Have you ever been confused by all the treatment jargon? Dual diagnosis, 12-Steps, Cognitive Behavioral Therapy, Art Therapy, Equine Therapy, etc.? What are all these methods and, far more important, which ones work?
That’s what research tries to solve. The answers found through this research are referred to as evidence-based treatment. Some people may be very surprised to learn that Alcoholics Anonymous and other 12-Step programs common throughout the US do not necessarily constitute evidence-based treatment leading to positive outcomes for those trying to break free from addiction.
To be clear, there are 12-Step based therapies, particularly Twelve-Step Facilitation (TSF) that research has proven to be effective. This is similar to AA, but is centered around groups facilitated by licensed clinicians, not just your average person in recovery, which is common for most regular AA groups throughout the country.
Other therapies, like Art Therapy and Equine Therapy have yet to be validated by extensive research.
Yet, all these methods are commonly found incorporated into treatment programs and listed on their websites. So what’s really important is to understand which therapies are currently validated by research that provide better treatment outcomes for those struggling with addiction.
What is Cognitive Behavioral Therapy?
Cognitive Behavioral Therapy (CBT) is a mainstay among quality recovery centers. CBT uses mental techniques to treat addiction and builds itself off of ideas of self-empowerment and actually training the brain to rewire each individual’s thoughts and behaviors.
CBT programs tend to be more secular as a component of the recovery process and address the process of self-correction instead of needing to attend regular AA meetings to stay clean. We do want to stress though that just because you have taken a CBT approach to recovery does not mean that you cannot participate in local AA meetings or hold religious values. You can still go through CBT-based treatment and keep traditional 12-Step. Both can work for different people and different reasons. It’s important to find what works for you.
So How Does Cognitive Behavioral Therapy Work?
Cognitive Behavioral Therapy approaches can only be taught by licensed clinicians, not just recovery counselors. This means that the staff at the center has to be properly trained and qualified. If a center doesn’t actually have licensed staff, this is a good sign that they aren’t using evidence-based approaches to treatment. If they claim to, it’s a sign that you might want to look elsewhere.
CBT techniques work by getting each individual to identify how their own thoughts and feelings are influencing their actions. Through repeated thinking approaches learned at the center, people struggling with addiction can physically rewire their own brains to disrupt their addiction patterns! Attacking the addiction at this level usually has a higher chance of lasting recovery, though relapses are still a possibility if the brain isn’t fully rewired.
What Is Dialectical Behavioral Therapy?
When centers embrace evidence-based treatment, it usually involves more than one evidence-based method. Cognitive behavioral therapy is a common choice, but so is its counterpart, Dialectical Behavioral Therapy (DBT). DBT is a specific type of CBT that focuses on altering an individual’s negative thought patterns. These negative thoughts encourage many different types of negative emotions and ultimately, lead to negative behaviors.
What’s the Difference Between DBT and CBT?
CBT is based on the idea that we can change our feelings and how we act based solely on how we think. DBT takes this concept further and includes ideas of acceptance and validation. Individuals learn that everything they are feeling is real, but they have to learn to accept it.
DBT is important in addiction treatment because these negative emotions have been found to heavily influence whether or not someone is going to use. DBT allows the person struggling with addiction to be in-tune with their own emotions and be willing to accept themselves for who they are. Often, the root cause of the addiction itself is uncovered during these sessions and once clients know how to deal with that, the recovery process can really start.
Both CBT and DBT can be used alone or in combination with 12-Step models. Both have been tested and shown to be effective forms of addiction treatment.
How Does Motivational Interviewing Help Addiction?
A lot of centers, 12-Step or 12-Step Alternatives, will have some sort of Motivational Interviewing. This is another evidence-based approach that works with each client to understand themselves and their own insecurities even more. Ultimately, Motivational Interviewing techniques are designed to encourage the client to understand that they are capable of changing their own behaviors.
There is a lot of self-empowerment taught in this approach which is why it can be confusing when combined with 12-Step methodology. 12-Step methods are based on the idea that we as humans have a lack of power and must submit to God or a higher power to help control our addiction.
It is situations like these where combining traditional 12-Step approaches to recovery with specific evidence-based techniques can be confusing for individuals in recovery since specific aspects could contradict each other. Understanding where each approach is coming from can help combat these feelings.
Family Involvement In Addiction Recovery
Strong recovery programs will allow for opportunities for family involvement in the recovery process, as long as this is what the patient wants. Addiction takes a toll on not only the user, but loved ones as well. When the individual goes to rehab, it is almost equally important that the family members have some guidance about recovery as well.
By having the family more involved, they will be better able to spot negative behaviors that might lead to relapse. Also, family members might have frustrations and emotions related to the addiction that they need to work out if they want to try to help put an end to the addiction cycle. By working through recovery themselves, it gives the Family members a better chance at healing.
Is Addiction Recovery the Same For Everyone?
Not everyone’s story of addiction is the same and as such, their recovery journey shouldn’t be either. While a program can offer these evidence-based treatments, it’s how they use them that really matters. Whichever treatment method/methods are employed, it needs to be tailored for each individual receiving the treatment.
Not everyone is going to respond the same way and each patient is going to have difference values, preferences, and overall needs that must be met. The more each clinician works with each person in recovery, individual treatment programs should be made based on evidence from their sessions. If everyone is receiving the same treatment program, there is a good chance that the clinical program is lacking.
Does the Relationship With the Counselor Matter?
A clinician could have a perfect modality to work with on a particular client, but that is not going to matter if there is no rapport built between the two. The more open and connected they can be with one another, the more successful the treatment can be. Because of the important of this relationship, treatment centers should have some flexibility about which client works with which counselor. Individuals in recovery should not be forced to see one particular clinician without any other options.
The center needs to look into which treatment provider might be the best match and pair the two accordingly. We want to stress that this does not mean the patient is in the right to choose their own counselor since they might not have the best judgement regarding this. We are suggesting that the patient/counselor pairing needs to be a collaborative effort!
How To Choose An Addiction Treatment Center?
The process of finding a treatment center that is going to be right for you or a loved one can be tricky. It is important that you know what to ask about when you call. A lot of times, centers will list the features we mentioned in this article on their website, but when it comes to actually incorporating them into their program, they become lost and aren’t used. Here are some things you might want to ask:
- Are your clinicians licensed? Who runs the groups (make sure it’s not just someone else in recovery or other patients)? Also, if they just have a counselor certification, they should not be running most of the groups (some are OK).
- How are patients involved in their own recovery (you’re trying to assess here whether they’re teaching skills that patients practice or just giving educational lectures. Educational lectures have been proven not to work.
- If 12-Step/AA is a major part of treatment, who facilitates it?
- Is treatment tailored to each individual patient or does everyone complete the same program?
Is Evidence-Based Treatment For Me?
If you are considering evidence-based treatment, know that it is not something you can do alone. You will need access to a certified therapist in either an inpatient or outpatient rehab setting. Once you find a program that works for you, your next step will be to sit down with a clinician and find a treatment solution that will work for you.
More often than not, more than one evidence-based therapy will be applied and your recovery program will continue to evolve as you complete more and more of the recovery process. Still have more questions? We’d be happy to answer them. Contact us today!