FAQ: Therapy

How does therapy fit into an addiction treatment plan?

Therapy is arguably the main focus of addiction treatment. Though many people living in active addiction tend to focus on the withdrawal symptoms that define detox, the physical dependence upon the substance of choice is only part of the issue. Withdrawal symptoms may pass in the first few weeks of sobriety, but the cravings to drink or get high will linger for months or even years, in some cases.

Therapy addresses those cravings. It delves into where those cravings began and why, and provides the client with actionable coping mechanisms to not only limit the intensity of the cravings but also their frequency, and render them powerless when they arise.

After detox, clients immediately begin to take part in therapy. Many even begin attending therapy sessions during detox in order to ensure that they have the professional and peer support necessary to navigate the emotional issues that often arise during that process. Throughout treatment, therapy becomes a tool to not only connect clients with therapists and others in support groups but to also explore their own feelings and needs in day-to-day life.

What therapies should be standard in the recovery process?

Each client will benefit from a different combination of therapies, but there are some therapies that are considered standard, though they may be modified to meet each client’s needs. These include:

• Personal therapy: Meeting regularly with a personal therapist can help to set the tone for rehabilitation. These meetings can serve to identify personal treatment goals, the other types of therapy that will help to accomplish those goals, and coping skills that will empower the client to manage stressors and triggers for relapse as they occur.
• Group therapy: Group sessions led by a substance abuse treatment therapist will provide clients with a safe forum to work toward shared treatment goals, benefit from others’ personal experiences, and manage personal issues in rehab. A substance abuse treatment professional will facilitate the group and provide guidance to participants as they work together toward recovery.
• Support groups: Support groups offer clients a way to benefit from the experience of those who have gone through similar struggles and are also working toward building a new life in recovery. Strong bonds are created in the context of support groups and supported by a professional therapist.
• Family therapy: Family members can play a large role in the recovery of clients. Family therapy sessions are often incorporated into treatment to facilitate the repair of bonds broken during addiction, provide for effective communication, and enable preparation for a future in recovery.
• Alternative therapies: A wide range of alternative therapies, including artistic therapies, sport and movement therapies, outdoor and adventure therapies, animal-assisted therapies, and more, can help to provide an experiential option for clients. Rather than using talk therapy and narrative to explore the details of past experiences and hopes for the future, alternative therapies provide an active approach to healing and help clients to move outside their comfort zones and improve growth and wellness.

Additionally, holistic treatment options are often considered standard in some rehab programs. In fact, many programs incorporate yoga, meditation, acupuncture sessions, and other holistic treatments as a standard part of recovery.

If traditional therapy fails, are there nontraditional options available?

Yes. Traditional talk therapies in private and group settings as well as 12-Step meetings offer a firm foundation in recovery for most clients, but many find that real progress is made in nontraditional treatments. Holistic options and alternative therapies are often exceptionally engaging to clients and motivate them to work through rough spots as they discover all that sobriety has to offer.

How do you find the right therapist for your loved one?

When you interview different rehab programs, take the time to find out more about the therapeutic team who will be working directly with your loved one. Ask questions that include:

• What is the educational experience of therapeutic staff members? What aspects of substance abuse treatment did they study? What type of therapies are their specialties? How do they work together to provide therapeutic treatment to clients?
• How long have the different therapists been working in substance abuse treatment? How long have they been with this program?
• Are there alumni I can speak to who would like to share their experience with different therapists and the therapeutic process here?
• How do the different therapists manage any issues that arise? If there is a personal conflict, how is is handled by the program? Is there an option to primarily work with other therapists if my loved one feels uncomfortable?

What benefits do group therapy sessions offer?

There are a number of benefits that participants experience when they take an active role in group therapy sessions. These include:

• Bonding with other members of the group, forming relationships that can last long into recovery
• Guidance and tips on how to handle – and how not to handle – specific situations in recovery
• A safe place to vent and share concerns
• The opportunity to listen to the needs of others and offer support
• A safe place to practice positive communication and manage conflict

How many therapy sessions per week are needed?

Depending on the type of therapy, it may be indicated in the protocol that one treatment session is recommended per week. In other instances, two or more weekly sessions may be recommended. For case management, cognitive, and/or behavioral therapies, a single 60- to 90-minute session per week is a baseline. If more sessions are deemed necessary to achieve treatment goals, then the number of sessions may be increased per week.

Similarly, holistic therapies, alternative therapies, and group therapies are also scheduled one or two times per week. If more sessions are needed, the schedule can be adjusted.

In general, clients usually attend an average of four or five hours of different types of personal, group, and alternative therapy sessions each day when in residence at a comprehensive treatment program.

How can a therapist address co-occurring issues such as depression or anxiety?

In the event that a client is diagnosed with a co-occurring mental health disorder as well as a substance abuse or addiction disorder – an issue that occurs about half the time – it is imperative that the treatment plan for that client includes comprehensive care for the co-occurring disorder. This can include psychiatric care when needed, as well as medication to aid in the management of symptoms, and/or treatment goals in therapy that are in line with increasing the ability of the client to understand and manage the disorder.

Anxiety, depression, eating disorders, trauma, and other issues are not uncommon among people struggling with drug and alcohol addiction. Because the symptoms of one disorder often inform the symptoms of the other, undergoing concurrent treatment is essential for progress in either area.

Can or should medication be combined with addiction therapy?

In some cases, medication can be an important part of a client’s recovery, providing for a more rapid stabilization of mental health and physical withdrawal symptoms as well as an increased ability to manage the urge to relapse in early recovery. Medication is not available or appropriate in all cases, but for some clients, one or more of the following types of medication can prove beneficial:

• Antidepressants: For those who are diagnosed with moderate to severe depression and those who are experiencing depression as a part of their recoveries from addiction, antidepressants can help to balance things out and provide for a shift in focus to the positive aspects of recovery.
• Anti-anxiety medications: It can be anxiety-inducing to completely change one’s life, especially for those who are living with an anxiety disorder and became addicted to their medications or attempted to use other substances to manage anxiety. Nonaddictive medications can be helpful in lowering overall feelings of anxiety in both the short- and long-term.
• Detox medications: When physical withdrawal symptoms are significant, a range of nonaddictive medications or maintenance medications may be appropriate during the first weeks – or months – of recovery.
• Psychiatric medications: Anticonvulsants, anti-hallucinogens, blood pressure medications, and other drugs may be helpful in managing symptoms associated with personality disorders, schizoid disorders, and intrusive mental health symptoms. When these medications are taken as prescribed, they can be hugely and almost immediately effective in helping a client focus on the work of recovery.

What if our loved one needs to talk to someone outside of normal work hours?

During residential treatment, onsite staff members are available to clients 24 hours a day. Personnel can assist with emotional support or physical/medical needs as they arise. For those who are not in residence at the time of crisis, the 24-hour call center is always available to respond to a client’s needs. If a client has a specific and/or common issue or must speak directly with a therapist at a moment’s notice, arrangements can be made in advance for the client to have access to the therapeutic support needed.

Can holistic therapies be undertaken in combination with cognitive therapy?

Absolutely. Holistic therapies can and should be taken in combination with cognitive therapies, behavioral therapies, experiential therapies, and in conjunction with medical treatment. Because holistic therapies serve to lessen a client’s stress levels and improve the connection between the spirit, body, and mind, they can help to encourage more rapid progress in more traditional therapies. Oftentimes, holistic therapies help the client to be more open and receptive to change and less susceptible to relapse.