There are different types of therapy used in the treatment of individuals with a substance use disorder (SUD). The best therapies for substance abuse treatment are those that are evidence-based. This means that there is substantial research and evidence supporting that these types of treatments yield positive outcomes. From researchers to those working with patients, certain types of treatments have been found to work better than others when it comes to substance abuse treatment therapies.
What is Psychotherapy?
Often referred to as simply ‘therapy’ these are actually psychotherapies. The American Psychiatric Association defines psychotherapy as a talk therapy used to help individuals with a broad range of mental and emotional issues to eliminate or control associated symptoms so they can better function on a daily basis as well as increase overall well-being.
Psychotherapy is often used to treat issues associated with the following:
- Substance or alcohol use disorder
- Medical illness or loss
- Loss of a loved one
- Mental health disorders like anxiety and depression
Therapy can be provided by different types of service professionals. These include:
- Licensed social workers
- Licensed professional counselors
- Licensed marriage and family therapists
- Psychiatric nurses
- Other specially trained in psychotherapy
In addition to a number of different types of providers, there are also different types of therapy sessions. Some of the most common types of therapy used with substance abuse treatment are as follows:
- Individual therapy
- Group therapy
- Family therapy
- Couples therapy
The specific type of therapy, who provides it, and the types of sessions involved depending on the individual and their unique needs. One of the first steps in determining this is undergoing a comprehensive evaluation. For those with an alcohol or substance use issue, there can also be co-occurring disorders such as anxiety or depression. In addition, many with substance abuse issues have trauma in their past. For these reasons and more, it is crucial to get a thorough evaluation by a professional when seeking treatment for either a drug or alcohol issue.
Research indicates that when a person has co-occurring disorders, such as alcohol use disorder (AUD) and anxiety, it’s imperative to treat both mental health disorders at once. This helps the individual to address unresolved issues which may be fueling both issues. When it comes to co-occurring disorders, one often fuels or worsens the other and vice versa.
Does Therapy for Substance Abuse Work?
The American Psychological Association reports that about 75% of individuals who engage in therapy find benefits from it. Psychotherapy has been shown to have the following benefits:
- Improve emotional states
- Improve behaviors
- Decrease associated symptoms
- Fewer medical problems
- Fewer sick days
- Increase satisfaction at work
- Increase overall life satisfaction
In addition to these changes, therapy has shown changes in the brain. Several studies have revealed changes in the brains of individuals who have undergone therapy. Individuals with depression, panic disorder, PTSD, and more show brain changes similar to those in people who have taken medications to help with their mental health disorders.
Psychotherapy or therapy works by first developing trust between the individual and therapist. Once trust has been established individuals are able to open up about past and present issues causing them distress. In some cases, the person may not be fully aware of what is causing the distress, in these cases the therapists help them to uncover this. In addition to this piece of therapy, an important part is the identification of thoughts, behaviors, and patterns that aren’t working and replacing these with healthier, more productive ones.
When it comes to therapy for alcohol or drug use, there are certain types that have proven to be more successful than others.
3 Types of Substance Abuse Treatment Therapies
While there are many different types of therapies available, years of research and hands-on work have shown a few to be more successful when it comes to treatment for substance abuse. These include treatment for alcohol use disorders, substance use disorders, and process substance abuses such as sex and love substance abuse or gambling. It’s important to understand that just as each person is not the same, the type of therapy used for one person may not be what’s best for the next. In addition, only engaging in one type of therapy may not be best for everyone. For example, an individual recovering from alcohol abuse may need to participate in individual, group, and family counseling. substance abuse treatment is not a one size fits all approach. Treatment programs should be built to best meet each person’s unique and often complex needs.
Here are some of the most commonly used and most effective types of treatment for substance use disorders:
1. Cognitive-behavioral therapy or CBT
This type of psychotherapy has been shown to lead to significant improvement in functioning and quality of daily life. According to the American Psychological Association, CBT is based on several core principles. These are:
- Mental health disorders are partly based on faulty or unhelpful ways of thinking
- Mental health disorders are partly based on learned patterns that are unhelpful
- When individuals with these disorders learn new ways of thinking and coping, symptoms are relieved and they are more effective in their day to day lives
CBT works, in part, by changing thought patterns, there are several ways commonly used to do this. The first step is the realization of these distorted thought patterns. After this recognition, the therapist helps the individual to re-evaluate these thoughts and see if they are accurate. Next, individuals learn to gain a more comprehensive understanding of others’ behaviors and motives.
In addition, part of the CBT program is to learn new coping skills and behaviors particularly in times of stress or when facing problems. This portion of therapy is often accomplished by encouraging individuals to face their fears, teaching them effective ways to calm their minds, and sometimes role-playing to prepare for potentially stressful situations or interactions.
While CBT helps the individual to take a look at what may have caused their unhelpful thoughts and behaviors, this type of therapy mostly addresses what is currently occurring in the individual’s life, not so much on digging up the past as with other therapies.
The goal of CBT is to not only change destructive thoughts and behaviors, learn new coping skills, but also to teach the individual to essentially become their own therapist. Through ongoing work with the counselor and homework to help reinforce changes, patients can learn to identify and change their own faulty thinking and associated behaviors throughout life.
2. Dialectical-behavioral therapy or DBT
This type of evidence-based therapy was originally developed to treat women with borderline personality disorder. However, since that time it has been used to successfully treat a number of other types of mental health disorders including substance and alcohol use disorders. In addition, it is often used to treat individuals with suicidal ideations, self-harm behaviors, eating disorders, depression in the elderly, and mood disorders.
This type of therapy involves recognizing triggers that lead to emotional reactions and learning what appropriate coping skills to use in each situation. In DBT, the aim is to help individuals employ emotional and cognitive regulation by knowing their triggers and learning, as well as using effective coping mechanisms.
DBT is a modified type of CBT first developed by Marsha M. Linehan, a psychology researcher at the University of Washington. It differs from CBT with its concept of distress tolerance, mindfulness practice, and acceptance of situations. DBT is based on the biosocial theory of mental health disorders. This theory believes that individuals are biologically predisposed to certain mental health issues and are stimulated by environmental factors.
The four modules of DBT include:
- Acceptance and change
- Distress tolerance
- Emotional regulation
The modules used can vary from one person to the next. In addition, one person may use all of the modules while another may only use two. DBT can be tailored to meet each person’s unique needs for psychotherapy.
3. Eye movement desensitization and reprocessing or EMDR
EMDR is a type of therapy developed by Francine Shapiro in 1988 that is used to help patients process traumatic events from the past. EMDR helps individuals to assess, process, and finally, bring them to a resolution.
EMDR is led by a trained therapist. In the sessions, the therapist leads the individual in recalling a past traumatic event in small amounts while simultaneously focusing on an external stimulus. Therapist-led lateral eye movements, hand tapping, and audio stimulus are most commonly used to facilitate this process.
With this type of therapy used for substance abuse treatment and trauma, new associations with the memory or memories are formed thus resulting in the elimination of the associated emotional distress and new thoughtful insights into the event.
EMDR uses a three-prong approach which is as follows:
- New associative links are developed about the past event that may have caused dysfunction for the individual
- Any current circumstances causing distress are addressed and any internal or external triggers are also addressed and desensitized
- Plans for addressing future events that may be triggers are incorporated
Research indicates that individuals with past traumatic events can heal and relieve emotional distress from EMDR that takes years in traditional types of psychotherapy. In EMDR, it is illustrated that the mind, like the body, can heal itself from trauma when blocks are removed. EMDR removes these blocks and allows the mind to heal.
There are other types of therapies used for substance abuse treatment as well. Many of these other therapies are used in conjunction with CBT, DBT, or EMDR. These include experiential therapy, adventure therapy, contingency management, motivational interviewing, and more.
If you or a loved one are living with an alcohol or substance use disorder or struggling with a mental health issue, Futures Recovery Healthcare can help. At Futures, we utilize evidence-based therapies including CBT, DBT, and EMDR. Each of our three substance abuse treatment programs (Core, Orenda, Rise) offers these types of therapies and more. In addition, we have a mental health program solely devoted to those with mental health issues like depression, anxiety, and mood disorders. Each of these programs offers something a bit different from the next with the focus on helping each person who comes to us to get the comprehensive and individualized treatment they need.