Treating drug and alcohol addiction is not the same thing as dealing with an illness where a doctor can look up a recommended dosage for a medication and write a general prescription for a patient. Unfortunately, this chronic brain illness cannot be treated that simply or that generally.
Once addiction takes hold, it requires commitment on the part of the individual as well as the help and support of dedicated professionals to help move the individual forward into a recovery phase. In order for that to happen, a personalized approach to treatment offers the best odds for long-term sobriety.
Problems With A One-Size-Fits-All Type Of Treatment
A one-size-fits-all approach can be both ineffective and risky by forcing an addict into a particular plan that may not work for them specifically which increases the chances of treatment failure and relapse.
Benefits Of Personalized Treatment
The best way to treat addiction is to get to the root of why a client became addicted to drugs or alcohol in the first place. While we know that there are a number of similar reasons why a person could become an addict, the exact reasons a particular person started drinking, using drugs or turned to food as a comfort measure are all unique.
That is why we perform a complete assessment on a client’s past and current drug use as well as their mental health history. Only then can we create a personalized treatment plan that focuses on a client’s individual condition and goals.
The Best Chance For Life-Long Sobriety And Relapse Prevention
We want to ensure that we are meeting our clients’ needs and that we are addressing the appropriate issues to help them learn the tools they will need to be able to deal with stress, heal relationships with loved ones and cope with cravings and urges to drink/use/binge when they return to their homes.
Since each individual will have different issues they want to work on and different triggers that will put them at a potential risk for a relapse, a customized treatment plan must be created to prevent relapse and promote a healthy and successful recovery. There is no way that a cookie-cutter approach to treatment will work successfully for life-long sobriety. And isn’t life-long sobriety what you want for yourself or a loved-one?
In individual therapy, clients engage one-on-one with a trained therapist in a non-judgmental and confidential environment. During therapy, clients are encouraged to explore feelings, beliefs, and behaviors in order to better understand themselves. They will also be prompted to work through negative memories and deal with difficult experiences.
Additionally, clients will identify areas in their lives they would like to improve, and set personal goals that will bring about the desired changes. In addition to these changes, the goals of therapy are to promote personal growth, greater self-awareness, and to gain more insight into feelings and behaviors.
Therapy is used for a variety of reasons, including substance abuse issues, coping with significant life challenges, dealing with past trauma, bereavement, and addressing mental illness such as anxiety and depression.
Common Approaches to Individual Therapy
Psychoanalysis and the Psychodynamic Approach
Psychoanalysis, or psychotherapy, uses a process of verbal exchange between the therapist and client that is characterized by mutual trust. The goal is to help individuals alter unhealthy or destructive behaviors, thoughts, and emotions. Experienced therapists may combine several techniques.
The psychodynamic approach emphasizes uncovering unconscious motivations and breaking down emotional walls. This type of therapy may be beneficial when a person’s problems are largely fueled by internal conflicts, as is often the case for those with alcohol and drug addictions.
Behavior-oriented therapy is focused on helping individuals view their problems as learned behaviors that can be altered (versus unconscious motivations.) This approach is based on the theory that when a behavior is changed, feelings can change as a result. An example is behavior modification, which is geared toward curbing unwanted habits by providing positive reinforcement for the desired behaviors.
The goal of cognitive-behavioral therapy is to help individuals break free of harmful patterns of thinking and replace them with healthy ones. During therapy, the therapist may point out irrational thought patterns using a variety of techniques. One such method, for example, is thought substitution, in which a negative though is eliminated by substituting a positive thought in its place.
Individual Therapy for Addiction
Regardless of approach, individual therapy can help a person gain insight into their internal problems, and find ways of eliciting positive changes in their thoughts, feelings, behaviors, and life overall. It can help people improve problem-solving, decision-making, and coping skills.
Regarding addiction, individual therapy seeks to uncover the personal and emotional reasons why people engage in substance abuse – be it past trauma, isolation, social pain, or any number of factors. By identifying the reasons behind use, individuals can have a better understanding of themselves and their addiction, and determine ways to make the internal and external lifestyle changes necessary to promote abstinence.
Group therapy consists of one or more therapists working with a number of people at the same time. It is often integrated into a comprehensive treatment plan that also includes individual therapy, counseling, and medication.
Groups can be small (i.e. 3-4 people) but often involve larger numbers, sometimes a dozen or more. Group therapy can be very effective, particularly for certain issues. Research has shown that group therapy can be an effective treatment for depression, traumatic stress, and addiction.
The Principles of Group Therapy
- Fostering Hope – Group therapy usually includes members at different phases of the treatment process.
That is, those at the beginning of the process can see those in advanced stages recovering, and can share knowledge and experiences. This can be a great way to instill hope for the future.
- Universality – Participating in a group with others who share similar experiences can help people see that they are not alone, and that others feel the same. In other words, it promotes a sense of belonging and acceptance.
- Conveyance of Information – Members help and inform each other by sharing information and experiences.
- Altruism – Members share their strengths and help others, which can promote self-esteem and confidence, as well as feelings of accomplishment. They may serve as role models to other members. Then, as each person progresses, they themselves can serve as a support figure for others.
- Corrective Replacement of the Primary Family Group – Group therapy is much like a family in many ways. Within the group, each member can investigate their own childhood experiences and trauma that may have contributed to their development, personalty, and behaviors. They can learn to avoid the negative thoughts, feelings, and behaviors that are are harmful or unhelpful in their lives.
- Development of Socialization Skills – A group environment is conducive to practicing new behaviors. The setting provides a safe and supportive surrounding to experiment and socially engage without fear of failure or judgment.
In a group format, the therapist also has an advantage over individual therapy, in that he or she can see how each person responds socially to others in the group. This allows the therapist to provide important feedback to the participants.
- Imitation – Members can model the behaviors of others in the group, and observe and/or imitate the therapist’s behavior, as well.
- Interpersonal Learning – Through personal interaction and the reception of feedback from the therapist and the group, members can garner a better understanding of themselves and their behaviors.
- Group Cohesion – Because the group is committed to a common goal, members gain a sense of acceptance and belonging.
- Catharsis/Purging of Feelings – By sharing feelings and experiences with the group, individuals often find it therapeutic to express and let go of pain, shame, guilt, stress, and anxiety.
- Existentialism – Group therapy can help individual members understand that they are responsible for their own lives, decisions, and behaviors.
What Does a Group Therapy Session Work?
Typically, the group meets in a room where the chairs are arranged in a large circle. This format allows each member to see every other in the group face-to-face. Sometimes groups are segregated by gender.
A session often begins with personal introductions and the sharing of reasons for each member’s participation. Members may also share recent experiences, changes, and progress since the last session.
The specific manner in which the meeting is conducted depends on the group goals and therapist style. For example, some therapists encourage free dialogue, and each member contributes as they themselves deem appropriate. Still others have a structured plan for each meeting that may include asking participants to practice new skills with other group members.
How Group Therapy Is Used to Treat Addiction
There are six stages which form the basis for group therapy in the treatment of addiction. The therapist and other members will help each participant through these phases.
- Pre-contemplation – During this stage, members are not actively seeking to change their substance abuse behavior. They either do not consider it to be a serious problem, or simply do not have the desire/will to change. In this case, it is often legal issues or family members that have prompted them into therapy.
- Contemplation – In this stage, guidance from the therapist and group members begins to encourage participants to decrease their substance use or quit altogether.
- Preparation – The member is still using the substance, but has plans to quit due to the acknowledgment that the consequences of their condition are dire, and that there are keen advantages to quitting.
- Action – Action consists of adopting a strategy to stop the substance abuse, as well as making the changes necessary to enact the plan (with support from the therapist and group members.)
- Maintenance – In this phase, the member is working hard to maintain abstinence and avoid relapse. This is the last stage for some participants.
- Recurrence – This is when a member relapses and falls back into the behaviors of a previous stage. However, they are often quick to progress back to the maintenance stage, and will have likely gained improved understanding of the reasons why they relapsed.
Substance Addictions Commonly Treated by Group Therapy
- Alcohol addiction
- Prescription pain medication
- Opiate addiction
- Illegal drugs such as cocaine, heroin, methamphetamine
Group therapy is not meant to take the place of individual therapy, but has benefits that one-on-one therapy does not. These include member role modeling, practicing of skills, information sharing, and social interaction. In addition, a therapist simply cannot instill the sense of belonging that a group can provide. Group therapy is especially effective when used in conjunction with other therapies, and can be quite useful for treating mental illness, traumatic stress, and addiction.
Addiction is a condition that has repercussions far beyond individual suffering. Family and friends of the addict or alcoholic are also negatively affected in a variety of ways.
For example, addicts and alcoholics, by nature, can be very selfish. This is because they must put habitual needs above those of others. When addiction takes over the brain, the drive to continue using overtakes every other priority in life.
This may result in emotional pain and suffering on the part of those who love the client. This is a critical problem, because very often the people needed most for support are unable to provide it because of ongoing relationship dysfunction.
However, by including family therapy in addiction treatment, wounds can be healed, and improvements in understanding and communication can help rebuild the foundation for the client’s support system.
Components of Family Therapy
The staff at Just Believe Recovery understand the importance of involving the client’s family and friends in the recovery process. Moreover, the family is a critical component of the client’s ongoing treatment.
In addition to the client, our professionals assess the needs of the family, and provide education about chemical dependence and the facets of addiction. We also provide family support throughout the client’s treatment and recovery.
Within the first week of treatment, a therapist will establish communication with the family. As appropriate, staff will schedule visitations and/or phone conversations between the client and his or her family. As treatment progresses, these sessions will begin to focus on the reintegration of the client and the family.
By addressing addiction using the active involvement of a support system, clients are privy to the love and acceptance they require to regain a foothold in the world outside of addiction. In addition, it also assists loved ones in their own recovery from the damage caused by the user’s addiction.
Music therapy, as defined, is the clinical use of music to accomplish individual goals within a therapeutic relationship. Music is used to help people deal with both physical and emotional conditions, and to promote well-being and improve mental health.
In a therapeutic setting, the client/patient is encouraged to interact with music in a variety of ways, such as listening, singing, dancing, and writing/discussing song lyrics. Some can even play instruments, although it is not necessary to have any musical experience in order to benefit from therapy.
Why Music Therapy?
For many people, music has a tremendous impact on their life, memories, and relationships. Music can influence moods, thoughts, and emotions. It inspires ideas. It allows people to communicate with others on a different level. Research has found that music therapy an improve a person’s ability to deal with a variety of conditions.
How Music Therapy Works
Music therapy involves wielding the power of music in a controlled manner. A music therapist is trained to use music to produce therapeutic results, and to expertly approach each client uniquely.
When a therapist meets with a client, together they will determine the goals of treatment, and these goals will guide the process. Therapy may involve the creation of music, just listening, and anything in between.
Benefits of Music Therapy
There are a number of benefits possible from engaging in music therapy. Some include:
- Stress reduction
- Reduction in depressive symptoms
- Improved ability to cope with anxiety
- Creation of a meditative state
- Improved concentration
- Increased optimism
- Boosted immune system
- Reduction in muscle tension
- Improved ability to cope with chronic pain
- Reduced feelings of loneliness
- Emotional release
- Increased spirituality
Music Therapy and Addiction
Music therapy is used for a wide variety of practices, and addiction is no exception.
While it is unlikely to cure addiction on its own, it can improve outcomes when used as part of a comprehensive recovery approach.
Benefits of music therapy for addiction include:
- Reduction in destructive emotions
- Improved management of stress levels and decreased likelihood of relapse as a result
- Reduction in feelings of boredom which can also lead to relapse
- Reduced feelings of loneliness
- Offers an outlet for channeling feelings previously medicated with drugs or alcohol
- Improved concentration levels for those suffering mental fogginess during early recovery
- Reduced feelings of depression
Music therapy can be beneficial to anyone of any age, and even to those who have previously been relatively unexposed to music. It is an easy, enjoyable activity that can garner many positive results related to mood, self-esteem, and coping skills.
Art therapy is an approach to recovery that uses a person’s creativity and imagination to express him or herself in a healthy and productive manner. The main goal of art therapy is to expand communication to better convey experiences.
Moreover, art therapy can tap into the psyche in a way that other therapies generally do not. This is especially helpful for those who have a fear of verbal communication or have difficulties expressing themselves in words. Creative methods commonly used in art therapy include:
Art therapy as a means of expression can be very beneficial for those who have a fear of verbal communication or have difficulties expressing themselves in words. It allows people to express thoughts and feelings in a way they may normally could not. And because art is a often non-verbal process, it allows people to convey emotions in a more abstract and creative form.
This can facilitate discussion (if desired) and help clients and other better understand issues in a person’s life than commentary can alone. As a result, art therapy can promote further insight and meaning into an individual’s own personal worldview and experiences.
Art therapy is used as an intervention for a number of conditions. It is especially relevant to addiction treatment because it provides persons with another way of understanding and coping with their substance dependency, as well as contributing factors to their addiction. Like many traditional therapies, art therapy puts focus on teaching individuals how to practice personal introspection, and improve coping skills.
When presented in a group setting, it can help addicts and alcoholics grow closer to others and better understand each other’s feelings and experiences. In summary, art therapy is an effective, safe, creative, and healthy way for a person to process the feelings, experiences, and troubles that have contributed to their addiction.
For many, it is a refreshing change from traditional, individualized talk-focused therapy, and offers an alternative means of effective communication.
EMDR, or Eye Movement Desensitizing and Reprocessing Therapy is an innovative trauma recovery technique offered by Just Believe Recovery Center. During a session, the therapist engages the patient in a stimulation exercise in which past trauma is discussed.
Simultaneously, different parts of the brain are activated through a series of eye movements, often facilitated by moving lights or objects. By alternating between positive and negative thoughts with corresponding eye movement, the brain begins to desensitize itself to negative images and memories.
How Does EMDR Work?
While the exact reason why EMDR is effective at eradicating negative memories is uncertain, many neuropsychologists contend that this technique enables the patient to accelerate the emotional processing of trauma-related thoughts and feelings – thus gaining insight and making progress toward closure. This is not dissimilar to the rapid accessing of information during REM sleep, which is believed to help reduce anxiety.
This effect was first encountered in 1989 by psychotherapist Francine Shapiro, Ph.D., who admitted the discovery was an accident. Along with associates, she developed multiple procedures for bilateral stimulation through trial, error, and refinement. Additional improvements have been made by research centers worldwide.
What does EMDR treat?
EMDP treats a range of emotional and behavioral problems, including substance abuse, depression, anxiety, PTSD, eating disorders, and other self-destructive behaviors.
Many of these mental health issues are partially the result of some trauma we have experienced, ranging from childhood to very recent events. The typical human response is to forget the trauma, but this does not allow the person to heal or come to any productive resolution.
Other models, such as cognitive behavioral therapy, have had some success by helping the patient to modify thoughts, feelings, and behaviors in addition to improved coping skills.
How does EMDR treat addiction?
Addiction may occur, in part, due to trauma or stressful life events. The person uses substances to self-medicate, or temporarily repress/forget traumatic memories.
Comorbidity (multiple illnesses) is common among both trauma victims and addicts, and the two conditions often present together, making each difficult to treat individually.
While EMDR is not a cure for addiction, it may effectively treat the underlying reason (trauma) for self-medication. Often, it is most effective when combined with other therapies, appropriate medication, or group support.
How effective is EMDR?
EMDR has proven to be effective in both clinical trials and practice. For example, the Journal of EMDR Practice and Research (2009) followed an addict who had been treated several times in a drug rehabilitation center. Although she had relapsed each time soon after release, the addition of the EMDR technique led to 1.5 years of abstinence – more than a three-fold increase in sobriety. She also reported improved quality of life.
Most significantly, EMDR is approved for treatment of PTSD by both the American Psychological Association and the Department of Defense. Current research reveals up to a 90% success rate for a variety of trauma, including both single and multiple events. The number of sessions varies, determinate upon the level of trauma, the length of trauma exposure, or the response of the patient.
Dialectical behavior therapy is a sub-category of cognitive-behavioral therapy (CBT.) Standard CBT tends to focus on large-scale change in a patient’s life perspective, as well as improving the ways in which one deals with stress and crisis.
Dialectical behavior therapy, on the other hand, is a more specific approach that focuses on a cumulative effort that builds from one therapy session to the next. The following skills are addressed:
Emotional regulation – the ability to cope with mood changes and control harmful impulses.
Distress tolerance – skills used to cope and survive during a crisis, and helps tolerate short-term or long-term pain.
Mindfulness – self-awareness of how a situation is, rather than how you believe it should be.
Interpersonal effectiveness – skills that help increase attendance to relationships, balance priorities versus demands, and build a sense of mastery and self-respect.
These skills are required to navigate one’s life without engaging in substance abuse as a coping mechanism.
What to Expect in Treatment
Behavioral therapy during alcohol or drug rehabilitation treatment takes place in either a classroom environment or one-on-one.
Therapists and patients discuss factors that led up to the harmful behavior, and patients are expected to understand that change is desirable and needed.
Many rehab centers that use dialectical behavior therapy for addiction treatment build upon previous sessions. Patients who have a problem during one session, for example, alternative methods of approaching the situation will be addressed at the next.
DBT offers a balance between acceptance and change. Moreover, CBT is some viewed by some as undesirable due to rapidly forced changes, leading patients to cease treatment. DBT, however, places an equal burden on both the patient and therapist.
For patients dependent on a substance, this condition is the highest priority DBT target among all behaviors that potentially interfere with life quality.
DBT’s substance abuse behavioral targets include:
Decreasing substance abuse, including illicit drugs and legally prescribed drugs.
Mitigating physical discomfort associated with abstinence or withdrawal.
Reducing urges, cravings, and temptations to abuse.
Avoidance of opportunities and triggers/cues to abuse.
Reducing behaviors conducive to drug abuse.
Increasing community reinforcement of healthy behaviors.
Working Between Sessions
Centers that employ dialectical behavior therapy for addiction treatment will usually assign patients homework between sessions.
Patients keep a diary of their thoughts and feelings and record (1) thoughts about a specific situation, (2) how they behaved in response to it, and (3) how they could have approached it better.
These diary entries are discussed during sessions, and those patients in group sessions usually compare and share notes. Patients who engage in therapy in a group session often feel a sense of both belonging and accountability with peers, which can expedite recovery and improve the effectiveness of treatment.
The DBT Approach to Abstinence
DBT urges immediate and permanent abstinence, and yet instills the belief that the desired result can still be achieved (acceptance) even in the event of a relapse.
This approach thus combines insistence on complete abstinence with non-judgmental, problem-solving responses that include techniques intended to reduce the dangers of an overdose or other negative consequences.
Establishing Abstinence By Promoting Change
The therapist begins to stress the expectation of abstinence during the first DBT session by requesting that the patient agree to cease substance use immediately.
But rather than a lifetime of sobriety, the therapist encourages the patient to commit to a specific length of abstinence.
This interval can be as short as just a few minutes – but regardless, at the period’s end, the patient is asked to renew the commitment. The goal is to achieve long-term abstinence by combining consecutive substance-free time periods.
Another strategy instructs patients how to “cope ahead,” in which the patient learns the skill of anticipating possible cues/triggers in upcoming minutes, hours, and days. The patient then proactively prepares responses to high-risk situations that may derail abstinence.
The patient is also encouraged to burn the bridges, so to speak, to his or her substance-abusing past. Moreover, obtain a new telephone number, inform others of his or her sobriety, and throw out or destroy drug paraphernalia.
Transforming the Addict Mind
Patients with a substance use disorder often begin DBT in a mental/behavioral state that may be referred to as “addict mind.”
That is, their thoughts, actions, and emotions are under the control of substances.
As they achieve long-term abstinence, their state of mind transforms into what is known as a “clean mind.”
During this time, they are off substances, but do not accurately gauge personal susceptibility to future problems – an overconfident outlook can lead to a relapse. Eventually, an alternation between these two states results in a philosophy that fosters the emergence of the “clear mind.”
At this point, the patient now enjoys abstinence, yet remains completely aware of the near dangers of the addict mind. He or she is thus free to take measures to avoid or cope with situations that can lead to relapse, or in other words, “restore” the addict mind.
Dialectical behavior therapy, although initially developed for the treatment of personality disorders has displayed effectiveness in the treatment of substance use disorders, as well, and now is often used instead of standard CBT.
It’s slower paced, skills- and accountability-based approach often works well with individuals who are very independent, highly willful, or more easily antagonized under standard CBT.
Treatment at Just Believe Recovery combines holistic healing with evidence-based practices. Techniques include cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), and eye movement desensitization and reprocessing (EMDR).
Psychoeducational groups, in addition to the Center’s individual and group therapy, strive to build clients’ confidence, improve self-awareness, and inspire positive choices in recovery. Recreational and social activities include kayaking, swimming, volleyball, yoga, and fishing. Residents also attend off-site 12-step meetings.