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Therapy for Drug and Alcohol Addiction Treatment

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Deciding to enter a drug and alcohol addiction treatment program can be one of the most beneficial and challenging decisions you ever make. It is important to choose a treatment program that suits your specific needs and recovery goals. This article will cover what addiction is, the risk factors for developing addiction, treatment options (including therapy for drug addiction), and how to locate effective addiction treatment programs near you.

Many treatment programs offer a variety of therapies that can include cognitive behavioral therapy, family counseling, and motivational interviewing.1 These therapies, along with other modalities, will be explored in greater detail.

What Is Addiction?

According to the American Society of Addiction Medicine, addiction—also called substance use disorder—is defined as a treatable and chronic medical disease that involves complex interactions among genetics, brain circuits, the environment, and an individual’s life experiences.2

Symptoms of addiction can range in severity and can present differently in each person. Addiction is characterized by uncontrollable or compulsive drug-seeking behavior and drug use despite negative consequences and can cause permanent changes in the brain.1

What Are the Risk Factors for Addiction?

Risk factors for addiction exist on an individual and societal level, and they are features that can be present in:3

  • The family.
  • Culture.
  • Community.
  • Biology.
  • Psychology.

The more risk factors you have, the more likely you are to have adverse outcomes and develop a drug or alcohol addiction.3

Risk factors can be permanent or temporary and can include:3

  • Childhood abuse, maltreatment, or trauma.
  • Having parents who use drugs and alcohol.
  • Having parents with mental illness.
  • Violence.
  • Lack of parental involvement/family support.
  • Poverty.
  • Experiencing racism.
  • Lack of economic opportunity.

Risk factors can present throughout your lifetime, and additional risk factors include:4

  • Availability of drugs and alcohol in school.
  • Poor peer refusal skills (difficulty saying no to peer pressure.)
  • Aggressive behavior in childhood.
  • Drug experimentation.
  • Community poverty.
  • Lack of parental supervision.
  • Age of first use. (The earlier a substance is taken, the higher the risk for addiction.)
  • Amount of substance taken.
  • How the substance is taken. (For example, injecting or smoking the substance increases the risk for addiction.)
  • Gender.
  • Ethnicity.
  • Underlying mental illness.

Researchers are finding that the impact the environment has on a person’s genetic expression (called epigenetics) accounts for 40%–60% of a person’s risk for developing an addiction.4

Protective factors counter risk factors and can include:3

  • Social competence.
  • Positive self-image.
  • Self-control.
  • Effective parenting.

Both risk and protective factors influence one another throughout a person’s life.3

Types of Treatment Programs for Drug and Alcohol Addiction

Fortunately, there are several different substance abuse treatment programs available to help you live a life free from addiction. Treatment programs are offered in several settings that range in intensity. Services and interventions vary depending on the treatment program you choose and on your treatment plan. You and a medical/addiction professional will develop a treatment plan that addresses your unique needs and overall recovery goals.

Common types of treatment programs include:5

  • Detoxification (detox): Detox is the elimination of drugs and alcohol from the body. It is important to note that detox alone is usually only the first step of a substance abuse treatment plan. Learn more about 3-day, 5-day and 7-day detox programs.
  • Inpatient treatment: Inpatient treatment is an intensive form of therapy that involves living at the treatment facility while receiving treatment, which can include therapy, support groups, and constant supervision by medical/addiction professionals.
  • Outpatient treatment: Outpatient treatment ranges in intensity depending on the type of outpatient program you choose; during an outpatient program, you will live at home and receive counseling and other services at an outpatient clinic.

If you struggle with a mental health disorder and substance use disorder, co-occurring disorder or dual diagnosis treatment may be included as part of your treatment plan. Co-occurring disorders refers to the presence of both a mental health issue and a substance use disorder. Effective treatment should address both disorders at the same time.6

Other services can be incorporated into your treatment plan. These services are summarized below, and also discussed in greater detail further down the page.

  • 12-Step programs: A group setting can be powerful because it capitalizes on the social reinforcement provided by peer discussion that helps encourage a substance-free lifestyle.5
  • Medication: Medication may be needed in conjunction with therapy and other counseling.6
  • Behavioral therapy: Includes many therapies that work on engaging people in treatment, providing incentives, and teaching skills to maintain abstinence.7
  • Cognitive behavioral therapy (CBT): Involves improving self-control through learning new skills and developing coping strategies to prevent relapse.8
  • Contingency management: Provides tangible rewards for achieving abstinence.9
  • Rational emotive behavioral therapy: A form of CBT that focuses on regulating thoughts, feelings, and behavioral disturbances.10
  • Dialectical behavioral therapy (DBT): A form of CBT that includes the skill of validating or accepting uncomfortable emotions, behaviors, and thoughts.11
  • Motivational interviewing: Helps to quickly motivate people to engage in treatment and commit to abstinence.12
  • Eye movement desensitization and reprocessing (EMDR): Used to treat PTSD by reducing emotional distress from traumatic memories.11
  • Family- and community-based treatment: Focuses on substance use and other co-occurring problems, such as family conflict, mental illness, childhood mistreatment, and unemployment.13
  • Community reinforcement approach: Uses a variety of reinforcers or rewards from different areas of your life (family, monetary, social) to help make abstinence more rewarding than substance use.14
  • The Matrix Model: Used to engage people who use stimulants in treatment and help them achieve abstinence through learning about addiction.15
  • Integrative approach: Applying concepts and interventions from various effective therapies.16
  • Aftercare planning: Working with a professional in planning for services once treatment is complete. These can include employment services, medication, and other social services.6

Behavioral Therapy

Many behavioral therapies are effective in treating substance use disorders and addiction, and they strive to:7

  • Work to engage people in treatment.
  • Provide incentives for abstinence.
  • Help change feelings and attitudes that contributed to addiction.
  • Improve skills to help manage stress and avoid relapse.

These behavioral therapies will be explored further.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (or CBT) helps you:8

  • Recognize unhealthy thoughts and behaviors that led to addiction.
  • Correct and replace unhealthy thoughts and behaviors through the learning of new skills.
  • Identify potential triggers for relapse and exercise self-control by developing healthy coping skills.

For example, if you struggle with alcohol addiction, you can learn ways to reduce your exposure to alcohol by attending restaurants where alcohol isn’t served and learning how to tolerate discomfort when around alcohol.

Contingency Management

With contingency management:9

  • You are provided with rewards in the form of vouchers or prizes when you meet abstinence milestones.

For example, once you achieve 10 days of sobriety, you could receive a voucher that holds a $10 monetary value that can be used for movies, food, or other incentives.

Rational Emotive Behavior Therapy

Rational emotive behavioral therapy:10

  • Is a form of CBT.
  • Believes that your thinking largely contributes to the behavioral and emotional upset that can lead to addiction and other problems.
  • Focuses on the present moment.
  • Identifies unhealthy thoughts and emotions, as well as problematic behaviors that negatively impact quality of life and life satisfaction.
  • Teaches strategies to replace dysfunctional thoughts with realistic, healthy, and rational thoughts that can improve healthy behaviors and increase life satisfaction.

For example, identify a dysfunctional belief you have about your capabilities and replace it with healthy, rational thoughts to improve self-esteem and reduce depression.

Dialectical Behavioral Therapy

Dialectical behavioral therapy, or DBT, uses concepts from the CBT approach, as well as:11

  • Incorporates acceptance and validation skills.
  • Strives to find a balance between change and acceptance.
  • Teaches acceptance skills, such as mindfulness to help tolerate unhealthy thoughts and emotions.
  • Teaches change skills, such as coping skills and behavior change.

For example, if you are struggling with grief and the loss of a loved one, acceptance can help you effectively work through your grief without reacting to it and making the situation worse.

Motivational Interviewing

Motivational interviewing is geared toward quickly increasing your motivation for change and involves:12

  • Completing an initial assessment session.
  • Attending 2–4 individual therapy sessions with a therapist.
  • Developing self-motivating statements about abstinence.
  • Building a plan for change through an increase in motivation.
  • Developing coping strategies for high-risk situations.

For example, you identify strong reasons why you want to remain abstinent and work on identifying goals you want to achieve, such as finding a new job, through your increased motivation.

Eye Movement Desensitization and Reprocessing

Eye movement desensitization and reprocessing (EMDR):11

  • Replaces negative emotional reactions with positive or neutral reactions or thoughts.
  • Uses repetitive eye movement in 20–30 second intervals to help change emotions and emotional reactivity.

For example, a therapist may use sound to stimulate your brain with back-and-forth eye movements while you recall traumatic memories.11

Family and Community-Based Treatments

Family therapy:13

  • Involves you and at least 1 other family member.
  • Teaches and applies behavioral skills taught in therapy to the whole family.
  • Seeks to improve overall family functioning.
  • Encourages behavioral and parenting goal-setting. Goals are reviewed each session, and you are rewarded by family members for goal achievement.

For example, if your goal is not to yell when angry, your loved one rewards you with a hug, positive praise, or other incentives when that is achieved.

Support and self-help groups, including 12-Step programs:17

  • Promote abstinence through affiliation and participation in 12-Step self-help groups.
  • Focus on acceptance of addiction as a disease and surrendering to a higher power.
  • Encourage active involvement in the 12-Step process along with others who are working towards recovery.

Self-help groups such as Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are shown to be effective in combination with other interventions and therapies.17

Community Reinforcement Approach

The community reinforcement approach:14

  • Is an intensive 24-week outpatient program.
  • Utilizes a variety of reinforcers, such as family, social, and recreational incentives, as well as material rewards, to make abstinence more attractive than substance use.
  • While abstinence is maintained, new life skills are being taught and applied to various areas of your life.

For example, you receive a variety of rewards, and their value is determined by your length of abstinence; through this process, you learn how to engage in relationships and manage stress without substances.

The Matrix Model

With the matrix model:15

  • You learn important concepts related to both addiction and relapse.
  • Your therapist acts as your coach and develops a strong rapport and trust with you.
  • The relationship with your therapist is used to reinforce positive behavior change.
  • Sessions focus on developing your self-esteem and self-worth.
  • Interventions include other treatment modalities such as relapse prevention, family therapy, and support groups.

For example, your treatment plan may include developing coping skills to prevent relapse, as well as family therapy sessions.

Integrative Approach

Research shows that combining different therapies and using a variety of approaches is beneficial and that there is no single treatment approach that is effective and suitable for all people.16

Integrative therapy combines a variety of different treatment styles, therapies, and approaches and addresses the unique needs of each person.16 No two people are alike, and effective treatment plans need to address the unique needs and factors of each person.6

How Can Therapy Help Me?

Research demonstrates that therapy can be effective in treating addiction by:18

  • Modifying behaviors, feelings, and thoughts that contribute to your addiction.
  • Preventing relapse.
  • Improving overall family functioning.
  • Helping you obtain mutual support from peers who share similar goals.
  • Addressing all of your unique needs and challenges that can include mental health, medical, social, and other individual needs.

Improving relationships with loved ones, managing symptoms of mental illness, and strengthening self-esteem are just some of the benefits—in addition to being substance-free—that can result from seeking addiction therapy.

Find Treatment Options or Rehab Centers Near Me

If you are struggling with addiction, don’t wait to get help. You can benefit from all that treatment and therapy have to offer, such as learning healthy coping skills to manage stress, improving relationships, and managing mental health symptoms, when you start treatment. American Addiction Centers (AAC) maintains trusted facilities across the country. Call AAC free today at to learn more about rehab programs and treatment options. You can also locate a rehab center using our online directory or instantly check your coverage provided by your health insurance provider.

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Kristen Fuller, MD, enjoys writing about evidence-based topics in the cutting-edge world of mental health and addiction medicine and contributes to medicine board education. Her passion lies in educating the public on the stigma associated with mental health. Dr. Fuller is also an outdoor activist, an avid photographer, and is the founder of an outdoor women's blog titled, GoldenStateofMinds. In her free time, she enjoys hiking, backpacking, skiing, camping, and paddle boarding with her dogs in Mammoth Lakes, California, where she calls home.
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