You are ready to enter substance abuse treatment. But there are so many choices available! How do you know which one is the best? According to Substance Abuse and Mental Health Services Administration’s statistics, 23.5 million people age twelve and over need treatment for substance abuse, yet only 2.6 million actually enter treatment. Many of the methods suggested here could potentially help more people seek help.Everyone reacts differently to treatment, and so no one method of substance abuse treatment works for all. That is why a wide range of plans, programs, and treatment methods have been developed. Each program emphasizes recovery, but may approach the topic differently. Finding the one that fits your needs best is vital for a full recovery.
Evidence-Based Treatment Programs
As you search for a treatment program, consider selecting an evidence-based treatment program. The term ‘evidence-based’ is borrowed from the field of medicine. With evidence-based medicine, three factors are taken into account when selecting treatment for individuals:
- Clinical research: Clinical research demonstrating the effectiveness of the treatment program is the first consideration. If there is overwhelming evidence a treatment method works with minimal side effects, it may be considered for the patient.
- Clinician judgment: Next, doctors or therapists must use their clinical judgment and experience to decide on the appropriate course of treatment. They base their recommendations on clinical research and expert opinion.
- Client choice: The last step in evidence-based medicine is client choice. The patient or client always has the right to refuse treatment or request different treatment. Clients must be informed of their choices.
With evidence-based treatment programs, psychologists and substance abuse counselors look for data to support the claims that recovery is possible with a particular treatment modality. Next, they may help clients sort through myriad treatment options to find the one that is best for their personal needs and beliefs. Clients can then choose for themselves which evidence-based substance abuse program of which they would like to participate.
The Four Strongest Evidence-Based Programs
There are countless recovery programs available, but the following four treatment programs are the ones most addiction and recovery doctors and therapists recommend first to their clients. Many people have successfully recovered in each of these four programs, and there is ample clinical research supporting the idea these programs work. Clients can choose among them for the one that seems like the best fit. The four strongest evidence-based substance abuse programs are:
- Cognitive behavioral therapy
- Motivational enhancement therapy
- 12-step programs
- Family behavior therapy
Cognitive Behavioral Therapy: Changing How You React By Changing Your Thinking
Cognitive behavioral therapy hinges on the assumption past traumas or incidents affect how you react to life’s stressors today. Cognitive behavioral therapy (CBT) helps you recognize situations that trigger cravings for alcohol or drugs and change your reaction so you think differently and choose differently. The short duration of the therapy — combined with its effectiveness at helping people overcome multiple problems in addition to substance abuse — makes it very appealing. It is covered by most insurance programs, making it more affordable than other therapeutic approaches.
Cognitive Behavioral Therapy Techniques
There are six steps in cognitive behavioral therapy:
- Assessment
- Reconceptualization
- Skills building
- Skills consolidation and application training
- Generalization and maintenance
- Post-treatment assessment
After an initial assessment, therapists help clients recognize poorly developed coping mechanisms that lead to relapse, and help people replace them with smarter choices. The goal is to anticipate possible triggers for cravings and change how you react to them. CBT techniques include visualization, thinking differently about situations, coming up with alternatives, and self-monitoring to help people know when they need to implement their CBT strategies. According to the National Institute on Drug Abuse, cognitive behavioral therapy alone is effective at helping people remain sober even after people leave therapy. However, its effectiveness may be enhanced when combined with other substance abuse treatment methods. While there are no statistics available on the exact number or percent of addicts helped by CBT, nearly all reputable organizations like NIDA and the U.S. National Library of Medicine agree cognitive behavioral therapy offers strong evidence of effectiveness as an evidence-based treatment program for substance abuse.
Motivational Enhancement Therapy to Overcome Personal Roadblocks
Motivational enhancement therapy is the second evidence-based treatment program for substance abuse that appears to be quite successful. With motivational enhancement therapy, substance abusers work to overcome their mental roadblocks to seeking treatment or staying recovered. While not a recovery treatment per se, if motivational enhancement therapy is offered in conjunction with other therapies, it seems to help the outcomes overall.In motivational enhancement therapy (MET), clients meet with a therapist for approximately four to six sessions. At your first session, the therapist will assess your condition and especially your motivation for entering treatment. Next, you will attend a series of two to four therapy sessions to discuss the results of your initial assessment, your current substance abuse level, and reasons for entering treatment. During MET, the therapist’s job is not to help you recover, but to help you get to a place where you want to recover. Providing feedback to you is like holding up a mirror and reflecting back your substance abuse — you get to see how you really are in the eyes of a professional. You might not like what you see, but it is a good motivator to enter treatment. The goal is to motivate you so you take the next step in your treatment. Without adequate motivation, the best recovery and treatment facility in the world cannot help you. After motivational enhancement therapy is complete, you may still have sessions where your therapist helps you develop coping strategies for risky situations. You may also learn new ways of dealing with cravings and temptations to relapse. MET can be a great therapy by itself or as an adjunct to keeping your motivation high for participating in other recovery programs.
The Twelve Steps and Twelve Step Facilitations
Perhaps the oldest and best-known of the evidence-based treatment programs for substance abuse are the Twelve Steps. Twelve-Step Programs began with Alcoholics Anonymous in the 1930s and have since spread to nearly all forms of addiction ranging from drug abuse to gambling and shopping addictions. Born from a religious movement called the Oxford Group, the 12 steps help individuals admit they have a problem, acknowledge they need help, work on their personal stumbling blocks and defects, seek restitution and repair broken relationships, and continue in recovery through service, fellowship, and a connection with a Higher Power.The Twelve Steps form the basis for many substance abuse treatment programs. From the single original program developed in the 1930s, today there are 94 verified Twelve Step fellowships. These include traditional “anonymous” meetings held in church basements, hospital meeting rooms, and other locations worldwide. But The Twelve Steps are also used in many other recovery programs. There are religious recovery programs based on the Twelve Steps, agnostic programs, and every other type of program in between. The Twelve Steps can be summarized as follows:
- Admitted we were powerless over drugs, alcohol or whatever substance or behavior we are addicted to.
- Came to believe a power greater than ourselves could restore us to sanity.
- Made a decision to turn our will and our lives over to our Higher Power as we understand him/her/it.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the nature of our wrongs.
- Were entirely ready to have God remove our defects of character.
- Humbly asked God to remove our shortcomings.
- Made a list of all persons we had harmed, and became willing to make amends to them all.
- Made direct amends to such people whenever possible, except when it would cause harm to them or others to do so.
- Sought through prayer and meditation to improve our conscious contact with God (Higher Power) as we understood Him, seeking only to understand His will for us and the power to carry it out.
- Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. Assessment
Millions of people worldwide have experienced the so-called “spiritual awakening” promised by the Twelve Steps, and have gained sobriety, peace of mind, happiness and usefulness to others. As the oldest among the evidence-based treatment programs, the Twelve Steps stand out as an effective recovery method.
Twelve Step Facilitation Therapy
Twelve Step Facilitation Therapy, like MET, is not about participation in The Twelve Steps on its own, but a means to encourage abusers to enter a 12-step program. Twelve Step Facilitation Therapy has three components:
- Acceptance, or realizing substance abuse is both a chronic and progressive disease from which there is no permanent cure, only a daily respite.
- Surrender, or giving oneself over to a Higher Power, the group’s wisdom, or some other spiritual method.
- Involvement, or working actively with a local 12-step group.
Twelve Step Facilitation can be thought of like the prologue to a book or the overture to a musical. It is not the final production in and of itself, but it sets the stage and tone for the rest of the story. This type of therapy can be useful for people who need more time to accept they really cannot stop their addiction by sheer willpower alone, and need help. From there, they can enter into a 12-step program and find recovery.
Family Therapy for Substance Abusers
Families today may look different from families 100 years ago, but the complex, messy relationships within are the same whether you have a traditional two-parent household, two households with step-parents, or same sex couples struggling to raise healthy kids. Family therapy for substance abusers focuses on helping families heal the problems within the core relationships among family members that may have led the substance abuser down the path to addiction. Participants in family therapy may not even be related by blood. Because family ties are both genetic and elective, family therapy may include people who are not blood relatives but emotionally tied to the substance abuser. An example may be godparents or close friends with whom they share such a tight bond they are “like sisters or brothers.” A good therapist can help you identify ‘family’ to invite into the sessions to help your recovery. Families are never to be blamed for an addict’s behavior. No matter how messed up a family is, it cannot be blamed solely for someone’s addiction. But strained family relationships, bad coping mechanisms and poor role models can all contribute to a substance abuser’s problems. Family therapy focuses not on individuals, but on the system itself — the family’s web of relationships, stories, personalities, coping, and communication mechanisms. Like any system, changes to one dynamic have ripple effects and can change other parts of the system. Change on relationship within the complex web of families and everyone changes to some extent. Good family support can greatly help a substance abuser successfully recover, but it can be hard for families to know how to handle their loved one’s addiction. Walking the fine line between enabling an addiction and loving an addict can be tough. Family therapy helps everyone in the family system understand and cope with the addict’s behavior. By identifying and gathering together the strengths in the family system, the family itself can act like a life raft or safety net for the addict, helping to keep them afloat during recovery.
Choosing a Treatment Center
People are highly individual, and so they need individualized treatment programs takes into account their substance abuse problems, personal history, and family situation. These four evidence-based treatment programs for substance abuse offer different approaches to the same problem. Used separately or together, they have helped many people recover from the chronic, debilitating disease of addiction. At The Ranch PA, we take a progressive approach to recovery. Individualized treatment plans and aftercare plans help you recover in ways that are comfortable for you. Our holistic recovery programs include techniques to help you recover in body, mind, and spirit from the debilitating effects of drug and alcohol addiction. The Ranch PA offers residential drug and alcohol treatment programs in a safe, friendly environment. Because we have a high staff-to-client ratio, you may feel a strong sense of support and community while you are with us for treatment. If you are struggling with drug or alcohol addiction, please contact us today: An intake specialist will be glad to speak with you.
