What are some of the most popular therapies used for de-addiction treatment?

Karan’s life spiralled into addiction, leaving him broken and isolated. Seeking help, he enrolled in therapy, where he found understanding and guidance. Through therapy, he uncovered the root causes of his addiction and learned healthier coping mechanisms. With support from group sessions, Karan realised he wasn’t alone and gained strength from shared experiences. Today, he continues his recovery journey, embracing a new life filled with joy and purpose.

Like Karan, many people benefit from one-on-one and group therapy sessions. Addiction can damage people’s relationships, professional life and their own mental and physical health. But de-addiction treatment offers the necessary support and helps break the cycle of substance abuse. Seeking help is a sign of strength towards reclaiming one’s life and creating a better, healthier and happier future. 

Let us have a look at some of the most popular therapies used in de-addiction treatment and some of the most popular techniques used in each of them. 

Cognitive Behavioral Therapy (CBT)

CBT is a widely recognised and effective therapeutic approach used in the treatment of addiction. It focuses on identifying and modifying negative thought patterns and behaviours that contribute to addictive behaviours. CBT is based on the idea that our thoughts, feelings, and behaviours are interconnected. It recognises that unhelpful thoughts and maladaptive behaviours can perpetuate addiction.

CBT aims to change these patterns by challenging negative thoughts, developing healthy coping strategies, and promoting positive behavioural changes. Therapists help individuals identify triggers, irrational beliefs, and distorted thinking patterns associated with substance abuse. By increasing self-awareness and challenging these negative thoughts, individuals can develop healthier perspectives and make informed choices.

Let’s look at two popular techniques used in CBT:

Cognitive restructuring: This technique involves challenging and reframing negative thoughts and beliefs related to addiction. Individuals learn to replace self-defeating thoughts with more rational and positive ones, promoting healthier behaviours and reducing the likelihood of relapse. 

For example, Sakshi is recovering from an alcohol addiction and has been sober for several months. However, she often experiences thoughts like, “I’m a failure, and I’ll never fully recover from my addiction. What’s the point of trying?” After evaluating the evidence using Socratic questioning and challenging a thought, more rational thought is generated, which would be something like: “I have made significant progress in my recovery, and every day, I am learning and growing. Recovery is a journey, and setbacks are normal. I am capable of continuing my positive changes.”

Behavioural activation: CBT also focuses on promoting positive behaviours and reducing negative ones. Through behavioural activation, individuals engage in activities that bring them pleasure, purpose, and a sense of accomplishment. This helps to replace addictive behaviours with healthier alternatives.

For example, John is recovering from a gambling addiction and is struggling with filling his free time productively, which often leads to thoughts of relapse. John recognises that he often spends his time watching tv, which leaves him feeling bored and unfulfilled. He decides to spend at least 30 minutes every day engaging in a hobby, for example, painting or playing an instrument. This helps reduce boredom, distracts urges to gamble and increases his overall sense of fulfilment. 

Dialectical Behaviour Therapy (DBT)

DBT is a comprehensive therapeutic approach that has gained recognition for its effectiveness in treating various mental health conditions, including addiction. DBT was initially developed to treat individuals with borderline personality disorder (BPD), but it has since been adapted for various mental health concerns, including addiction. It combines elements of CBT, mindfulness, and acceptance-based strategies to help individuals regulate their emotions, manage distress, and improve interpersonal relationships.

DBT is particularly beneficial for individuals struggling with addiction due to its focus on emotional regulation, impulse control, and developing healthier coping mechanisms. Let’s look at two popular techniques used in DBT:

Distress Tolerance: Distress tolerance skills help individuals withstand and navigate through distressing situations without resorting to self-destructive behaviours. These skills include self-soothing techniques, distraction strategies, and radical acceptance of difficult emotions.

For example, Harish, who is in recovery from drug addiction, finds himself facing a high-stress situation at work. He receives an unexpected deadline for a project, and the pressure triggers intense cravings to use drugs as a way to cope. Harish recognises the distress he is experiencing and engages in self-soothing techniques. He takes a moment to practice deep breathing, inhaling slowly through his nose and exhaling through his mouth, allowing himself to calm down and find some relief from the overwhelming stress.

Emotion Regulation: Many individuals turn to substances as a way to cope with overwhelming emotions. DBT focuses on teaching effective strategies for understanding and managing emotions. This includes identifying and labelling emotions, developing healthy ways of expressing them, and learning adaptive ways to regulate emotions without relying on substances.

For example, Dilip, who is recovering from drug addiction, experiences intense feelings of anger and frustration after a disagreement with a close friend. Dilip identifies this emotion, evaluates its intensity and appropriateness and determines that the action associated with his anger is to confront his friend aggressively. Dilip considers the consequences of this action. Dilip decides to use the opposite action technique by taking a step back and reminding himself to respond with calmness and understanding. He reminds himself that his friend is important to him, and he instead engages in self-care activities that promote relaxation. 

Motivational Interviewing (MI)

MI is a person-centred therapeutic approach widely used in the field of addiction treatment. Motivational Interviewing is a collaborative and goal-oriented approach that aims to evoke intrinsic motivation and resolve ambivalence about change. It recognises that individuals may have mixed feelings and uncertainties about addressing their addiction, and it seeks to strengthen their motivation for positive change.

MI fosters a non-judgmental and empathetic therapeutic relationship. Let’s look at two popularly used techniques in MI:

Open-ended Questions: MI utilises open-ended questions to elicit detailed responses and promote self-reflection. These questions encourage individuals to explore their own thoughts, feelings, and motivations related to their addiction. For example, asking questions like, “Tell me about your experiences with substance use and how it has affected your life,” or “How would you envision your life without the negative consequences associated with substance use?”

Reflective Listening: Reflective listening involves actively listening to the individual’s statements and reflecting them back. It shows empathy, deepens understanding, and helps individuals gain insight into their own thoughts and feelings. 

Here is an example of a conversation involving reflective listening:

Client: “I just can’t seem to stop using drugs even though I know it’s causing problems in my life.”

Practitioner: “It sounds like you’re feeling stuck and frustrated about your drug use and its impact on your life.”

Contingency Management

Contingency Management (CM) is a highly effective and evidence-based approach used in addiction treatment. Contingency Management is based on the principles of operant conditioning, where desirable behaviours are reinforced with tangible rewards or incentives. 

It involves creating a structured system of incentives to motivate and reinforce positive behaviours, such as abstinence from substances or adherence to treatment plans. Let’s look at some popular techniques used in CM:

Voucher-Based Reinforcement: Individuals earn vouchers when they meet predetermined criteria, such as submitting drug-free urine samples or attending therapy sessions. 

Positive Feedback and Reinforcement: Regular and explicit positive feedback is provided to individuals to acknowledge their efforts, achievements, and progress. This verbal reinforcement can serve as a powerful motivator and increase self-efficacy.

Other Psychotherapeutic Approaches

Acceptance and Commitment Therapy (ACT): Emphasizes acceptance of difficult emotions and thoughts while focusing on living a meaningful life in line with one’s values. ACT helps individuals develop psychological flexibility and build resilience in the face of addiction.

Family Therapy: Involves the participation of family members to address family dynamics, improve communication, and support the individual’s recovery. Family therapy aims to enhance the family system’s understanding of addiction and develop strategies for healthier functioning.

Psychodynamic Therapy: Explores the underlying psychological and emotional factors contributing to addiction. It aims to uncover unconscious conflicts, unresolved trauma, and early life experiences that may be driving addictive behaviours.

Mindfulness-Based Relapse Prevention (MBRP): Integrates mindfulness meditation practices with relapse prevention strategies. MBRP helps individuals develop an awareness of cravings and triggers, respond skillfully to urges, and cultivate a more balanced and present-focused mindset.

Trauma-Informed Therapy: Addresses the impact of past trauma on addiction and recovery. It involves creating a safe and supportive environment while helping individuals process and heal from traumatic experiences.

Addiction is a complex and multifaceted issue that affects individuals in unique ways. Recognising this, the importance of individualised treatment plans cannot be overstated. Each person’s journey through addiction and recovery is distinct, influenced by various factors such as their substance of choice, co-occurring mental health conditions, personal history, social support, and cultural background. 

If you or someone you know is struggling with addiction, remember that help is available, and recovery is possible with the right treatment and support. You can browse through our list of treatment centres across India here.