The most effective therapy for substance abuse depends on each person’s specific needs and circumstances. Therefore, treatment plans typically involve a combination of different strategies and services to develop an overall holistic approach to recovery. Some of the most widely acclaimed and researched treatments for substance misuse include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and motivational enhancement therapy (MET). There are many more, however, all of which can be incorporated into an individual’s treatment plan.

Bishop Health offers innovative outpatient psychiatry and mental health treatment designed to help individuals achieve their desired results. We provide a comprehensive array of outpatient treatments and psychiatry services, using highly-individualized programs with flexible options. Our team is composed of knowledgeable and supportive providers who go the extra mile to treat each person with an all-encompassing, holistic approach to recovery.

What Are the Available Therapies for Substance Abuse?

A wide variety of therapeutic approaches are shown to be effective in treating substance misuse. 

Commonly Used Evidence-Based Therapies Include:

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is a form of psychotherapy based on the proposition that our thoughts, feelings, and behaviors are interconnected. (1) CBT focuses on changing harmful thinking patterns and behavior to help people manage their emotions and improve their quality of life. It also teaches coping skills and strategies for managing difficult situations more healthily.

Dialectical Behavioral Therapy

Dialectical behavioral therapy (DBT) combines cognitive behavioral techniques with mindfulness practices and is specially adapted for people who experience emotions intensely. (2) DBT focuses on helping people accept the reality of their lives and behaviors and learn to transform them for the better.

Motivational Enhancement Therapy

Motivational enhancement therapy (MET) is a type of psychotherapy designed to help people struggling with substance use disorders. (3) It is based on the idea that the individual’s motivations and desires for change are the most essential factor in the recovery process. The goal of MET is to help the patient increase their own motivation to change and to help them develop the tools and strategies they need to sustain that change over time. 

Contingency Management

Contingency management (CM) is a form of behavioral therapy based on the principles of operant conditioning. (4)  It is a reinforcement-based approach to change behavior by providing rewards for desired behaviors and adverse consequences for undesired behaviors. For example, a person recovering from substance misuse might receive a voucher or prize for passing a drug test, reinforcing their continued sobriety.

Individual, Group, & Family Therapies

Individual therapy involves one-on-one sessions between a therapist and a patient who work together to identify and address the patient’s psycho-emotional problems to improve their overall mental health and well-being.

Group therapy involves a small group of individuals meeting regularly with a trained therapist to work on their emotional and psychological issues. Unlike individual therapy, where the focus is on one person, group therapy provides a supportive and interactive environment where people can work through their problems and receive feedback and support from others.

Family therapy involves one or more family members or those with close relationships working with a trained therapist to address emotional and psychological issues affecting the unit as a whole. Family therapy aims to improve communication, build stronger relationships, and resolve conflicts within the family system.

Eye Movement Desensitization & Reprocessing

Eye movement desensitization and reprocessing (EMDR) helps individuals who’ve experienced traumatic events, such as childhood abuse, heal emotionally. (5) This treatment is based on the idea that traumatic experiences become trapped in the brain, resulting in psychological symptoms such as anxiety and depression. EMDR involves using eye movements to help individuals process traumatic memories. It is thought that this technique stimulates the brain’s natural healing processes.

Rational Emotive Behavioral Therapy

Rational emotive behavioral therapy (REBT) is a form of CBT based on the idea that people’s emotions and behaviors are primarily influenced by their thoughts and beliefs and that altering them can promote emotional and behavioral improvements. (6) In REBT, the therapist works with the client to identify and challenge irrational or self-defeating thoughts and beliefs and replace them with healthier and more adaptive ones.

12-Step Programs

12-step programs are support groups based on a spiritual and psychological approach to addiction and recovery. They are designed to help individuals struggling with substance misuse or other forms of addiction. Alcoholics Anonymous (AA) was the first program of this kind. Since its inception, the steps have been adapted for a wide range of other addiction and recovery programs, including Narcotics Anonymous (NA) and others.

Which Is the Most Effective Evidence-Based Therapy?

As noted, because no individual is exactly like any other, no one treatment protocol will work for everyone. With so many beneficial therapies available, relying on a singular approach is usually unnecessary. Instead, individuals can be provided with a combination of treatments and services designed to treat all aspects of an individual’s mental, physical, and spiritual wellness. 

That said, a vast amount of research supports the use of CBT for most mental health issues. For example, a paper in the journal Frontiers in Psychiatry states that CBT is “the gold standard psychological treatment.” It is the most studied form of psychotherapy, and no other treatment has been shown to be “systematically superior.” (7)

Treating Mental Health Disorders With Therapy

CBT is also an extremely popular treatment modality to effectively treat most mental health and behavioral issues. Other approaches may be more beneficial for some people than others, so identifying the best strategies for an individual may require trial and error and plan adjustments.

Psychological Disorders Treated With Therapy Include:

Anxiety

Anxiety is a feeling of nervousness or unease about something with an uncertain outcome. (8) Although anxiety is a normal response to stress, when it becomes constant or overwhelming, it can be incapacitating and interfere with daily activities, such as work, school, and relationships. Therapists often use CBT as a first-line strategy for anxiety, usually in addition to medication such as antidepressants.

Depression

Depression is hallmarked by persistent feelings of sadness, hopelessness, and helplessness. (9) Individuals who experience clinical depression lose interest in activities they once enjoyed and are held back in life by fatigue and low energy. As with anxiety, CBT is typically the go-to approach to treating depression, in combination with medication such as antidepressants.

Addictions

Both substance misuse and behavioral addictions (e.g., gambling, shopping, etc.) are chronic disorders that alter a person’s brain and reward system in a way that makes them singularly focused on a substance or pattern of behavior. Individuals with addictions are plagued by dependence and compulsive behavior that persists despite adverse consequences.

Both behavioral addictions and substance misuse are often treated first with CBT. Certain medications are also used to treat substance misuse to help reduce drug cravings and withdrawal symptoms.

Personality Disorders

A personality disorder is a particularly persistent pattern of thoughts, emotions, behaviors, and interpersonal functioning that differs significantly from cultural norms and causes significant distress or impairment. (10) Examples include borderline, narcissistic, and antisocial personality disorders. Treatment for personality disorders typically involves psychotherapy, such as CBT or DBT, and medication in some cases.

Bipolar Disorder

Bipolar disorder is characterized by extreme mood swings or changes, from periods of extreme highs (mania) to periods of extreme lows (depression). (11) Treatment for bipolar disorder typically involves a combination of medication and therapy, such as CBT or family-focused therapy. Mood stabilizers such as antipsychotics are also frequently prescribed.

Schizophrenia

Schizophrenia is a severe, chronic mental illness characterized by changes in thinking, perception, emotion, and behavior. (12) Hallmark signs of schizophrenia are delusions, hallucinations, and disordered thinking. Medication, including antipsychotics, is typically a vital component of treatment accompanied by CBT.

Adjustment Disorders

Adjustment disorders develop in response to stressors in a person’s life. (13) These stressors can be any significant change or challenge, such as a change in living situation, loss of a loved one, medical illness or injury, or meaningful life change or event. Treatment may include CBT, medication, and recommended lifestyle modifications.

How Do Therapies Help Treat Drug & Alcohol Use Disorders?

Therapy provides individuals with addiction education and relapse prevention techniques and helps them learn new coping skills and how to build a solid support network. Working with a therapist can help people let go of negative thoughts and feelings, such as shame and guilt, and improve their self-image. Furthermore, they learn how to identify and explore motivations and triggers that lead to substance misuse. Overall, individuals should be provided with the tools, support, and resources they need to maintain sobriety and improve their overall well-being. 

Therapies We Offer for Behavioral & Mental Health Disorders

Bishop Health is a full-service mental health treatment center in Portland, Maine. We offer various evidence-based treatment modalities in combination with traditional therapies, such as the following:

If you would like to learn more about Bishop Health and how we can help you begin your recovery journey, contact us today for a free, no-obligation assessment and health insurance benefits check. Let us help you take the first step toward a healthy and drug-free life.

SOURCES

(1)https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

(2)https://behavioraltech.org/resources/faqs/dialectical-behavior-therapy-dbt/

(3)https://www.columbiadoctors.org/treatments-conditions/motivational-enhancement-therapy

(4)https://www.healthaffairs.org/do/10.1377/forefront.20200305.965186/full/

(5)https://my.clevelandclinic.org/health/treatments/22641-emdr-therapy

(6)https://www.psychologytoday.com/us/therapy-types/rational-emotive-behavior-therapy

(7)https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5797481/

(8)https://www.apa.org/topics/anxiety

(9)https://www.psychiatry.org/patients-families/depression/what-is-depression

(10)https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders

(11)https://www.psychiatry.org/patients-families/bipolar-disorders/what-are-bipolar-disorders

(12)https://www.psychiatry.org/patients-families/schizophrenia/what-is-schizophrenia

(13)https://www.hopkinsmedicine.org/health/conditions-and-diseases/adjustment-disorders

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