Substance Use Disorder Treatment Therapy Models | Treating Drug Addiction
Just as there are many types of substances — both legal and illicit — that a person can grow addicted to, there are a wealth of alcohol and drug addiction counseling techniques to help a person overcome substance use disorder (SUD).
Once a person has safely detoxed from the drug(s) in question, the focus can shift to overcoming cravings and tackling any co-occurring disorders, such as anxiety, depression, or post-traumatic stress disorder (PTSD).
Medications may be prescribed for both the pangs of withdrawal and for any ongoing mental health conditions, but turning to one of the many available substance use disorder treatment models (or a combination of therapies) can help an individual better achieve sobriety.
What Is Psychotherapy?
Psychotherapy is a very popular treatment mode that’s also referred to as talk therapy. It covers several treatment approaches, usually designed to help people identify and work on changing problematic thoughts and behaviors. It can include improving low self-esteem, gaining confidence, identifying triggers, or developing relaxation techniques.
Usually licensed and trained mental health professionals — psychiatrists, psychologists, social workers, psychiatric nurses, or counselors — meet with clients one-on-one or in a group.
Reasons people participate in psychotherapy include:
- Working through stress (job, family, loss of a loved one, end of a relationship, etc.)
- Depression, bipolar disorder, or PTSD, either as the primary treatment, or paired with medication
- Use of alcohol and/or drugs to the point where it harms oneself or others
A person’s primary care physician typically conducts an initial screening to make sure there is no other root cause to the symptoms in question.
When looking for a therapist, people should consider credentials, experience, and specialties.
Psychotherapy can take many forms, and many therapists combine approaches to find ways to best help their clients.
Different Types of Psychotherapy
There are many types of psychotherapy, including (but not limited to):
- Cognitive behavioral therapy (CBT). Originally used to help problem drinkers, CBT has expanded to help with other addictions. Clients learn to identify troubling behaviors, patterns, and triggers as they develop healthier coping strategies — essentially changing one’s actions to change one’s feelings. Sometimes CBT is combined with other behavioral therapies or medications (for co-occurring disorders such as depression).
- Dialectical behavior therapy (DBT). DBT has a lot in common with CBT, but it encourages clients to accept uncomfortable feelings, thoughts, and behaviors instead of fighting them. It is a way to come to terms with them and move forward from there. Therapists act as guides through the process and coach their clients through new strategies to relax and cope.
- Eye movement desensitization and reprocessing therapy (EMDR). This approach is commonly used to treat PTSD (a problem many military veterans face, sometimes coupled with substance use disorder). There is some controversy whether the treatment is effective, but clients typically perform back-and-forth eye movements and focus on tapping or other light distractions for short periods of time while recalling a traumatic event. The shift in focus allows people to relive memories while keeping more detached from them.
- Exposure therapy. This approach is a form of CBT, most often used for anxiety disorders. Here, clients learn how to cope with factors that trigger their anxiety, either by being exposed to the source of stress all at once, or in small increments.
- Psychodynamic psychotherapy. The goal here is to identify negative behaviors and feelings stemming from current and past experiences and resolve them. Communication, wants, needs, and healthy and unhealthy coping mechanisms may be discussed. Someone with an overbearing parent, for example, may struggle with forming a romantic relationship later in life. Becoming aware of that may make it easier for the client to move forward.
Psychodrama Therapy
Another form of treatment, psychodrama therapy, has been around since the 1920s. Today there are dozens of techniques, rooted in theater, psychology, and sociology, where individuals, duos, or groups act out scenes to try to get closer to an emotional resolution.
During the course of this therapy, individuals may be instructed to speak, essentially thinking out loud, to work through their thoughts and feelings.
In larger groups, one person may mirror another, repeating or reenacting what the individual may be experiencing. Role reversals and role playing are also sometimes utilized to find different perspectives.
Using another approach, group members may act out different roles from a person’s life. The therapy also may use dolls or puppets to help people express their thoughts or work through their emotions.
Psychodrama therapy has been used in Europe to help people with schizophrenia, anxiety (such as worries about a job interview), and substance use disorder.
Narrative Therapy Treatment Plan
Narrative therapy is a fairly recent development. In this type of therapy, a person’s experiences make up their narrative, or story. If that storyline is destructive, the therapist and the client will collaborate to develop a new, more positive narrative.
Liken it to a client being the writer of their story. Their therapist acts as their editor, guiding and shaping the process as they point out significant events and behaviors, and encouraging the client to, in essence, not relive the same story.
This process externalizes problems. By taking a detached view, the client can better observe and overcome obstacles as well as craft a more positive outcome.
In the narrative approach, the person is not defined by a behavior. The client is not just a drug user. There are reasons why they resorted to substance use disorder. The narrative approach aims to get to the bottom of that and map out a drug-free future.
Does Psychotherapy Work?
Psychotherapy is a respected and effective approach to working with mental illness and one of the addiction treatment models with a solid track record. CBT and DBT in particular have proven valuable in helping people overcome addiction. Each case is unique, however, and a therapist should work with their client to develop a plan that best suits them.
Sources
- nimh.nih.gov – Psychotherapies
- drugabuse.gov – Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine)
- nami.org – Psychotherapy
- ptsd.va.gov – PTSD and Substance Use Disorder in Veterans
- healthline.com– EMDR Therapy: What You Need to Know
- health.harvard.edu – Types of Psychotherapy
- ncbi.nlm.nih.gov – The Core Techniques of Morenian Psychodrama: A Systematic Review of Literature
- books.google.com – Understanding Narrative Therapy: A Guidebook for the Social Worker
- scholarworks.smith.edu – The Efficacy of Narrative Therapy Approaches with Self-Injurious Clients
Medical disclaimer:
Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.
Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.
