Types of Addiction Therapy Used in Treatment

Effective addiction treatment programs utilize a variety of evidence-based therapies and treatment modalities to help address the underlying issues that influenced your substance use and addiction. The treatment team creates an individualized treatment plan, consisting of a combination of interventions, tailored to meet your unique needs. Many types of addiction therapy can help you quit using drugs and alcohol and avoid relapse in the future.

Cognitive-Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is a commonly used therapy for the treatment of drug and alcohol addictions. A core principle of CBT is that drugs and alcohol reinforce continued use. The reinforcing effects of substance use then become tied to various stimuli, such as a bar or friend’s house, the sound of a can opening, interpersonal conflicts, or negative emotions.¹

The goal of CBT is to diminish the reinforcing effects of drugs and alcohol by building coping strategies that help you to maintain abstinence and providing opportunities for substance-free rewards, such as a recreational activity.¹

Another core principle of CBT is that your thoughts, feelings, and behaviors all influence each other, in both directions. For example, if you’re thinking that you’re a failure, then that’s going to make you feel depressed or upset, and if you’re depressed then you may seek out drugs or alcohol to self-medicate these unwanted feelings. And the opposite is true as well. Engaging in substance-using behaviors can cause you to feel guilty or ashamed, which may lead to negative self-talk and thoughts.

A therapist will help you to understand the connection between your cognitions, emotions, and actions to break unhealthy cycles of substance use and to know how to avoid high-risk situations or when to use various relapse prevention skills you’ve learned. An important aspect of CBT is also that of cognitive restructuring, which means the therapist helps to change your beliefs and expectations related to substance use. A common example is that many people believe using substances can help them manage particular situations, such as alcohol helping relieve social anxiety. In this case, the counselor will encourage you to gather evidence from situations in which you did not drink and were able to have fun and socialize.¹

Dialectical Behavior Therapy

Dialectical behavior therapy (DBT) was originally established to treat borderline personality disorder, although it has been expanded to treat a myriad of conditions, including substance use disorders, or addictions.It is a comprehensive therapy comprised of individual therapy, group counseling, and a consultation team. As such, it is more like a treatment program than a single therapeutic technique.² It is a type of CBT that aims to teach mindfulness, stress management, emotional regulation, effective communication, and conflict resolution.

DBT includes five essential elements, including:³

• Enhancing patient capabilities
• Improving patient motivation to stop using substances
• Generalizing new behaviors
• Structuring the environment
• Improving therapist capability and motivation

Behavioral targets for addiction patients include:³

• Relieving uncomfortable withdrawal symptoms
• Reducing cravings or urges to use substances
• Avoiding high-risk situations and cutting off people, things, and places associated with substance use
• Decreasing behaviors that motivate substance use, such as temporarily giving up the goal to quit drugs or alcohol
• Increasing healthy behaviors, such as meeting new sober friends or seeking environments that are conducive to abstinence

DBT treats slips or relapses to substance use as an opportunity as a problem to solve as opposed to a failure on the patient, therapist, or program’s part. An important facet of DBT is that of acceptance, and through acceptance of the situation, such as a lapse, patients can get back on track faster without shaming themselves. With the help of their therapist, they can analyze the events that led to substance use and take this as an opportunity to learn for the future.³

Contingency Management

Contingency management is an addiction therapy program that includes providing patients with tangible rewards to reinforce desirable behaviors like abstinence. There is a body of evidence supporting that contingency management helps reduce treatment drop-out rates and improve substance-free behaviors.⁴

There are voucher-based programs, in which patients receive a voucher for substance-free urine samples and then can use the voucher to buy movie passes, food, or other goods. The vouchers gradually increase in value over time as the person remains in treatment. Additionally, there are prize incentives that involve actual cash instead of vouchers.⁴

Motivational Enhancement Therapy

Motivational enhancement therapy (MET) for addiction is a short-term intervention that helps resolve patient ambivalence to change and treatment engagement. The counselor works with you to help foster internal motivation to quit using drugs and alcohol.⁵

This type of addiction therapy consists of about four treatment sessions. In the first session, the therapist discusses the patient assessment and patient substance use history. They also build a plan in this initial session. The counselor also discusses and teaches coping skills for drug-using triggers and stressors and encourages commitment to recovery. Unlike the other addiction therapy techniques on this list, motivational enhancement therapy is better for getting a patient to enter treatment, rather than changing drug-using behaviors in the long term.⁵

The Matrix Model

The Matrix Model is an addiction therapy that is typically used to treat an addiction to stimulants like cocaine and methamphetamines. The goal of the Matrix Model is to engage individuals in recovery programs and to help them achieve sobriety.⁶

The function of the therapist within this framework is that of a coach and a teacher, supporting, encouraging, and empowering the patient to motivate abstinent behaviors. Counselors are trained to foster self-worth, dignity, and self-esteem in their patients during therapy sessions. This positive therapeutic alliance is crucial to engaging the patient in treatment and reducing the risk of dropping out.⁶

Interventions and modalities used within the Matrix Model include:⁶

• Family therapy
• Group counseling
• Drug education
• Self-help classes
• Relapse prevention strategies
• Recovery skills
• Urine tests
• Social support groups.

Group Therapy

There are many types of group addiction therapy, with the most common types including:⁷

• Skills groups, in which people learn and practice coping skills
• Psychoeducational groups, in which patients learn about drugs and alcohol and the effects of misuse and addiction
• Support groups, in which patients can promote change within one another and debunk each other’s misconceptions and beliefs about substance use
• Cognitive-behavioral groups, in which patients work to change their thinking and behavioral patterns related to addiction
• Interpersonal process groups, in which patients have a safe space to re-enact their past experiences that may have influenced their substance use and mental health issues

Regardless of the type of group therapy, patients benefit from the sober social interactions and encouragement and support they receive from others.

Family Therapy

There are several types of family therapy, including:⁸

• Family Behavior Therapy: Contingency management is combined with behavioral contracting to rectify drug and alcohol use as well as other behavioral issues. The teen and caregiver have an active role in choosing the treatment plan and therapies used. The therapists also teach the caregiver interventions to use in the home environment as well.
• Functional Family Therapy: Using a family systems perspective, this addiction therapy focuses in improving parenting skills, conflict resolution, problem solving, and communication.
• Multidimensional Family Therapy: This is a community–and family-based addiction therapy for addicted teenagers and those at risk for conduct disorder. The goal is to enhance family collaboration with school and juvenile systems.
• Multisystemic Therapy: This addiction therapy for adolescents helps reduce substance use and violent or delinquent behaviors. The therapist analyzes the family skills, such as conflict, poor discipline, and parental drug use, the teen’s attitude and view of substance use, academic performance, and community environment to contextualize substance use and create change.

Eye Movement Desensitization and Reprocessing (EMDR)

Many people struggling with alcohol and drug addiction have also experienced trauma at some point in their lives, which often results in the development of post-traumatic stress disorder (PTSD). Untreated PTSD may just be one factor influencing drug and alcohol misuse, as many people with this mental health condition use substances to self-medicate troubling symptoms.

Typically used to treat PTSD, EMDR is a therapeutic intervention that involves a patient focusing intently on a traumatic memory while experiencing bilateral eye movements and hand tapping. This process typically decreases emotion associated with past trauma memories.EMDR does not involve exposure to the traumatic memory or vivid descriptions.⁹

If you or someone you know is struggling with substance abuse, give us a call at 866-968-5444Who Answers?. Our rehab support specialists can help you find a treatment program that uses a variety of addiction therapy techniques.

Resources

1. McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511–525.
2. Chapman A. L. (2006). Dialectical behavior therapy: current indications and unique elements. Psychiatry (Edgmont (Pa. : Township)), 3(9), 62–68.
3. Dimeff, L. A., & Linehan, M. M. (2008). Dialectical behavior therapy for substance abusers. Addiction science & clinical practice, 4(2), 39–47.
4. National Institute on Drug Abuse. (2018). Contingency Management Interventions/Motivational Incentives (Alcohol, Stimulants, Opioids, Marijuana, Nicotine).
5. National Institute on Drug Abuse. (2018). Motivational Enhancement Therapy (Alcohol, Marijuana, Nicotine).
6. National Institute on Drug Abuse. (2018). The Matrix Model (Stimulants).
7. Substance Abuse Treatment: Group Therapy [Internet]. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2005. (Treatment Improvement Protocol (TIP) Series, No. 41.) 1 Groups and Substance Abuse Treatment. 
8. National Institute on Drug Abuse. (2014). Family-Based Approaches.
9. American Psychological Association. (2017). Eye Movement Desensitization and Reprocessing (EMDR) Therapy.