)
- Identifying and developing discrepancies (raising awareness to the difference between where the individual is “at” and where he or she wants “to be)”
- “Rolling” with resistance (meeting people where they are currently at)
- Fostering self-efficacy (helping people manage obstacles and succeed)
Motivational interviewing tends to be a brief, short-term intervention. However, it can be tremendously helpful in supporting people who feel uncertain about moving forward.
Cognitive-behavioral therapy (CBT) is a widely-known therapeutic approach that can treat a variety of psychiatric disorders. CBT operates on the premise that thoughts, feelings, and behaviors all intricately connected. By learning how to change your thoughts and reframe your perspective, you can learn how to change your feelings and your behaviors.
CBT clinicians believe that individuals often live with faulty thinking or cognitive distortions. In people struggling with addiction, these distortions may include:
- Polarized thinking (“I will never get better” or “I will always relapse”)
- Catastrophizing (“No matter what, I will feel miserable and bad things will happen”)
- Overgeneralization (“I felt triggered at that meeting, so I will feel triggered in all meetings”)
- Emotional reasoning (“Because I feel sad, life is sad”)
- Personalization (“This person couldn’t help me because they don’t like me”)
Learning these distortions- and developing healthier ways to change your thinking- can be a first step in changing your worldviews. CBT techniques entail a variety of interventions to help you engage in more realistic thinking and healthy behaviors. Such interventions can include:
- Pleasant activity scheduling (identifying and planning specific activities you will engage in on a regular basis)
- Mindfulness meditation
- Cognitive restructuring (identifying automatic thoughts and triggers and reframing them in a healthier way)
- Social skills and assertiveness training
Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) is an evidence-based treatment modality used to help individuals who struggle with emotional regulation, interpersonal distress, and compulsive tendencies. DBT helps people think and behave rationally, which makes it practical for acute issues related to substance use and other self-destructive behaviors like suicidal ideation.
DBT has four modules that include:
- Mindfulness (increasing engagement and awareness of the present moment)
- Interpersonal effectiveness (building assertiveness and promoting healthy relationships)
- Distress tolerance (learning to manage and cope with stressful life situations)
- Emotion regulation (developing healthy strategies for coping with painful emotions)
DBT is an active and engaged modality that can be taught in both individual and group therapy sessions. DBT focuses on helping individuals “find the middle ground” in difficult situations, which allows people react less intensely or negatively to particular emotions.
Many people use drugs or alcohol to self-medicate trauma. Unfortunately, even if the individual wants to forget the troubling details of their past, this strategy rarely works. Once becoming sober, trauma symptoms often return with a vengeance. Unequipped to cope with these symptoms, many people relapse.
Trauma therapy helps individuals learn, cope, and heal from their pasts. To live a meaningful life in recovery, people must learn to cope with various triggers. That often includes facing and dealing with the issues that propelled drug use.
Trauma therapists work with clients by focusing on:
- Building a safe and supportive therapeutic alliance
- Increasing the ability to talk about the events that happened
- Strengthening healthy coping skills to manage trauma-related symptoms
- Improving self-esteem and expanding one’s concept of self-worth
- Cultivating new meaning and joy regardless of the trauma
- Creating a healthy support system
Trauma therapy can be brief, but many people benefit from more long-term treatment. Building trust and safety with another person can take time. Likewise, trauma work can be inherently triggering. Therefore, the individual must know how to self-regulate in case substance cravings arise.
Addiction can affect every aspect of one’s interpersonal relationships. Most addiction experts agree that addiction is a family disease. In other words, each member plays a role in maintaining and potentially reinforcing the ongoing problem.
Family therapy can help untangle some of the issues present in family systems plagued by addiction. These issues may include:
- Unhealthy communication styles
- Intergenerational trauma
- Codependency and enabling
- Parenting and co-parenting needs
- Family reunification
- Misconceptions or lack of awareness about substance problems
In family therapy, the addicted client is not the scapegoat for the family’s issues. It’s not about placing blame or asserting who’s responsible for what problem. Instead, the therapist works collaboratively with each member to provide a roadmap for healing.
It may not always be appropriate to have the entire family member present. Likewise, marital or couples counseling may be a better option- especially if addiction is threatening an intimate relationship. That said, the intentions are the same. Therapists work with whoever is in the room to focus on creating sustainable and meaningful changes.
Group therapy provides a powerful opportunity for people to learn that they are not alone in their struggles. Many treatment centers offer a variety of group therapies focusing on essential skills including:
- Relapse prevention
- Healthy living
- Holistic support (acupuncture, fitness, nutrition)
- Stress management
- Self-esteem and self-worth
- Healthy relationships
- Family dynamics
- Creative expression (art, music, writing, dance)
Professional facilitators run these groups, and they ensure group safety and comfort within the room. They often balance providing useful education while also encouraging members to share and discuss relevant issues freely. Groups teach people how to increase their vulnerability among others while strengthening their active listening skills.
With over two million members, Alcoholics Anonymous (AA) has a presence in 180 countries worldwide. Today, there are dozens of other extensions of AA, such as Narcotics Anonymous, Cocaine Anonymous, Heroin Anonymous, and Pills Anonymous.
12-Step programs are free, anonymous, and widely accessible without any age, education, or socioeconomic requirements. The only requirement is a desire to stop drinking. Members attend meetings and participate, share, and build relationships with others. Some members obtain sponsors and work the 12 Steps under the pretense that engaging in these actions will build a new, positive way of living.
Medication can be an essential component of one’s treatment. Likewise, many people benefit from Medication-Assisted Treatment (MAT) as part of their recovery plans. Regarding such programs, compliance and commitment are the most essential cornerstones in predicting successful outcomes.
Additionally, people often take medication to manage co-occurring psychiatric conditions or physical health conditions. Failure to take these medications can exacerbate unwanted symptoms- which can trigger cravings and increase the risk for relapsing.
Thus, medication compliance remains an essential part of a successful recovery. People often benefit from having a wraparound team of professionals that may consist of:
- Medical doctors
- Licensed therapists or social workers
- Case managers
This team works together to track symptoms, measure compliance, and provide you with the support you need should you require changes to your medication.
Contingency management reinforces positive, desirable behaviors via incentive-based interventions. The premise is simple: promote good behavior (like abstinence) with enticing rewards, and the individual will be more likely to remain motivated in achieving specific goals.
Of course, the types of rewards and behaviors will vary depending on the person and situation. In a formal treatment program, the facility may offer rewards including:
- Cell phone privileges
- Visitations with family and friends
- Excursions to outside activities
- Food items
The rewards need to be realistically appropriate for the age group and demographic. They should not be so grandiose that they are unsustainable in the long run. However, they should be motivating enough that the individual will want them.
Final Thoughts on Intervention Strategies
Everyone’s recovery process looks different. What works well for one person may be downright ineffective for someone else.
That said, effective treatment facilities tailor their programs to meet the individual needs of each client. If you are looking for support on your journey for recovery, don’t wait another day. Contact us to learn how we can provide you with the best treatment options for you or your loved one.