Types of Therapies

There’s no one “right” treatment for someone trying to overcome an addiction. That means that you and any health care professionals you’re working with can and should use different types of treatment to find a way to recovery that works best for you. After all, when it comes to addiction every person has a different recovery story, just as with any disease or illness.

When you enter treatment, the first thing you’re likely to experience is detoxification, or the removal of the substance(s) or behavior(s). Detox brings with it the symptoms of withdrawal. These can include physical symptoms such as nausea, vomiting, muscle aches, headaches, shakiness, seizures and even coma, as well as psychological symptoms: feeling depressed, anxious, sad, angry and/or upset. If you commit to treatment for your addiction, chances are you’ll encounter several of the following approaches as part of your treatment plan:

Drug therapy: Medication can be used to help ease the symptoms of withdrawal and to prevent cravings that lead to relapse. When drugs are used to treat addiction, it’s called medication-assisted therapy (MAT). According to the Substance Abuse and Mental Health Services Administration (SAMHSA), prescription medications can also be used to restore normal brain function (namely the production of dopamine) in addicts. Here are some of the ways that prescription medications are used to treat specific types of addiction:

  • For opioid addiction: Opioids are a type of powerful painkiller that includes both the illicit drug heroin and prescription medications like morphine, oxycodone and hydrocodone. Addictions to these drugs can be treated with methadone, buprenorphine hydrochloride (brand name: Subutex) or buprenorphine hydrochloride and naloxone hydrochloride tablets (brand name: Suboxone). Methadone and Subutex help suppress withdrawal symptoms, including cravings, while Suboxone blocks opioids’ ability to elicit a reaction from brain receptors. All of these drugs alleviate drug-seeking behavior, too. (Methadone should be used cautiously due to its risk for life-threatening breathing problems, says the National Institutes of Health). The drug naltrexone (brand names: Depade, ReVia and Vivitrol, an injectable form) is also approved for treating opioid addictions; it works by erasing the effects of opioids so that cravings eventually diminish.  Your doctor may also prescribe an anti-anxiety medication if you’re dealing with post-traumatic stress disorder (PSTD) or anxiety issues; both are fairly common in people with addiction.
  • For tobacco addiction: Tobacco products contain nicotine, which is addictive. Various nicotine replacement therapies — patches, sprays, gums, lozenges — are available over-the-counter to curb nicotine cravings. Bupropion (brand names: Wellbutrin, Zyban) and varenicline (brand name: Chantix) are both FDA-approved for smoking cessation.
  • For alcoholism: Naltrexone (brand names: ReVia, Depade and Vivitrol, an injectable form) is used to quell cravings for alcohol, while acamprosate (brand name: Campral) reduces withdrawal symptoms. Disulfiram (brand name: Antabuse), the oldest medication for alcoholism, causes unpleasant symptoms when you drink like nausea and skin-flushing to deter patients from drinking.
  • For video gaming addiction: The antidepressant bupropion (brand names: Aplezin, Budeprion, Buproban, Wellbutrin, Zyban) is sometimes used to treat gaming disorders; as with its use in treating some substance use disorders, it can help reduce cravings for gaming.

In addition, several medications are under investigation for the treatment of gambling disorder, but none have been approved by the Food and Drug Administration. And drugs are being developed for treating addictions to stimulants such as cocaine and methamphetamine as well as marijuana addiction, but all are still in the pipeline, reports NIDA. People who are addicted to more than one substance (what are called “poly-drug” users) will need help for each drug they abuse.

Psychotherapy:  If you seek medical help for your addiction, it’s very likely that at some point your doctor or another health care professional will suggest counseling. That could mean one-on-one “talk therapy” between you and a therapist, social worker, psychologist, psychiatrist or an addiction counselor. You could also have group therapy (in which you meet and talk with a group of about six to 10 other people, often with the same addiction or issues as you have).

Your treatment plan could include other types of therapy, too, and the approach that’s used could change over time. For instance, in the beginning the work you do in counseling sessions may focus on recognizing your triggers and stopping them and finding ways to soothe yourself when you feel anxious or upset. When your recovery is better established, you and your therapist may then turn to exploring your past in more depth. As with any other part of your treatment regimen, how counseling works will be unique to you and your path to recovery.

Here are some of the more common, and more successful, approaches to counseling when it comes to treating addiction:

Cognitive Behavioral Therapy (CBT): CBT is a very popular treatment approach for mental disorders and also for both substance and behavioral addictions. CBT focuses on questioning and changing negative and unproductive thoughts and beliefs in order to improve behavior and emotions that lead to addictive tendencies. If you do opt to use counseling as part of your treatment, it’s very likely that your therapist will incorporate CBT.

Dialectical Behavioral Therapy (DBT): Sometimes patients need more support and acceptance to overcome addiction and other problems that stem from a difficult childhood or trauma. In Dialectical Behavioral Therapy, the clinician lets a patient know when a behavior or belief is unhealthy, while always offering total acceptance. DBT follows a standard protocol: At every session, the patient reports the problems he or she faced in the previous week. The therapy attempts to teach the addict strategies and coping skills for dealing with life’s difficulties while being mindful to react to situations in the present and not to layer on problems of the past.

Motivational Interviewing: In this type of psychotherapy, a counselor helps an addict to gradually feel more capable of making positive changes in his or her life.

Group Therapy: As mentioned above, therapists who hold group sessions work with people who share similar issues, such as the same type of addiction or the same co-occurring disorders, such as depression and alcoholism. In sessions the therapist poses questions or proposes a problem for members to discuss, acting primarily as a guide and keeping the conversation productive and focused. Group therapy is a lot like talk therapy except that it utilizes group dynamics to help members change behavior and thought processes.

Family & Couples Therapy:  Family therapy (also sometimes called Multidimensional Family Therapy, or MDFT) is structured so that every member of the family has a voice with the goal of improving relationships, communication and the family’s home life. When a family goes to therapy because one member has an addiction, it’s a step toward solving ongoing problems of daily living and healing past hurts; doing so can address factors within the family that are perpetuating an addiction.

In couples therapy, the therapist works with a couple dealing with an addiction to help both partners come to terms with the ways in which the problematic drug and/or behavior has hurt their relationship and to help the couple reconnect, or, if necessary, part ways. If unresolved issues, such as childhood trauma or neglect or unmanaged mental disorders, are at play, these may need to be dealt with in individual therapy sessions.

Other Treatment Options:

You may also encounter these therapies as part of your treatment for addiction:

Adventure therapy: Nature can be a big part of healing. These programs — which might include rock climbing, orienteering and zip lining, among other activities — focus on using the outdoors to learn how to overcome challenges, both in the wilderness and in ordinary life.

Art therapy: Certified art therapists use different media (watercolors, oil pastels, clay) to help patients explore their feelings. Through art, the therapist helps you to resolve inner conflicts, gain self-awareness, manage behavior, increase social skills, reduce anxiety and improve self-esteem, according to the American Art Therapy Association.

Equine therapy: When addicts work with, care for and ride horses, they develop a connection that can be powerful and healing.

Eye Movement Desensitization and Reprocessing (EMDR): This form of psychotherapy claims to relieve anxiety, trauma, post-traumatic stress disorder (PTSD) and depression. A specially trained EMDR therapist uses a technique in which the client follows the therapist’s fingers with their eyes from side to side while recalling a negative memory. The combination of the repetitive eye movement and memory recall is said to help the client process the memory and relieve negative emotions, such as past trauma that may be contributing to a drug addiction. The process is repeated in session until the client’s distress over past events is relieved.

Motivational incentives: Clinicians offer rewards, such as special privileges (like an outing, voucher or prize), as encouragement to help clients in residential treatment programs and sober living communities to stay clean.

Recreational therapy: Scrapbooking, knitting, going to a baseball game or bowling — all are examples of recreational therapy. This approach is based on the simple premise that through such experiences the addict can learn healthy ways to have fun, relieve stress and form relationships.

Wilderness therapy: Participants (usually teens and young adults) learn skills that will enable them to rely completely on themselves to survive in nature. These programs generally include treatment plans and 12-step work and can last for several weeks.

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