Most who need substance abuse or addiction treatment aren’t fully aware of what the whole rehab process entails.
Some people think that rehab only entails detox, but detox in and of itself does not represent addiction treatment. Individuals who seek continued therapeutic treatment within a month of completing detox are far less likely to relapse, and those who do relapse will take 40 percent longer to do so, per the Partnership for Drug-Free Kids. This continued treatment includes many helpful approaches to addressing addiction, the most beneficial and necessary of which is therapy.
If you’re seeking treatment for a family member in need, there are many different therapeutic options to choose from. The key is to find the therapy that will work best for the person in your life. Oftentimes, rehab centers will employ a variety of therapies into the treatment plan for an individual.
Cognitive Behavioral Therapy
Cognitive Behavioral Therapy (CBT) came along in the 1960s as a treatment for undesirable behaviors. The treatment method stems from the belief that individuals can change the way they act by changing the way they respond to their own feelings. Case in point, those who habitually abuse marijuana in effort to self-medicate anxiety may need CBT to teach them how to manage anxious symptoms without illicit substances. By learning not to react immediately to triggers that cause tenseness or paranoia, people can evaluate the stressors from an unbiased standpoint and make a conscious determination of how to allow the emotions to affect them.
A National Institute on Alcohol Abuse and Alcoholism review of 21 studies on CBT techniques as a form of treatment for substance abuse notes 15 of them showed CBT as being more effective than the comparison treatment.
CBT is also a fantastic treatment option for individuals who suffer from co-occurring mental health disorders, and it works particularly well in conjunction with medication treatment. The American Family Physician relayed the results of a study in which depressive symptoms improved by 85 percent for people treated with both CBT and an antidepressant, compared to just 55 percent for those who received only the medication, and 52 percent for those who were only exposed to CBT. Despite its high rate of efficacy, a survey of American psychologists reports 69 percent only took advantage of CBT techniques part-time or as part of other therapy interventions when treating clients suffering from depression or anxiety, per The New York Times.
Overcoming addiction isn’t just about working on the issues that brought someone to treatment, but also those that are foreseeable in the future. Clients need to be prepared for what awaits them post treatment, and CBT can help with that. While it is always advisable to eliminate and avoid triggers, it’s not always possible. Taking CBT practices into account, individuals leaving treatment can prepare themselves with the coping skills they have learned in therapy so that when they encounter a trigger, they can take a step back and think about how to proceed before they act. That’s really what CBT is all about – retraining negative thought patterns to positive ones.
Motivational Interviewing (MI) approaches clients in a manner that allows them to come to terms with the reasons they are in treatment and what they need to address on their own. This guided process uses specific methods of questioning clients so they can come to terms with what has been stopping them from moving forward with the changes they desire to make. A Psych Central publication notes that when MI was used to encourage treatment among war veterans suffering from mental health disorders, 62 percent of the treated group sought help, compared to only 26 percent of those who were only exposed to check-in sessions with no formal therapy.
There are four core principles to the MI process. They are:
- Therapists indirectly repeats clients’ statements back to them through reflective listening in order to convey that they are present and understand how they feel.
- Therapists subtly point out how clients’ current behaviors interfere with the positive changes they want to see happen in their lives.
- Therapists use compassion and empathy in the face of resistance, rather than confrontation or demands.
- Therapists boost clients’ self-esteem and self-confidence, encouraging them to reach their goals.
Solution-Focused Therapy (SFT) is less traditional than other forms of substance abuse treatment. Instead of reflecting on childhood traumas, unsupervised adolescent years, or the negative events that may have spurred periods of substance abuse during adulthood, SFT concentrates on solving the problem at hand. This form of therapy is best for individuals who aren’t planning to stay in treatment very long.
With regard to treating substance abuse, the focus is on stopping the current drug and alcohol abuse and learning coping skills for triggers, as well as what changes need to be made to reach the goals the individual sets at the beginning of the therapist-client relationship. While SFT does not focus on recovering from past experiences, part of its purpose serves to repair the damage those experiences caused in the future by making healthier choices.
Eye Movement Desensitization and Reprocessing
Eye Movement Desensitization and Reprocessing (EMDR) therapy is considered an alternative method of therapy. The Fix reported on a small scale study of individuals who were ordered by courts to complete treatment for a substance abuse problem as part of a drug court program, noting that 91 percent who were treated with EMDR successfully completed the program after a year, versus only 62 percent in the comparison group.
EMDR came along in 1987 when Francine Shapiro, a psychologist, realized shifting her eyes from left to right in rapid succession led to relief of anxiety-related symptoms she experienced. This model of treatment also incorporates CBT, psychodynamic therapy, interpersonal therapy, body-centered therapy, and experiential therapy to increase the healing effects of EMDR.
The first step in treating someone with EMDR involves educating the client on what desensitization is and setting treatment goals. Next, the targeted traumas are brought to light, and the client is encouraged to dig deep and find a positive thought that works against the negative feelings that the trauma causes to arise. This positive thought is the focus while the client follows the therapist’s finger back and forth to initiate rapid eye movement for as long as 30 seconds or however long the therapist deems necessary. After this process is complete, the client discusses the experience with the therapist. The EMDR process is then repeated as long as negative feelings remain present in an effort to retrain the mind in how to respond to the initial traumatizing thoughts. If the client exhibits any warning signs of being emotionally unstable or ill-equipped to handle this part of treatment, it will be delayed at the treatment professional’s discretion.
This method also specializes in the treatment of clients with co-occurring substance abuse and trauma-related problems. EMDR is effective in treating other mental health disorders, such as eating disorders and a variety of anxiety disorders, like phobias and panic disorder. This therapy can be highly beneficial among people with substance use disorders since 20 percent also battle anxiety, per the Anxiety and Depression Association of America. EMDR is endorsed by the U.S. Department of Veterans Affairs and the American Psychological Association as a quality and effective form of treatment, primarily for PTSD.
While it is a less common approach to treatment, systems thinking isn’t a budding trend in the rehab industry. It’s been used for years to help counselors better understand the environment clients live and interact in. Often, people in treatment need help learning how to reintegrate into their lives as sober individuals. This can be tough if their families, coworkers, and peers have not been supportive of their choice to get help, and even more so for those who feel those groups contributed to their addiction problems. This situation is most common with family units.
The systems thinking approach allows therapists to focus on the entire family instead of just the client. The method is rooted in a belief that the problems do not lie solely with the affected party, but within the interactions of the family. As such, working with family members and counseling them on how to communicate effectively, express emotions in healthy ways, and support one another can contribute to healing addiction as well.
Initially, family members are guided by the therapist in confronting the substance abuse problem and then learning how to cope with the transition from abusing drugs and alcohol to getting help. This might seem like it should be an easy step, but many people struggle with it. Family members are frequently unsupportive in the initial phases of treatment, and a lot assume the individual won’t stick with it or will relapse soon after seeking help. Statistically, it’s understandable why many have that view. Everyday Health reports 40-60 percent of people in recovery succumb to relapse within a year of completing treatment. However, loved ones should be supportive of the person in rehab, rather than predicting an early relapse. The transition into recovery requires family members to make use of solid coping skills and many of those skills must be taught.
The last step in the process is making sure each family member feels prepared to face the changes that come with recovery.
The Seeking Safety method of treatment is geared toward individuals who are plagued by substance abuse and have endured some sort of trauma. The two issues often occur together, usually with the trauma coming first, but not always. Sometimes, the environments people spend their time in when abusing drugs and alcohol are more likely to host traumatic events.
Around 75 percent of people in treatment for a substance abuse problem have a history of abuse or trauma, per the National Association of State Mental Health Program Directors. This therapy can be especially helpful to those who are suffering from co-occurring post-traumatic stress disorder. Healthy Place attests that 30-50 percent of people affected by PTSD are also battling substance abuse problems or an addiction.
Seeking Safety was developed for trauma sufferers with addiction problems. It is appealing to many since it doesn’t require individuals to rehash the events of a trauma or deeply explore the emotional turmoil it causes. Instead, it works by encouraging clients to concentrate on overall safety. They are guided in imagining what safety looks and feels like in hopes of developing environments within their lives that cultivate the same sense of security. Clients are also taught coping mechanisms that they may have been lacking prior to treatment, such as:
- Maintaining honesty
- Learning relationship boundaries
- Managing self-care
- Learning how to handle triggers
- Creating meaning in their lives
- Having compassion for themselves and others
- Repairing anger and fear
- Learning how to approach life from a recovering point of view
Equine-assisted therapy (EAT) is a growing trend in the substance abuse treatment community. On the surface, clients build relationships with horses. They are responsible for grooming and feeding these animals, and clients will bond with them during these processes.
With regard to substance abuse and addiction, horses mirror body language and can often give therapists cues as to what issues they need to work on with clients. Research continues to back EAT’s efficacy in treating a variety of disorders, and addiction is just the tip of the iceberg. Animals have long assisted people of all ages who face the potential for negative effects stemming from substance abuse, mental illness, and other factors. An Australian Journal of Counselling Psychology study notes 82 percent of at-risk young people experienced improvement following exposure to EAT.
The 12-Step program may be the most recognized form of treatment around. Made famous by organizations like Alcoholics Anonymous, the plan focuses on 12 core steps that must be followed in numerical order to reach a place of total recovery and sobriety. From the first step through the last, the focus is on admitting the problem, making amends with those who have suffered harm because of it, and encouraging others to do the same.
Twelve-Step programs are primarily used as support for those in recovery from substance abuse and behavioral addictions. These groups are generally used as forms of aftercare following more structured and comprehensive treatment.
Individual and Group Therapy
Individual therapy may be one of the most beneficial components of rehab. Solo sessions with a therapist or counselor can heal wounds that have been contributing to someone’s substance abuse behaviors. In addition, coping skills can be taught during these sessions that will help the client to avoid relapse during recovery.
There are many ways family members can give and receive support during their loved one’s treatment experience, and family therapy is one of them. Attending sessions together allows the family unit to heal broken relationships and build a solid foundation of trust once again.
Research consistently supports the idea of family members being involved in the treatment process during rehabilitation. Children shouldn’t be excluded either. SAMHSA reports 70 percent of females and half of men in treatment have kids at home. The frequency of family therapy sessions varies according to the specific program and the specific client.
Often, clients will need assistance repairing the damage the addiction has caused to relationships with partners and spouses. Couples therapy is recommended for most people in treatment and especially for those whose partners also have substance abuse histories, as a partner’s substance use can serve as a trigger for relapse. Medical Daily reports the divorce rate is 50 percent when one spouse drinks heavily, but if both or neither do, that rate drops to 30 percent. Ongoing counseling is often recommended for couples since they are likely to encounter some bumps along the road during the post-treatment recovery process.
Art therapy and music therapy are both promising forms of expressive therapy for substance abuse rehabilitation. Neither require the client to be artistically inclined. Rather, individuals learn different art techniques through classroom sessions that focus on giving participants healthy and positive ways to relieve stress while doing something they enjoy. Engaging in these activities has beneficial effects on overall health by decreasing cortisol levels and boosting dopamine, norepinephrine, and serotonin levels.
These therapies are less about the end product – the musical performance or the finished artwork – and more about the creation process. Oftentimes, various feelings and issues may come up in the creation process that are further explored in individual therapy.
Paying for Therapy
In most cases, insurance policies cover therapy with a licensed practitioner. However, some may require the use of in-network providers, and if the policy doesn’t offer substance abuse coverage, then a therapist on staff at an addiction treatment center may not be a covered option. It’s very important that individuals entering treatment verify all benefits ahead of time. The financial aspect of treatment is often a deciding factor for many in need of such services. That being said, quality treatment should always be the top priority.
The Affordable Care Act made way for 16.4 million Americans to become insured who previously didn’t have that coverage, per the Washington Post. Clients should contact their insurance carriers to find in-network treatment centers and discuss what percentage of their treatment costs they may be liable for, including deductibles, copayments, and out-of-pocket maximums. In addition, clients should be sure to ask about the differences between outpatient and inpatient coverage, too. Most treatment centers will be able to assist with the insurance navigation process, helping prospective clients to get a clear idea of what total out-of-pocket costs will be.
For those without insurance, it can be even tougher to secure treatment options. SAMHSA reports 37.3 percent of people who needed rehabilitation services to treat a substance abuse problem in 2011 and didn’t receive that treatment cited a lack of insurance as their primary reason.
Fortunately, there are other ways to pay for treatment besides insurance. Some clients choose to borrow money from family and friends while others opt for bank loans. In addition, treatment facilities can assist clients in applying for local grants. Many facilities now offer payment plans that allow individuals to make regular payments over a predetermined period of time.
The Importance of Timing
If you have a family member who needs substance abuse treatment, the time to act is now. Research continually shows that early intervention is directly linked to better recovery outcomes. Help your family member get on the path to a better future; reach out for help today.