There are a number of common drug and alcohol rehabilitation therapies, each designed to help an individual recover from addiction. While each has its strengths and weaknesses, no single approach works best for everyone. An effective rehabilitation program will be flexible, tailoring therapy to the personal circumstances of each patient. Indeed, the most effective therapy will employ a mixture of different methodologies from multiple therapeutic approaches.
Motivational Enhancement Therapy
Motivational Enhancement Therapy is applied to therapy that works to enhance and understand the motivation that exists in a patient’s interaction with an object of addiction. Two primary methods are used in this method:
- Motivational Interviewing
- Resistance Reduction
Motivational Interviewing involves the therapist asking pointed questions to help the patient understand the value he or she has placed in the object of addiction, and how dependence and abuse have affected the patient’s life. From this should come increased understanding of the patient’s uncertainty concerning rehabilitation, an increased motivation to stop using, and a desire to develop a recovery plan.
Resistance Reduction, instead of focusing on the ambivalence a patient has towards changing his or her behavior, Resistance Reduction addresses this uncertainty without requiring the client to change. Through this, it is believed the patient increases his or her tolerance for these thoughts and feelings, thereby reducing opposition to therapy and the changes it brings. This is accomplished because of intensive exploration of how behavior patterns operate, and the validity that any number of possible outcomes may have. Resistance Reduction does not require patients to want to change in order for therapy to move forward.
Cognitive Behavior Therapy (CBT)
Cognitive Behavior Therapy centers on the premise that individuals can and will monitor and control their behavior, if they have the proper skill-sets. The therapy involves changing how the patient thinks about conditions and circumstances, teaching and reinforcing rational processes to control the processes that contribute to substance abuse. This therapeutic approach also works to eliminate the patient’s belief, common to many who are addicted, that he or she cannot function without the object of addiction.
Dialectical Behavior Therapy (DBT)
Dialectical Behavior Therapy is a specialized form of Cognitive Behavior Therapy focusing on the patients developing skills for tolerating stress and emotional discomfort, by helping them to understand and accept difficult situations while at the same time developing ways to change the behaviors that contribute to those situations.
Psychodynamic Therapy stems from a Freudian approach that seeks to have patients delve into their subconscious and understand how this influences behavior. Therapy involves exploring unresolved conflicts and unsuccessful relationships with the underlying belief that resolving the attendant issues will eliminate the need for the substance or behavior on which the patient has become dependent.
Rising from the approach developed by Alcoholics Anonymous (AA), 12-step counseling involves working with a therapist, while at the same time attending AA (or appropriately themed groups) meeting. This differs from the traditional AA approach which does not rely on mental health professionals in its process. Like AA, however, 12-Step Counseling does follow three critical beliefs and principles:
- People who are addicted have lost the ability to control the substance or behavior identified.
- No effective cure for addiction exists – abstinence most be total and ongoing.
- Hope for recovery rests in accepting the loss of control and placing faith in a higher power.
Working with the therapist is not a permanent situation, and gradually the patient begins regular and exclusive attendance at 12-step meetings.