Human beings are born with biological and psychological systems that can lead to drug and alcohol problems. My work with people recovering from addiction includes individual therapy with substance use disorders, group therapy for women who are in recovery and group therapy with both men and women working to stay in recovery. There are also opportunities to work in Intensive Outpatient Treatment in my psychotherapy practice. In my practice, I accept referrals from adults with addiction problems and at times I am able to work with adolescents.
My recent reading of the addiction research literature involves reviewing theories of addiction including the Gateway model, the Disease model and the Biopsychosocial model. It has become clear to me that drug and alcohol problems do not happen right away: addiction is a process. Adults and teens use drugs in a non-problem way BEFORE they have substance abuse problems. The individualized cycle develops for each person according to their family, social and school environments. As well, each person goes through a different cycle for each substance he/she experiments with: each person has a unique relationship with each drug. Brain change due to alcohol and drug problems are described in sessions and groups and explained in my work with all people who abuse substances. Topics including classes of drugs likely to be abused are discussed in therapy and in group work: depressants, hallucinogens, stimulants and opiates. Medicine that is currently used to treat alcohol and drug addiction is described and explained. There are numerous treatment programs to help prevent alcohol and drug abuse in children and teens and many methods of treatment once the teen has moved down the road toward addiction; these programs are reviewed and used as needed.
Theories and Research for Substance Use Disorders
Cognitive Behavioral Therapy (CBT)
CBT is evidence-based and is the most frequently used form of therapy used today. As part of group and individualized treatment plans, CBT is used as a way to help people identify self-defeating thoughts and behaviors which may often drive addiction. It is common for individuals struggling with substance use disorder to have destructive, negative thinking. Recognizing these thought patterns is essential. Since cognition affects our emotions and wellbeing, changing harmful thought patterns heals. CBT is present-oriented, problem-focused, and goal-directed. CBT can be provided in group and individual therapy. CBT skills are useful, practical strategies that can be incorporated into the client’s everyday life. CBT helps clients formulate coping strategies to handle potential stressors or difficulties following addiction treatment.
Motivational Interviewing (MI) Treatment
Motivational Interviewing (MI) can help facilitate change. It is a strength-based approach that highlights people’s ability to change harmful behaviors. For clients seeking addiction treatment, two of the most common obstacles are ambivalence and the fear of change. Frequently, according to SAMHSA, individuals struggling with addiction are usually aware of the dangers of their substance-using behavior but continue to use anyway. These experiences are normal and despite the health risks and consequences of substance use, client feelings of ambivalence arise. For some clients with substance abuse issues, there is an internal struggle of wants and needs as opposed to rational choices. Uncertainty about the severity of their substance use may be related to the client’s motivation to change. Entering treatment programs, many individuals claim their substance use is “not all that serious”, despite medical problems, inability to remain employed, etc. Individuals experience these natural disparate feelings regardless of their state of readiness. Ambivalence should not be interpreted as denial or resistance and utilizing MI can facilitate exploration of stage-specific motivational conflicts that can potentially hinder further progress.
Substance abuse can leave lasting damage on the mind, body, and spirit. Studies by the Center for Disease Control and Prevention (CDC), SAMHSA, and American Diabetes Association all report that people with addiction and mental health disorders there are greater chances of morbidity and mortality compared to the general population. Furthermore, these increased rates are mostly attributed to preventable medical conditions such as diabetes or cardiovascular, respiratory, or infectious diseases (including HIV). Learning to take care of one’s body, mind and spirit is an essential part of recovery.
Topics Covered According to SAMHSA Guidelines
- Relapse Prevention, Relapse Recovery, Relapse Drift
- 12 Step Programs and Principles
- Health Realization Theory
- Sleep problems
- Scheduling, Schedule Books and Planners
- Guilt and Shame
- Sex and Recovery
- Anxiety and Depression
Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders: Counselor’s Family Education Manual, 10/2015
Using Matrix with Women Clients: A Supplement to the Matrix Intensive Outpatient Treatment for People with Stimulant Use Disorders, 10/2015
Substance Abuse Treatment: Group Therapy, 9/2015
Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook, 1/2014
Substance Abuse Treatment: Addressing the Specific Needs of Women: Quick Guide for Clinicians, 11/2013
Substance Abuse Treatment for Adults in the Criminal Justice System, 9/2013
Medication-Assisted Treatment for Opioid Addiction in Opioid Treatment Programs, 1/2012
Continuity of Offender Treatment for Substance Use Disorder, 12/2001
Call or email to discuss how each treatment modality, individual psychotherapy, women’s group therapy, group therapy for men and women and intensive outpatient treatment, might work for you or your family member. Each person struggles with substance use disorder in their own unique way and deserves to have a treatment program individualized to their needs. This is the goal of my work in addiction treatment.