12 Evidence-Based Therapies for Individualized Addiction Treatment
Finding individualized evidence-based therapies for treatment can be the key to long-term recovery from addiction. Everyone’s experience with addiction is different, so the type of addiction treatment you choose is a vital key to recovery success. Simply put, it’s critical to find a therapy that works best for you.
When I got sober ten years ago, I lived in the U.K. The only options in my area were Alcoholics Anonymous (AA) or very limited private treatment. I was out of work and there were no programs that could fund treatment. It felt like I had no choice but to get sober in AA.
I’d tried to do it alone multiple times, but I couldn’t get more than a few days of sober time. I kept relapsing using the “cold turkey” method. But as I grew, so too did my revelations about recovery and the kind of support I needed.
AA has this analogy that recovery is like peeling back layers of an onion to get to the core of who you are. That was my experience in navigating different therapies throughout my recovery journey. The more I revealed, the more I was able to meet my needs for healing.
Determining Your Needs for Treatment
A critical part of the recovery process is being able to get in touch with your needs. Even in the midst of addiction, you can determine that you need to find and pay for treatment or housing, for example.
To determine the right kind of addiction therapy for you, consider:
- Severity of use: The duration and intensity of use will help you to determine if you’ll benefit from inpatient treatment and/or detox. It can be dangerous to stop using certain medications so it’s best to speak to a treatment specialist who can advise you on the best course of action.
- Dual-diagnosis: If you have any other medical conditions, including mental health diagnoses, you may also benefit from treatment under medical supervision in an inpatient facility.
- Commitments at home: If you have responsibilities, like children, and can’t leave home, you may want to opt for outpatient treatment options or partial hospitalization.
Evidence-Based Therapies for Addiction
There are a range of clinical and non-clinical therapies available for addiction treatment. We’re going to focus on evidence-based therapies. These treatments fall into the clinical category.
When we’re talking about treatment, we usually think of rehab. But addiction therapies are not limited to inpatient addiction treatment.
They also include:
- Detox: As the name suggests, this therapy provides physical detoxification from substances that can be dangerous to stop alone. Generally, this type of treatment is for people on the acute end of the substance use disorder spectrum and have a physical dependency on a substance.
- Inpatient Treatment Programs: Otherwise known as rehab, inpatient programs involve staying at a facility staffed with nurses, doctors, techs, and psychologists or counselors. They help you achieve a sustained period of recovery. Typically, stays are 30, 60, or 90 days in duration depending on the severity of addiction and any co-occurring disorders. Think of inpatient treatment as a one stop shop for treating your addiction and providing you with the tools you need to sustain sobriety. Note: some inpatient programs also provide detoxification services.
- Intensive Outpatient Programs: As the name suggests, it is outpatient (meaning you can stay at home), but also intensive enough to sustain recovery. Intensive outpatient programs typically require a person to attend nine to 20 hours per week of treatment over the course of two months to a year. This type of program is best suited to those who have a strong family support system, a stable home environment, access to transportation, and a willingness to attend regular treatment sessions.
- Outpatient Addiction Treatment: Like inpatient rehab , but you attend less intensively, during evenings or weekends. Outpatient is best suited to people who have work or school commitments and each facility will have different expectations as to the frequency of visits per week.
- Partial Hospitalization: This involves staying at a stand alone clinic or hospital for 4-8 hours per day, but returning home at the end of the day. These programs last around 3 months and are best suited to people with a stable and supportive home environment.
- Residential Programs: These provide a sober living environment together with treatment services. Stays can be anywhere from a month to a year or longer. These programs have various phases of treatment to assist the person in establishing and maintaining recovery. These types of programs are great for people who don’t have stable living or employment, and/or limited social support.
- Medication-Assisted Treatment (MAT): Otherwise known as pharmacology or pharmacotherapy, this is the use of medications, together with behavioral therapies, for the treatment of opioid use disorder and alcohol use disorder. MAT is now considered the gold standard of therapies for opioid addiction because it reduces cravings, improves patient survival rates, and increases retention in treatment programs. MAT is best suited to those with opioid use disorder or alcohol use disorder.
Behavioral Evidence-Based Therapies
There are a range of behavioral therapies that can be used alone or in combination with the above treatment programs. Typically, any kind of formal treatment program will involve some kind of behavioral therapy, of which there are many (see below).
The science demonstrates that, overall, psychological approaches are effective — particularly cognitive behavioral approaches — at treating substance use. And they are even more effective when combined with other therapies like medication.
Some of the most effective evidence-based therapies include:
- Eye Movement Desensitization and Reprocessing (EMDR) is an 8-stage therapy that uses eye movements, light, and psychotherapy to help individuals overcome trauma.
- 12-Step Facilitation is a semi-structured program that is led by a facilitator over the course of four to 12 sessions. Ultimately, the goal is participation in the 12 Step program like Alcoholics Anonymous to help people abstain from drugs and alcohol. The facilitation sessions also offer the opportunity to discuss attendance at AA and to discuss anything that arises.
- Cognitive-Behavioral Therapy (CBT) includes a range of approaches that work on the premise that behavior is influenced by a cognitive process. The belief underpinning CBT is that addiction is a maladaptive coping strategy, therefore the therapy focuses on developing new behavioral skills for coping. The therapies involved under the umbrella of CBT include:
- Dialectical Behavioral Therapy (DBT) also includes skill-building to positively influence behaviors, with the addition of mindfulness strategies to regulate emotions and cope with stress.
- Contingency Management also works on behavioral modification, but with an incentive-based approach to positively reinforce change. Participants may be given vouchers, financial incentives, or other privileges to reward positive changes.
- Rational Emotional Behavioral Therapy (REBT) is an action-oriented therapy that identifies negative or irrational thought patterns that lead to negative thoughts or emotions. By identifying these thought processes, the idea is that you can use REBT to interrupt these patterns and create healthier and more productive beliefs and behaviors.
- Behavioral Couples Therapy: As the name suggests, this type of therapy involves both partners in therapy i.e., the person with substance use disorder and their partner. The goal of couples therapy is to overcome addiction and to improve the relationship through better communication, acceptance, and change.
- Family Therapy: Like couple’s therapy, family therapy involves anyone in the immediate family of those struggling with addiction. Similarly, it also works to improve family communication, create lasting change, and improve relationships.
- Motivational Interviewing (MI) This is a technique used to explore and resolve ambivalence around substance use by motivating the individual to make positive behavioral MI involves empathetic listening, reinforcement, and supports the individual in their ability to meet their goals.
- Acceptance and Commitment Therapy (ACT): This works on the principles of acceptance, mindfulness, tolerance and personal values. ACT’s goal is to develop the flexibility to tolerate difficult emotions and experiences while maintaining recovery.
- Community Reinforcement Approach (CRA/ACRA): This therapy uses group-based behavioral interventions that provide responses (or consequences) and rewards in response to certain behaviors, like addiction or sustained recovery.
- Relapse Prevention or Mindfulness Based Relapse Prevention (RP/MBRP) This utilizes strategies and skills-building to help promote recovery and decrease relapse.
How My Needs Changed Throughout My Recovery
As I mentioned earlier, 12-step recovery initially helped me get sober. But as I progressed in my journey — or revealed more layers of the onion — I found that I had other issues to deal with: unresolved trauma, depression, and ADHD.
Ultimately, that led me to seek out a trauma therapist to help work through my traumatic childhood. Once I had gained some healing, I could then move on to developing solid coping strategies and emotional regulation techniques through dialectical behavioral therapy.
The combination of evidence-based therapies during sustained recovery has been life changing. No longer do I feel like I’m on an emotional rollercoaster and I haven’t had a desire to drink or use for years. These coping strategies have been essential to me not only in sustaining recovery, but also in my ability to take on challenges in life, like buying a house, getting married, and going back to school.
Whatever you choose in your pathway of recovery, know that there are always options available to you as you progress through your journey.
If you or someone you love is experiencing a substance use disorder, help is available. Call 800-662-HELP (4357) (Who Answers?) today to speak with a treatment specialist.