Therapy for Alcohol & Drug Addiction: A Complete Guide

Therapy is an integral part of treatment for drug and alcohol abuse. Addiction is a complex neuropsychological disorder that can impact nearly every area of a person’s life, including their mental health, physical well-being, personal relationships, and livelihood. According to an annual report from the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 20.7 million Americans needed treatment for substance use disorders in 2017. However, only 2.5 million people in the United States received treatment or therapy for alcohol and drug addiction.

While initially daunting, substance abuse treatment can help individuals regain control of their lives. Effective treatment for substance use disorder includes an individualized treatment plan that treats the physical symptoms of addiction while also addressing the underlying causes of substance abuse and how it impacts the person’s mental health, social interactions, family relationships, career, and experiences with the law.

Addiction treatment programs generally involve a combination of individual and group therapy sessions that are designed to provide people in recovery with the necessary tools to be productive members of society and navigate their lives without drugs or alcohol.

While behavioral therapy is the most commonly utilized form of addiction treatment therapy, there are many different kinds of therapy used to treat drug and alcohol addiction. In fact, behavioral therapy is often combined with other types of treatment, including experiential, holistic, somatic, and neuroscientific therapies which are designed to treat alcohol and drug dependency.

What Therapies Are Available to Treat Substance Use Disorder?

Addiction treatment occurs either in an inpatient or outpatient treatment setting and often begins with detoxification to rid the body of drugs and alcohol. For some people, medication is prescribed, such as methadone or naltrexone to manage withdrawal symptoms. Once detoxification is complete, it is essential to treat the root cause of addiction and change behaviors to avoid relapse.

When people think of therapy for drug and alcohol addiction, they often think of “talk therapies,” such as counseling or psychotherapy. While these can be a good place to start, there is a far wider array of treatment options available. Treatment providers can help identify what types of treatment would be most effective, based on an individual’s unique needs and experience with substance abuse; including the length of time and specific substances that have been abused. Some therapies work alone, but a combination of treatments is often the most effective.

Talk Therapies for Addiction Treatment

Counseling is a broad term for talk therapies involving one or more facilitators and patients. Counseling helps individuals to understand their addiction and its root causes. Triggers are identified, and the necessary tools are developed to enable patients to address behavior patterns and prevent relapse.

Counseling is readily available. In fact, a 2019 SAMHSA (Substance Abuse and Mental Health Services Administration) report stated that individual and group counseling was available at 96.8% and 93% of US treatment facilities, respectively.

There are many different forms of counseling, including:

Individual Counseling

Taking place one-on-one with a counselor, individual therapy enables a person to identify and address their personal issues.

Learn more about individual therapy for addiction.

Group Therapy

Support group sessions often follow a plan such as the 12-Step Program to recovery used by Alcoholics Anonymous and Narcotics Anonymous. Group counseling provides the support of others in the same situation.

Learn more about group therapy.

Couples and Family Therapy

These sessions are available through a Marriage and Family Therapist (MFT). The aim is to counsel and support family members during the addiction treatment process. The impact on loved ones and the benefit of support from friends and family during the recovery process are important considerations.

Counseling incorporates a variety of methods and formats, and some of the most commonly used approaches are:

Cognitive-Behavioral Therapy

Cognitive-Behavioral Therapy (CBT) started in the 1930s and, as a result, is one of the most well-researched and successful forms of addiction treatment. CBT includes several different but related techniques that link an individual’s thoughts and feelings to their actions. A series of therapy sessions aim to break the cycle of negative thoughts causing detrimental addictive behaviors.

Originally developed as a method to prevent relapse when treating alcohol abuse, CBT is known to be effective in treating a range of mental health issues, including addiction. According to the National Institute on Drug Abuse, the skills that individuals learn through cognitive-behavioral therapy remain after the completion of treatment. In fact, as reported in one particular study, 60% of the patients in the CBT condition provided clean toxicology screens at their one-year check-ups.

Dialectical Behavior Therapy

A modified form of CBT, Dialectical Behavior Therapy (DBT), encourages individuals to develop skills that enable them to have improved emotional control and make healthier choices.

“Distress tolerance” is a key aspect of DBT. An individual is encouraged to develop mechanisms to cope with stressful circumstances without resorting to substance abuse.

Relapse Prevention

Relapse Prevention (RP) is a form of cognitive–behavioral therapy that aims to address high-risk situations for relapse and assist individuals in maintaining desired behavioral changes.

Acceptance and Commitment Therapy

This form of CBT relates to accepting and acknowledging an individual’s feelings towards things happening in their life. Once patients learn to accept that their feelings can be justified, they can start to make positive changes to their behavior patterns.

Motivational Interviewing

Motivational Interviewing aims to resolve ambivalence within an individual and motivate change. This type of CBT is designed to enable collaboration between the patient and the facilitator. Individuals are encouraged to feel in charge of their own sobriety, and this has been proven to increase commitment and, ultimately, success.

Rational Emotive Behavioral Therapy

Rational Emotive Behavioral Therapy (REBT) teaches that a person’s response to external events affects their feelings and behaviors, not the events themselves. By recognizing this and identifying irrational personal beliefs, individuals can make healthier behavior choices in times of stress or conflict.

Exposure Therapy and Systematic Desensitization

These therapies are similar because they seek to change an individual’s response to potentially triggering events and situations. Exposure therapy aims to stop the response altogether, whereas systemic desensitization seeks to change the response through “counter-conditioning.” Either way, an individual learns to handle situations differently without using stimulants and other substances.

Schema Therapy

Schema Therapy was devised as an alternative treatment approach when standard CBT is ineffective. Psychotherapists assist patients with identifying their long-held negative beliefs or schemas, many of which relate to early childhood. By changing their associated pattern of thinking, individuals can break the behavior cycle that is detrimental to their life.

Cognitive Therapy

Falling within the category of CBT, Cognitive Therapy primarily focuses on thoughts, feelings, and beliefs and less on behavior. Treatment aims to overcome the root cause of the problem by addressing the disorder and not just the behavior resulting from it.

Contingency Management

Contingency Management (CM) relies on the desire for a reward being greater than the desire to use the substance. CM incentivizes patients to reach pre-agreed goals through a voucher-based system or prizes.

While CM has been criticized by some for not addressing the root cause of the problem, it can be useful in breaking the cycle of behavior and starting a patient on the road to long-term recovery. According to the National Institute on Drug Abuse, giving patients tangible rewards, such as vouchers or even monetary incentives can be effective in treating substance abuse disorders by helping reinforce abstinence and other positive behaviors associated with recovery. A 2005 clinical study published in Arch Gen Psychiatry, found that incentive-based addiction treatment may also contribute to improved treatment retention.

Somatic and Neuroscientific Therapies for Treating Addiction

Post-traumatic stress syndrome (PTSD) is one of the most common root causes of drug and alcohol addiction. In addition to therapies that treat the emotional and psychological features of addiction, many treatment centers now offer programs that directly address trauma and how it is experienced in the body. Somatic and Neuroscientist therapies use a combination of psychotherapy and physical therapies to connect a person’s mind and body. Examples include:

EMDR (Eye Movement Desensitization and Reprocessing) Therapy

Research suggests there’s a connection between the rhythm of someone’s eye movements (similar to when they enter REM sleep) and traumatic memory. EDMR therapy is the practice of helping someone address their trauma through sporadic visual stimulation.

EMDR is an effective treatment to help patients heal from traumatic events, adverse reactions, and other triggers associated with their addiction. Unlike other types of therapy, which may be long-term and ongoing, EMDR consists of 8 treatments where the patient is asked to focus on their past, present, and future in relation to traumatic events.

During EMDR treatment, patients will be asked to recall traumatic memories while their vision is stimulated. This can help reprocess how these memories are stored, reducing their intense feelings and the need to escape them through drugs and alcohol.

Sensorimotor Psychotherapy

This somatic therapy is designed to treat trauma, trauma-related disorders such as PTSD, and difficulties stemming from unhealthy attachment patterns in infancy and early childhood. Known as a “body-centered talking therapy,” sensorimotor psychotherapy pairs elements of talk therapy with somatic movement (body movement) to address thoughts, feelings, and somatic experiences related to trauma. The goal is to manage the body, thoughts, and emotions to promote total healing.

Alternative Therapies for Holistic Treatment of Addiction

Holistic therapies for substance abuse focus on the mind, body, and soul and complement other forms of addiction treatment. These therapies are designed to focus on the body as a whole rather than address a specific element or ailment. Holistic therapies treat various conditions, from mental health concerns such as eating disorders to physical issues such as infertility. By taking care of one’s psychological and physical well-being, individuals can deal with the stresses and strains of everyday life more effectively. Patients can learn to handle challenging situations without resorting to previous detrimental behaviors.

There are a wide variety of holistic treatments available, and they are becoming increasingly popular. For example, the Society for Complementary and Integrative Health found that meditation practice in the US had grown threefold in popularity between 2013 and 2018. Its popularity makes it easy to continue engaging in meditation practices outside therapy sessions.

Examples of holistic therapies that can assist with addiction recovery include:

Meditation

A valuable additional tool in treating addiction, meditation can assist with ignoring cravings and other triggers that may resort in a relapse. It encourages people to look inward, focus on breathing, and ignore their external surroundings. By calming the mind and relaxing the body, individuals are more capable of dealing with stressful situations.

Mindfulness

Awareness of surroundings is encouraged without attributing negative thoughts and feelings. Individuals are encouraged to appreciate the simple things in life, such as the colors and smells of nature. When the world seems more pleasant and positive, a person’s motivation and commitment to recovery increase.

Nutritional and Exercise Coaching

A healthy body supports a healthy mind. Coaches teach individuals about the nutritional benefits of food and encourage exercise regimes such as yoga. Patients feel physically better, creating a more positive mindset and providing the strength to commit to recovery.

Acupuncture and Massage

Using ancient and modern techniques, holistic therapies, such as acupuncture and massage, have been used for centuries to combat many ailments. They provide physical relief and psychological relaxation and can be used as additional tools in the addiction recovery process.

Experiential Therapies for Treating Addiction

Experiential therapy involves taking patients outside of traditional therapy settings and providing them with activities that engage them. Participating in these activities encourages individuals to learn to cope with an array of emotions associated with everyday situations.

Addiction can be related to previous experiences, and this therapy can reawaken memories or feelings from the past. Experiential therapy enables patients to explore these issues and their personal responses to situations that may be triggering for them. Examples include experiencing pleasure, frustration, success, and pressure.

Examples of experiential therapies that can be used in recovery from substance abuse include:

Expressive Arts Therapy

Through drawing, painting, dancing, and playing music, a person can express themselves in non-verbal ways. Participants can express their thoughts and feelings through color, sound, and movement using imagination and creativity. Therapists are able to analyze the work created, devise a complementary therapy plan, and track progress.

Equine Therapy

During equine therapy, individuals work with specially trained horses and learn about caring for them. Working with horses requires concentration, selflessness, and teamwork. As a result, equine therapy programs can help people learn about boundaries and responsibilities, while improving self-esteem, self-awareness, confidence, and empathy.

Adventure and Wilderness Therapy

A form of group therapy, taking patients on adventures in natural spaces encourages them to reassess their surroundings and gain a greater understanding of their place in the world. It also encourages teamwork, strengthens bonds and relationships, and helps to develop a support network.

Additional Substance Abuse Treatments

New and innovative therapies are being developed that can be used alongside more traditional methods to support recovery from addiction. Examples of these include:

Nicotinamide Adenine Dinucleotide (NAD)

Nicotinamide Adenine Dinucleotide (NAD) is a coenzyme naturally found in the body. It has many functions, including acting as an antidepressant. NAD is administered in liquid form as an alternative to other medications used to detox the body. NAD provides patients with more energy, a sense of well-being, and positivity that can help stop the desire to relapse. NAD is particularly effective for those with alcohol, nicotine, or opioid addiction.

Reality Therapy

This type of therapy is becoming increasingly popular and encompasses a combination of psychotherapy and real-life practices. Reality therapy enables individuals to develop better coping mechanisms and alternative thinking patterns. Focussing on the current and future situation rather than the past, therapists ask individuals to concentrate on practical solutions. Often patients are taken into real-life scenarios and encouraged to look after themselves. They are exposed to situations that would usually act as triggers.

Find Treatment for Alcohol and Drug Use Addiction

Therapy options for substance addiction are many and varied. While those listed here are the most common types of therapy, others do exist. Addiction is unique, and there is no single treatment plan that works for everyone. It is essential to find the treatment program and therapy, or combination of therapies, that are right for you. With the right support and guidance, you will find the addiction treatment program that suits you, motivates you, and ensures your long-term recovery from addiction. Start your journey by talking to a trusted treatment provider today.