Because addiction can affect many aspects of a person's life, multiple types of treatment are often required. In many cases, individual or group psychotherapy is used in combination with medication to control cravings and relieve withdrawal symptoms. The most effective and sustainable treatment approaches also address any co-occurring medical, psychiatric, and social problems. In some cases, treatment may include hospitalization, therapeutic communities or sober houses, or outpatient rehabilitation programs.
Psychotherapy can help addicts understand their behavior and motivations, develop improved self-regard, cope with stress more effectively, and address co-occurring mental health problems, such as depression or anxiety.
Behavioral Couples Therapy (BCT)
Behavioral couples therapy focuses both on reducing alcohol or substance use by the addicted individual and on improving overall marital satisfaction for both partners. A key feature of BCT is a daily Sobriety Contract, in which the addict states their intent not to drink or use drugs that day, and the partner expresses support for their efforts to abstain. Behavioral assignments help both partners increase positive feelings, shared activities, and constructive communication.
Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy helps patients become more aware of inaccurate or negative thinking so they can view challenging situations more accurately and respond to them more effectively. As patients become more aware of their thinking and activities, they learn to identify how those thoughts and activities affect their mood and behavior. They then learn techniques to change thinking and behavior that contribute to substance use, and to improve coping skills, mood, and interpersonal functioning.
Motivational incentives are rewards for specific behavioral goals related to recovery from addiction. For example, behavior that might be rewarded includes generating negative drug test results, adhering to treatment, and accomplishing pre-defined treatment goals.
Community Reinforcement Approach (CRA)
The Community Reinforcement Approach is a type of CBT that focuses on environmental factors that impact the patient's behavior. CRA uses family, social, recreational, and occupational events to support the individual in changing their addictive behaviors and in creating a successful sobriety. CRA builds the patient's motivation to quit drinking or using, helps the patient initiate sobriety, analyzes the patient's addiction pattern, increases positive reinforcement, teaches new coping behaviors, and involves significant others in the recovery process.
Motivational Interviewing (MI)
Motivational interviewing uses an empathic, guiding approach intended to heighten awareness of ambivalence about change, clarify values, promote commitment to change, and enhance self-efficacy. Motivational enhancement therapy, or MET, is a more structured form of motivational interviewing that utilizes systematic assessment.