Overcoming addiction, whether it’s an addiction to alcohol, prescription medication, or illegal drugs, is a major achievement. Detoxification is only the first step in a long-term struggle to overcome cravings and prevent relapse. Counseling is an essential part of this process and can help a recovering drug or alcohol abuser shift from short- to long-term sobriety. Approaches to counseling include cognitive behavioral therapy (CBT), family counseling, and psychotherapy, among others. Most forms of counseling also address co-occurring mental health issues that contribute to addiction.
All forms of addiction involve much more than physical dependence. Following detoxification, physical dependence is cured – and yet, recovering addicts still have a high risk of relapsing. Why? A variety of social, psychological, and behavioral factors can contribute to relapse. Some of the major factors include:
- Stress, especially sudden or otherwise unexpected acute stress, for instance the death of a parent or close friend
- Environmental cues, such as walking down a particular street or eating at a certain restaurant
- People, including those in your social network who continue to use drugs
These factors are nearly unavoidable for the individual trying to overcome addiction. However, counseling helps patients to cope with these factors and the cravings they produce without resorting to relapse. As with most types of treatment, there is no one particular form of counseling that works better than others. The approach depends on the individual, the details of his or her addiction, and his or her current situation. Individual counseling is tailored according to these factors.
Cognitive Behavioral Therapy (CBT)
CBT is a type of therapy that teaches the patient to identify his or her mood, thoughts, and triggers when it comes to addiction. The therapist helps the individual to come up with a plan to overcome negative thoughts and feelings, replacing them with positive, constructive ones. CBT is highly effective and is based on the teaching of actual skills, most of which can be applied to a wide variety of other situations. It is a powerful way to combat drug abuse. However, one of the downsides is that training is intense and complex; not all therapists are trained in CBT.
Contingency Management Therapy
Contingency management involves the use of rewards or incentives to stay drug-free. The individual is given vouchers to obtain goods and services in a process called Voucher-Based Reinforcement (VBR). This has been shown to be effective amongst adults who abuse opioids, primarily heroin, and stimulants such as cocaine. The voucher, which might be for anything from a food item to movie passes, is given when the patient passes a urine sample. A similar model enters patients who have passed clean urine samples into a draw to win a cash prize. One of the issues with contingency management therapy is that it is expensive and incentives can’t last forever, meaning that the individual must learn to eventually cope without them.