In 2021, 44.1 million adults in the United States had a substance use disorder (SUD). Addictive substances and behaviors may include stimulants, sedatives, opiates, gambling, video games, and eating, just to name a few.
Yet, even when someone wants to overcome addiction, recovery can be physically, mentally, and emotionally difficult. Therapy for addiction can help you address the thoughts and behaviors behind your addiction and teach you the skills leading to long-term recovery.
Addiction therapy is highly adaptable to meet different circumstances, forms of addiction, and personality types. Insight into what to expect during addiction therapy can help you make that vital first appointment.
Understanding addiction therapy
Addiction treatment goes beyond stopping the use of a substance or behavior. There are factors — psychological, emotional, and physical — that need to be addressed for a full recovery.
There can be many factors and influences contributing to addictive behavior. Hence, there’s not one all-encompassing prescribed treatment method. Instead, therapists design treatment plans based on the needs of each individual, with the intent to change behavior over time.
For example, a therapist may choose brief opportunistic interventions (BI) and/or motivational interviewing (MI) to specifically identify how addiction affects you and the reasons behind your desire to change. Therapy may then progress to methods like cognitive behavior therapy (CBT), a popular treatment method that focuses on how thoughts and feelings affect behaviors. Establishing new habits and behaviors can come through other types of therapy, too.
The therapeutic techniques used when treating substance abuse disorders generally strive to:
Discover the source of your addiction
Address behaviors that contribute to addiction
Identify motivators to change those behaviors
Reinforce healthy behaviors
Create effective relapse treatment plans
Types of Addiction Therapy: Approaches and Techniques
A therapist can use any number of approaches and techniques to address your specific issues. The line between any of these methods is gray so that you can seamlessly move in and out of each method as needed.
We spoke with Alan Deibel, a therapist with Grow Therapy, who says, “The first step is to determine whether or not the person needs medically supervised detox. If the individual has been using alcohol, benzodiazepines, or opiates, there is a good chance they will first undergo about three to five days of medically supervised detox.”
Therapy begins during or after this process and starts with identifying motivators. Deibel says, “Motivational interviewing is a very common approach where [the] clinician learns about the client’s goals and the motivation and collaborates to meet them where they are at.”
CBT is another common therapy method as it teaches a broad range of coping and behavior skills while identifying problematic thinking patterns. Therapists might also use methods that teach life skills for long-term success.
Other therapeutic methods that are common when treating addiction include:
Contingency management
Exposure-based therapies
12-step program support groups
Therapists collaborate with clients to create a plan of action, with both parties being open to adaptation throughout the process. Together you create what’s called a therapeutic alliance, a relationship of trust that acts as a foundation for therapy throughout treatment.
Benefits of Addiction Therapy
Deibel says that a therapist and client work together to determine the kind of benefits the client wants from therapy. He adds that those benefits may be complete abstinence in some cases, while in others, it could be changing behavior patterns to reduce harm.
Each person has different motivators and goals, and a therapist helps you achieve those goals.
Therapy may begin with inpatient treatment for alcohol addiction, for example. Or, it could start with contingency management, where a series of positive rewards reinforce desired behaviors. With this approach, you might get a reward for keeping your therapy appointments or fulfilling your weekly assignments outside of therapy sessions.
The therapy process may also involve your loved ones to make changes in the environment in which you live your daily life.
Addiction therapy can also help by creating a realistic relapse prevention plan. Many people experience some level of relapse, but planning ahead can give you actionable steps to get help.
Treatment for addiction offers you support and encouragement through episodes of success and relapse, which are both normal parts of addiction recovery.
What to Look For in an Addiction Specialist
It’s important to find a licensed therapist with experience and/or a specialty in addiction treatment. You should feel like you can create a relationship of trust with your therapist, which means you may need to shop around. You can ask questions, such as:
How many years have you been practicing?
What is your experience with addiction?
Have you worked with a rehab or treatment facility?
Do you have personal experience with addiction?
You’re looking for a knowledgeable person with whom you can build a relationship of trust. Ask questions and tell the therapist about your concerns to address them right away.
What to Expect During Treatment
You may need a medically supervised detox depending on the severity and type of addiction. You’ll also begin a process of identifying motivators to set short and long-term goals.
Your therapist will probably identify where you are in the stages of change. Each stage has different thought patterns and motivations (or lack thereof) that affect your progress toward recovery.
The five stages include:
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
In the pre-contemplation stage, a person may not be ready to change the addictive behavior. In this case, a therapist may use consciousness-raising or self-evaluation to build awareness of the benefits of change.
The contemplation stage is when you learn about your treatment options and begin to think about which might work best for you.
In the preparation stage, you may prepare to quit the addiction by taking small steps to reduce the associated behavior. At this stage, you’ve already contemplated making the change but haven’t taken the necessary action(s) to stop the behavior.
The action stage is the one that most people associate with addiction therapy. It’s the stage in which you stop the addictive behavior and may experience withdrawals.
In the maintenance stage, there’s an emphasis on relapse as part of the process, not as failure. Your relapse prevention plan will help you recognize when you might be likely to relapse and what you can do to prevent it.
You may go through the action/relapse cycle before you have longer-term success, and that’s completely normal.
Addressing Common Concerns and Obstacles
No matter how motivated you are, chances are you’ll run into some kind of barrier. Although new technology and public awareness have overcome many of these barriers, here are some you may run into:
Treatment Costs
The out-of-pocket costs of therapy is a big deterrent for many people. Online therapy can be a less expensive solution in some cases. However, many health insurance plans include mental health coverage of varying levels that go unused or underutilized.
Grow Therapy has a marketplace of therapists who accept insurance and have specialties that include addiction, with options for in-person or online therapy, making the overall cost more affordable.
Proximity to Treatment
Access to addiction therapy specialists can be a serious problem, especially in rural areas. Online therapy can overcome most geographical barriers.
Grow Therapy can help here too. With a wide selection of therapists who offer telehealth, the pool of therapists you can use is drastically expanded and more easily accessible.
Social Stigma
There are stigmas around both addiction and therapy, but times have changed. More and more people openly embrace the benefits of mental health care. Additionally, mental health services are often located in the same facilities as primary care providers to further reduce stigma while making it easier to access services.
The Importance of Treating Addiction and Mental Health Issues Together
Addiction doesn’t happen in a vacuum. Instead, it often happens alongside other mental health issues. For example, alcohol use disorder may develop as a form of self-medication to reduce the symptoms of the co-occurring disorder.
Mental health disorders may happen alongside addiction because of:
Genetic or environmental predisposition: Mental health disorders and addiction can run in families.
Substance use can lead to mental health disorders: In the case of substance use, the abused substances can trigger changes in the brain that can cause or contribute to the development of mental health disorders.
Mental health disorders can lead to substance use: Alcohol and drugs are common ways to self-medicate or cope with the symptoms of a mental health disorder. Additionally, some effects of mental health disorders on the brain may increase the chances of developing an addiction.
Some of the more common co-occurring disorders include (but are not limited to):
Personality disorders
Schizophrenia
It’s important to treat dual diagnosis at the same time because of potential links between the two.
Therapy for addiction addresses you as a whole person, which includes any other health conditions, physical or mental, you may have.
Family Involvement in Addiction Therapy
Family support is crucial to addiction therapy because addiction affects more than the addicted individual. Overcoming addiction may require changing old habits and communication patterns that are deeply ingrained within the family.
“It is important to remember that addiction treatment can be very challenging with many ups and downs. A support member who can empathize, partner, and enforce healthy interpersonal boundaries are some of the keys,” says Deibel. “This can be achieved by utilizing active communication, reflective listening, and participating in family education opportunities that treatment programs may offer. Family members may also attend Al-anon [alcoholics anonymous] or any -anon self-help group as a means for getting their own support.”
The role of your family and how they support you may also change as you go through therapy. What was helpful and supportive at the beginning of therapy may be different from what’s needed during relapse prevention, for example.
Families can be supportive by:
Communicating concerns in a judgment-free environment
Having open conversations with each other about addiction and how it may affect the other people in the family
Being patient and showing compassion
Addiction may have caused trauma for family members who may need help working through their feelings, too.
Relapse Prevention: Strategies for Maintaining Recovery
It’s tempting to see relapse as a failure, but for many people, it’s simply a part of recovery.
Try to look at relapse as another step toward a life of sobriety.
Relapse begins with an emotional relapse, where you feel the need to use, followed by a mental relapse into old thought patterns. Physical relapse, where you use the addictive substance again, is the last stage and may take several weeks or months to happen.
A relapse prevention plan teaches you to recognize relapse signs and gives you specific actions to take. For example, it might have a helpline so you can get support 24/7.
“I recommend creating a relapse prevention plan and to consult it and modify it often,” Deibel says. “This results in a more proactive approach to sobriety. It’s also important to stay connected to your goals, whatever they may be.”
Relapse prevention plans work to:
Identify triggers
Remind you of motivators
Ask for help from your support network and treatment providers
Help you take care of yourself
Be gentle with yourself. Recovery looks different for each person, and it takes time.
How Addiction Therapy Can Set the Foundation for a Better Life
Substance abuse acts more like a chronic illness than a bout with a bad flu that’s over and done in a short amount of time. Often, it requires maintenance and care for a lifetime.
Addiction therapy helps you develop new thought patterns and habits and gives you the tools and skills to maintain those changes long term. Long-term recovery also requires taking care of your physical and mental health, filling your life with meaningful activities, and cultivating a sense of community through strong personal relationships.
Lasting recovery looks different for each person. Some people choose to include faith-based support, while others opt for clinical treatment. Further, others find that carefully monitored medications, self-care, and strong peer support offer them the best long-term solutions.
A therapist may also adapt your relapse prevention plan to address challenges that arise as you change and grow as a person.
Final Thoughts
Addiction therapy isn’t one-size-fits-all because addiction looks different from person to person.
A licensed therapist with experience treating addiction can make all the difference. Specialists can identify techniques and methods that address your specific needs and circumstances, including plans to work with your support network and overcome relapse episodes.
At Grow Therapy, we believe everyone should have access to affordable mental health treatment. We can help you find a therapist who has experience in addiction recovery and accepts your health insurance.
About Jaclyn Gulotta
Dr. Jaclyn Gulotta is a licensed mental health counselor with over 10 years of experience in the mental health field. She helps individuals overcome numerous issues, including stress and anxiety disorders, self-esteem issues, relationship issues, depression, behavioral issues, and grief.
