Unless you’ve ever directly sought help for yourself or someone close to you, you may not know much about substance abuse treatment. The information we get from TV and movies is limited at best. We have probably seen the familiar “circle of chairs” with people discussing their problems with others, but is that really treatment?
More often than not, those with a substance use problem are also struggling with some type of a mental health disorder. As a result, many counselors treat them as one and the same. I’ll be the first to say that substance use and mental health problems need to be addressed simultaneously but they shouldn’t necessarily be treated the same. In fact, there are a few key components that should be included in any treatment for substance related problems.
Treatment for addition often includes some form of 12-step support meeting attendance but let’s be clear, this isn’t treatment. These are mutual support groups operated by others in recovery that typically have no professional training in helping others. The 12-step approach has endured over the decades because of it’s effectiveness with many addicts, but it isn’t treatment.
So what qualifies as treatment? One of the most popular approaches to counseling for any problem is called Cognitive Behavioral Therapy (CBT). These approaches examine and address the relationships among thoughts, feelings and behaviors. Addiction treatment can certainly utilize CBT or any number of other approaches including community reinforcement, therapeutic communities or medication assisted therapy. However, at its core, substance abuse treatment should include, at a minimum, the following components:
- Motivational Interviewing (MI) or Motivational Enhancement Therapy (MET) – Most people with substance use problems are in the early stages of the change process. They either fail to recognize their use as a problem or they recognize the problem but are ambivalent about making any real changes. Treatment for substance use disorders require a counseling that can accurately assess the patients current stage of change and utilize appropriate interventions to facilitate movement through the stages.
- Drug Testing – How do you measure success? In substance abuse treatment, success is often measured by an increase in functioning in various domains or roles. But these measures are often subjective and hard to determine. One of the easiest ways to measure success is through drug testing. Regular and preferably random drug testing adds a measure of accountability for the client and often helps encourage abstinence in the early stages of treatment. Modern drug testing can detect recent substance use in either urine or saliva are are becoming more affordable than ever.
- Relapse Prevention Therapy (RP) – Relapse Prevention Therapy is a “behavioral self-control program that teaches individuals with substance addiction how to anticipate and cope with the potential for relapse” (SAMHSA). RPT helps people identify potential triggers and warning signs and helps to identify and cope with various high risk situations. RPT provides those with the desire to recover with the tools needed to avoid or manage relapse. Some might argue that RPT isn’t required for successful substance abuse treatment but considering the amount of research to support its effectiveness, I believe it would be negligent not to include it.
While substance abuse treatment can come in many shapes and sizes, these are the important components that should always be present. When you’re investigating a potential treatment provider, make sure they mention these items. You should also ask if they practice “trauma-informed care” and what “evidence-based practices” they utilize. If they can’t answer these questions or don’t understand the concepts, keep looking.