Addiction counselling and approaches to therapy
Substance abuse can alter the structure of the brain and impede its normal functioning. This can result in physiological changes that can persist for many months or even years into recovery. That’s why drug users are often at risk of relapsing even after abstaining from drug use for a long time.
The best treatments for substance abuse take this into consideration. They should address the medical, social, psychological, legal and work related problems related to substance misuse and abuse. Treatment should consider the patient’s age, sex, culture and ethnicity as well.
It is important for addicts to remain in treatment for an appropriate period of time. The duration should depend on the type and extent of the problem and the needs of the individual. Generally, the longer the duration of a treatment episode, the greater the chance of full recovery.
Recovering from alcohol/drug abuse is a long-term process and requires a lot of hard work, discipline and persistence. Getting the right kind of medical assistance is critical in the process.
Individual or group counselling is the most common type of treatment for drug abuse. These therapies vary in their intensity and focus, but involve focusing on the individual’s motivation to change. They provide the right kind of incentives for abstinence and help the individual build critical skills to avoid relapsing in the future.
Counselling consists of constructive activities, such as improving the patient’s problem solving skills and helping them develop social skills through participating in group therapy sessions and support groups.
Along with the private counselling and psychotherapy, patients may also be given family therapy, medication, the provision of medical help, instructions on parenting, skill development, and vocational training. The treatment plan of the individual should be assessed on a continual basis and be changed or modified as needed, so that they match the person’s changing needs.
Patients are provided with a continuing care approach where the intensity of the treatment will depend on their changing needs. Many individuals who are affected drug addiction are also more likely to be suffering from many mental disorders. The treatment for such patients should address the use of psychiatric medications as well, wherever needed.
Behavioural treatments focus on changing attitudes, incentivising the patients to stay sober and modifying their behaviour. The goal is to help improve their life skills and make them capable of handling stressful situations, such as watching out for the environmental cues that could trigger a relapse and a fallback to drug misuse. Here’s a look at the most common behavioural therapies provided at rehab centres.
Cognitive-behavioural therapy (CBT) was originally developed as treatment for alcohol addiction. It is now used to treat all sorts of addictions, including drug addiction. In CBT, individuals learn to identify harmful behaviours and correct them through the application of a number of different skills for stopping the drug abuse.
The therapist will use a range of strategies to help the individual enhance their self-control. Different techniques are used to explore the positive and negative consequences of drug abuse. The individual performs self-monitoring to identify any cravings for the drug and well develop skills to prepare for possible high risk situations. The most important part of the treatment is to anticipate the problems well in advance, so that patients develop better coping strategies.
There is plenty of research that indicates that any skill learned by the individual through CBT remains with them even years after the conclusion of the treatment. There are many studies that indicate that the gains achieved through the CBT approach remain for at least a year or two years. Cognitive-behavioural therapy can be made even more effective by combining it with the right medications for drug abuse and using other types of behavioural therapies.
Motivational Incentives or Contingency Management Interventions
Motivational Incentives or contingency management interventions involve providing the patients with simple incentives that don’t cost much in return for giving drug-free urine samples during their stay at the rehab. The incentives provided in this approach can include vouchers that can be exchanged for movie tickets, cakes, chocolates and sweets, and so on.
There are plenty of studies that indicate that using an incentive based intervention can improve the chances of the patient staying at the rehab for the complete duration of the treatment and staying sober following the conclusion of their stay.
The only issue is that such interventions have an element of chance and could lead to gambling and other dangerous habits. However, researchers say that the possibility of this leading to pathological gambling is negligible, so this is not really an issue.
Motivational Enhancement Therapy
Motivational Enhancement Therapy (MET) is a different kind of counselling approach that believes in enforcing behavioural changes in patients by helping them resolve any confusion that they might have about participating in the treatment and preventing drug use permanently.
This unique approach makes use of strategies that result in fast and effective changes, where the motivation for the change comes from the patients themselves rather than through any external guidance.
This unique therapy begins with an initial assessment battery of the patient, following which the patient has two to four one-to-one sessions with a trained therapist. The therapist first gives their feedback on the initial assessment battery to the patient, and starts a discussion on their drug use. They use highly motivational interviewing techniques which start the patient on a self-motivational journey and help build a systematic plan for change.
The therapist trains the patient to develop a coping mechanism for high-risk scenarios. They monitor any change in the patient in the following sessions and motivate them to stick to the recovery plan for a more permanent abstinence. Patients are also asked to bring their partners with them to the sessions.
The success rate of the MET approach will depend on the goals of the intervention and can vary for different types of substance abuse. This approach works very well with alcohol addiction and results in immediate reduction in drinking.
It is also quite effective at treating abuse of drugs such as marijuana, especially when used in a combination with cognitive-behavioural therapy. However, there is still a debate over the effectiveness of this approach for substances such as heroin, cocaine and nicotine.
The Matrix Model (Stimulants)
The Matrix Model delivers a systematic framework to therapists for dealing with addicts who are abusing drugs such as methamphetamine and cocaine. It helps such individuals become sober and achieve abstinence on a permanent basis.
In this treatment, patients learn about issues critical to addiction and relapse, receive direction and support from a trained therapist, and become a part of various self-help programs. They are constantly monitored for drug use by the rehab staff. The therapist is both a teacher and coach, and develops a positive, friendly and encouraging relationship with the recovering addict and motivates them to bring about a positive behavioural change.
All interactions between the therapist and the recovering addict is frank and direct, but not argumentative or confrontational. The therapist does not behave like a parent, but acts as an equal. They help build the individual’s self-esteem, self-worth and reinforce their sense of self-pride and dignity.
This treatment approach will consist of the involvement of family education groups, early recovery skills groups, relapse prevention groups and social support groups. Different treatments and approaches are tried such as 12‑step programs, urine tests, combined sessions and relapse analysis. The Matrix Model approach has a high success rate and has helped tens of thousands across the world get over their addiction to drugs and alcohol use.
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