Behavioral Therapies

Behavioral therapy is defined as an umbrella treatment for substance abuse disorders. It seeks to identify and change unhealthy behaviors related to addiction. These approaches have been a recommended approach for resolving drug addiction. According to the National Institute on Drug Abuse these therapies have not only provided incentives for sobriety but also helped addicts remain abstinent.

Some behavioral therapies have been able to provide change to addicts from unhealthy learned behaviors from the past.  It is unique in that it addresses addiction with the user so that they can undo self-destructive behaviors.

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy is likely the most common and most appreciated behavioral addiction therapy in use today.  Cognitive Behavioral Therapy was developed in the 1970s as an alternative to AA.  It was meant to address problem drinking, and to prevent relapse in people.  Cognitive Behavioral Therapy, also called CBT or CBT Therapy, teaches participants how to identify and correct problematic and behavioral attitudes or practices.  CBT Therapy teaches its clients a full skill set that they can use to prevent themselves from abusing substances in the future.  CBT Therapy can also teach participants how to address other problems that tend to abound from addiction such as financial problems, responsibility shortcomings, health issues, familial damage, etc.

A big factor of CBT Therapy is underlying issues assessment and address.  The logic behind CBT Therapy is that drug and alcohol addiction takes its strength from past issues that started it all.  These are called underlying issues or trigger mechanisms.  The periodical, published by Psychology Today talks about the value of using therapy and holistic methods to address underlying issues and trigger mechanisms, rather than the ridiculously overused medicinal approach, which should only ever be used as a detox and withdrawal aide. According to the author:

"There is true hope for addicts to recovery. Drugs like Declinol and buprenorphine may be useful tools for helping addicts separate from their drug of choice. But after that separation, real recovery comes from helping addicts to recognize the underlying causes of their addiction(s), face those issues, heal the old injuries, and transform their lives such that they can experience health, joy, and a bright future."

Another key focus of CBT Therapy is to anticipate likely problems and enhance the participant’s ability to apply self-control when these problems come to a head. No matter the preventive measures a recovering addict takes, there will be problems to face in life, and one will have to know how to address these problems so as to avoid a relapse.  Some techniques involve approaches like exploring the negative consequences of using substances again.  Other techniques involve creating coping strategies for high risk situations where one might find themselves strongly craving drugs and alcohol again.

The National Association of Cognitive Behavioral Therapy comments on CBT Therapy as being the saving grace for addicts, a true therapy of almost infinite possibilities:

"[CBT] is based on the idea that our thoughts cause our feelings and behaviors not external things, like people, situations, and events.  The benefit of this fact is that we can change the way we think to feel / act better even if the situation does not change.  CBT therapists believe that the clients change because they learn how to think differently and they act on that learning.  Therefore, CBT therapists focus on teaching rational self-counseling skills.  Cognitive-behavioral therapy does not tell people how they should feel.  However, most people seeking therapy do not want to feel they way they have been feeling.  Most people want to have the fewest number of problems possible.  So when we learn how to more calmly accept a personal problem, not only do we feel better, but we usually put ourselves in a better position to make use of our intelligence, knowledge, energy, and resources to resolve the problem."

Simply put, Cognitive Behavioral Therapy acts as a beacon of truth in a turbulent sea of addiction morass.  CBT Therapy can, and does, save lives.  It gives people the chance to find themselves, to find their base so to speak, and to build off of that to vanquish the difficulties of addiction for life.

Dialectical Behavioral Therapy

In the famous words of Brownell Landrum, in, A Chorus of Voices: DUET stories Volume III:

Remember the balance; the give-and-take of energy. The symbol of yin and yang is more than the integration of male and female. It’s also the balance of light and dark, sort and hard, active and passive, in and out giver and receiver. You can’t have one without the other.

This concept is the keynote of Dialectical Behavioral Therapy.  Dialectical Behavioral Therapy was a treatment approach that sort of came on the heels of Cognitive Behavioral Therapy.  Dialectical Behavioral Therapy took a lot of its inspiration from CBT Therapy though formulated a treatment approach that was itself wholly different.

For a historical view of Dialectical Behavioral Therapy, this treatment method was developed in the late 1970s by Dr. Marsha Linehan, PhD, ABPP.  Dr. Linehan was attempting to apply Cognitive Behavioral Therapy to problems that adult women were having.  She was trying to help adult women who had histories of multiple suicide attempts, urges for self-harm and self-mutilation, and suicidal, destruction-related ideation.

In Dr. Linehan’s efforts to apply CBT Therapy to clients who met the above criteria though, she immediately encountered problems.  Clients became enraged at the fact that CBT Therapy focused so much on change when Dr. Linehan’s clients did not want to change themselves that much.  Also, clients became quite volatile as a result of the very self-reflectionary focus of CBT Therapy.  Essentially, CBT Therapy, while the basic belief system of the therapy was what clients needed, the method used was too much for clients.  Dr. Linehan had to innovate something else, so she constructed Dialectical Behavioral Therapy.

Dialectical Behavioral Therapy is a totally unique approach to behavioral treatment that started with helping women and has since then advanced into being an ideal treatment focus for helping people who struggle with drug and alcohol addiction.  But what does "dialectical" mean?

In a full article on just Dialectical Behavioral Therapy alone published by Behavioral Tech, Dialectical Behavioral Therapy is defined as:

The term "dialectical" means a synthesis or integration of opposites. The primary dialectic within DBT is between the seemingly opposite strategies of acceptance and change. For example, DBT therapists accept clients as they are while also acknowledging that they need to change in order to reach their goals. In addition, all of the skills and strategies taught in DBT are balanced in terms of acceptance and change. For example, the four skills modules include two sets of acceptance-oriented skills (mindfulness and distress tolerance) and two sets of change-oriented skills (emotion regulation and interpersonal effectiveness)."

The goal of Dialectical Behavioral Therapy differs from CBT Therapy in that Dialectical Behavioral Therapy aims to help clients build a life that they feel is worth living.  The therapy uses a lot of the same underlying issues address and trigger mechanisms address that CBT Therapy does, but the application of Dialectical Behavioral Therapy is more apportioned to giving clients a reason to live and a reason to stay sober.  The focus of Dialectical Behavioral Therapy is to decrease harmful behaviors and to instead replace them with positive and valuable behaviors.

Dialectical Behavioral Therapy is especially helpful for recovering addicts who have, "Lost the will to live," so to speak.  This is the best approach for the hopeless addict, the bereft addict, the addict who feels as though they lack purpose and will in life, the addict who sees no value or importance in trying to get sober.

Sadness and apathy and a hopeless attitude are all part and parcel to the behavioral implications of addiction.  Addressing these must be a mainstay of addiction recovery, and for that Dialectical Behavioral Therapy is the prime solution.

Psychotherapy

As research and information gathering has improved regarding addiction, it has become all too apparent that addiction is more of psychological problem than we perhaps ever thought before.  Why else would someone, after having gained years of sobriety and no longer having any physiological connections to substance abuse, suddenly relapse and resume old habit?

Addiction is more of a mental and spiritual problem than it is a physical problem.  True the physical implications of addiction are glaringly threatening and unpleasant, but they are not insurmountable.  Two weeks in a qualified detox center and all traces of chemical dependence and physical addiction will cease to exist.  But it takes years, sometimes a lifetime to address the psychological implications of addiction.

Put poetically and religiously, Charles A. Peabody speaks about addiction as being a spiritual problem, a psychological problem, a religious problem, all in much greater degrees than it is a physical dependency issue.  He writes that:

"The solution is spiritual action, or practically speaking, SERVICE. The very moment we become other-centered is the very moment we begin to change and recover permanently (mentally, not physically, as we will never be safe from actually drinking or using drugs of any sort. Our bodies are permanently damaged). But the secret to addiction is service, which is why the entire Western medical community has no clue how to treat it. They try and they try but they just can't seem to crack it. Plus there's no financial incentive in telling drug addicts to simply give of themselves. But if we really want to get better and truly change, we have to serve others instead of ourselves. Service is the SILVER BULLET. Best thing for addicts, by far.  And why does spiritual action and service work? Because with each right action, we are brought closer to God. And GOD, of course, can heal anybody of anything."

While Psychotherapy does not necessarily take a religious stance (though it can, depending on the style and format in which the psychotherapist delivers his or her sessions), psychotherapy does follow this same idea of Peabody’s of a focus on mental enlightening, service to others, and psychological self-evaluation.

Put simply, psychotherapy focuses on addressing addiction not as a "psychiatric disease" that needs to be medicated to the point of cocktail explosion, but rather as a mental and personal shortcoming that needs to be remedied through diligent focus and deliberate self-change.  Psychotherapy seeks to interview and analyze each client to find out exactly what their key problems are that cause them to consume drugs and alcohol.  Psychotherapy then delivers the right tools and remedies to address those underlying problems, effectively helping participants to handle and address the key stumbling blocks that prevent them from succeeding in life.

Motivational Therapy

Yet another reliable and extensive approach to behavioral rehabilitation is that of Motivational Therapy, also called Motivational Interviewing.  Motivational Therapy and Motivational Interviewing are a behavioral method that combine incentive-based recovery stems combined with humanistic treatment and cognitive-behavioral methods to help clients vanquish addiction.

Motivational Therapy and Interviewing are defined elegantly by the University of Massachusetts Amherst, which did a study on this very successful treatment method.  According to their study results:

"The definition of Motivational Interviewing (Motivational Therapy) has evolved and been refined since the original publications on its utility as an approach to behavior change.  The initial description, by William R. Miller in 1983, developed from his experience in the treatment of problem drinkers.  Through clinical experience and empirical research, the fundamental principles and methodologies of MI have been applied and tested in various settings and research findings have demonstrated its efficacy. MI is now established as an evidence-based practice in the treatment of individuals with substance use disorders.  Motivational Interviewing focuses on exploring and resolving ambivalence and centers on motivational processes within the individual that facilitate change.  The method differs from more "coercive" or externally-driven methods for motivating change as it does not impose change (that may be inconsistent with the person's own values, beliefs or wishes); but rather supports change in a manner congruent with the person's own values and concerns. The most recent definition of Motivational Interviewing (2009) is, 'A collaborative, person-centered form of guiding to elicit and strengthen motivation for change.'"

The focus of Motivational Interviewing is a much kinder, much more empathetic approach to addiction treatment than the more traditional therapies.  The incentive and main approach of Motivational Therapy and Interviewing is to encourage participants to develop a very negative view to the point of severe disdain for their substance abuse habits while also encouraging a positive and rewarding view of abstinence.

The Motivational Therapy approach is a very "light touch" method.  The therapist or counselor does not directly contradict the client, and the therapist won’t even necessarily explicitly advocate one-hundred and eighty-degree change in an individual.  Rather, Motivational Therapy counselors will express empathy, support self-efficacy, and stay away from resistance and confrontation.  Motivational Therapy is not usually recommended as a first-approach to addiction treatment.  Rather, Motivational Therapy and Motivational Interviewing are best saved for someone who has already had a fair amount of treatment and merely requires tools for staying sober and abstinent in life after rehab.  That is the true success of Motivational Therapy.

Motivational Therapy is often found in aftercare or sober living environments and other outpatient settings.  If it is delivered in a residential, inpatient treatment center it is often not begun until the recovering individual has experienced other treatments to deal with the crux of the addiction struggle.  Motivational Therapy is often thought to be the "Cherry on top" of addiction treatment in that it delivers a very peaceful, very loving, very calm and caring approach that focuses on self-validation, self-love, and on instilling a disdain and general disapproval of substance abuse.

Authors Ken Resnicow and Fiona McMaster in an article for the International Journal of Behavioral Nutrition and Physical Activity has this to say about the benefits of any type of Motivational Therapy or Interviewing:

"One goal of MI (Motivational Interviewing) is to assist individuals to work through their ambivalence or resistance about behavior change. MI appears to be particularly effective for individuals who are initially resistance to change.  The tone of MI is nonjudgmental and encouraging. Counselors establish a non-confrontational and supportive climate in which clients feel comfortable expressing both the positive and negative aspects of their current behavior. Ambivalence is explored prior to moving toward change."

This method delivers a unique and truly appreciated approach to addiction recovery that has clients walking away from each session feeling good about themselves and optimistic about their futures.

Behavioral Techniques are a Successful Route in Treating Addiction

Behavioral rehabilitation has several options for the treatment of substance abuse disorders. For assistance in finding such a program, be sure to reach out to Treatment-centers.net for assistance.  This site offers a database of recovery services and thousands of treatment facilities all across the country.  For more information, call today.