By now, most people know that healing from an addiction means spending a significant amount of time in the company of a licensed mental health professional. This type of talk therapy is considered a vital part of the recovery process, and as a result, most people who enroll in care expect to spend hours discussing their concerns and learning how to keep their cravings under control. Even so, people might have questions about what happens in each therapy session. Specifically, they might wonder what they’re expected to learn and how therapy might allow them to change their habits for the better. Therefore, it’s important to educate people who have questions with helpful information regarding their concerns.

Enhancing Motivation

Enrolling in care is a commitment, and most people who do so have at least some hope that they can leave drugs behind for good. However, some people who accept addiction care do so at the bidding of the people they love, and deep down, they might still feel as though using and abusing drugs is the right course of action for them.1 Their motivation to really recover is low, and that could force them to drop out of treatment before their work is complete.

Ambivalence about healing is considered normal and natural, according to the Substance Abuse and Mental Health Services Administration, and many people who use drugs harbor conflicting thoughts about their habits.2 They might want to stop using drugs, but at the same time, they might like the way the drugs make them feel. They want to stop, but they want to keep using at the same time.

Motivational interviewing (MI) is designed to help clients see these contradictions and work to overcome them. Through gentle questioning, therapists help clients to identify their life goals, and think about how substance abuse might help or hinder the achievement of those goals. Therapists might also help clients to think about how their lives might be different if they quit, and how life might stay the same if they continue to use. It’s not a combative therapy, but it can help encourage a loved one into therapy. In time, even an ambivalent person might become deeply committed to sobriety and willing to work hard to make it happen.

Providing Education

It’s been said that knowledge is power, and when it comes to addiction, many people who are afflicted don’t understand how their chemicals work and how those substances might harm them. For example, addicted people might claim that they can stop their use at any point, as long as they wanted to do so.

Research has suggested, on the other hand, that a remarkable number of people who use drugs become compulsive users who can’t control their intake.

Of those users:

Understanding how substances work can allow people to plan for the future. They’ll know that taking drugs, just once, could put them back on the path to misery, and they might be less likely to experiment as a result. A deep understanding of drugs can also help people to be patient when it comes to their own healing process.

Group classes involving drug chemistry, addictive behavior and typical healing patterns can be helpful, but some programs augment this learning by providing reading, videos and lectures for addicted people to take in on their own time. Homework assignments might help therapists to ensure that their clients are working toward sobriety outside of the therapy room.

Improving Skills

Addictions often have their roots in chemical damage caused by powerful substances. Each little hit leaves a mark behind, and in time, all of those wounds can result in a remarkable lack of control when it comes to substance use and abuse. Sometimes, however, there are specific emotional states that can make hidden damage spring to life, and people with addictions may have a lack of ability to soothe their minds without drugs when they’re placed under this kind of emotional pressure.

A study in the journal Psychopharmacology, for example, suggests that cravings for cocaine spike in addicts under stress.3 These people might always feel an urge for the powder, but when their emotions run high, their damaged brain cells call out for relief in the most efficient way possible. These cells call out for drugs, and their cries can be hard for addicted people to ignore. Strong feelings of sadness, anger or nervousness might cause a similar spike in cravings.

Therapy can help by providing people with tools they can use to soothe their distressed minds. They might learn how to meditate when they’re feeling anxious, focusing on an outcome that might fill them with pleasure rather than thinking about an ending that might cause them pain or distress. People might also learn how to use art, exercise, talking or writing to ameliorate strong sensations, without using drugs at all.

Skill-building sessions like this are often provided in group settings, allowing people to learn in the company of understanding peers. These sessions might also allow people to practice their new skills in real time. The people who make up the groups can change with time as some people learn faster than others, but the group setting always remains supportive and positive.

Reducing Exposure

While handling triggers when they arise is vital to preventing relapse, people who avoid the people, places and things that cause an upswing in distress might experience an even more profound sensation of relief. They won’t need to use their new skills as they won’t place themselves in situations in which distress and misery are likely. Cognitive Behavioral Therapy (CBT) can allow people to identify their triggers for drug use and come up with techniques they can use to keep these situations out of their lives in the future. For some, this involves making new friendships. For others, this involves moving to a new neighborhood or finding a new job. For still others, this means avoiding bars, chat rooms or other places in which drug talk is common. By leaving these spurs behind, people might not be so tempted to use and abuse drugs of any sort.

Dealing with Underlying Issues

While situations can certainly cause a spike in the need to use drugs, some people have underlying mental illnesses that work as a constant impediment to their ability to heal. The National Alliance on Mental Illness suggests that the link between drugs and mental illness is complex, as some people develop drug addictions in response to mental illness while others develop a mental illness in response to drugs, but everyone who has these concerns needs specialized therapy in order to heal.In essence, they need therapy that assists with the mental illness, and that therapy should be infused with knowledge of drug addiction chemistry.

People who have anxiety disorders, for example, might use drugs to help them sedate their nervous feelings when they’re forced to interact with the object of their fears. Exposure therapy might allow people like this to slowly become accustomed to the target of their anxiety. They might look at photos of the object, and then watch videos. In time, they might look at the object from afar, and then touch the object. At each point, the person might be tempted to use drugs, but the therapist can provide alternate self-soothing techniques that can take the place of intoxication. In no time at all, people might feel much more comfortable when they’re forced to interact with their fears, and they might not have the need to use drugs.

Therapy like this is individualized as the treatments provided for specific mental illnesses can vary dramatically. In addition, some people with addictions have a long and well-known history of mental illness while others might have never been diagnosed with a mental health concern in the past. Programs that specialize in providing care to people with both mental illnesses and addictions tend to provide thorough evaluations, ensuring that the treatment team understands the issues the addicted person faces.2 Evaluations like this can also help to make the path to healing a little easier for the treatment team to map.

Including the Family

Addictions often begin with the habits and preferences of an individual, but the choices that person makes can impact families in the following ways:

  • Finances
  • Emotional health
  • Communication styles
  • Connectivity

Families impacted by an addiction can be fractured, unable to support one another and unable to see how the damage began. Inadvertently, a family like this can keep an addiction in play. Loving partners might coddle an addicted person through a bad binge, or they might take over household responsibilities and provide the person with more time to binge. Breaking these habits is vital to the healing process, and family therapy can make it happen. Here, people learn more about how the addiction has changed the whole family and what they all might need to do in order to make the issue fade away with time. The group might also learn new techniques they can employ as they communicate with one another, and they can also learn how to effectively support young sobriety in the person they love.

Family therapy sessions are sometimes large, including each and every person who is a member of that family.3 However, they can also be quite small, including just one or two people who have a specific need for healing at that time. Some families need only a few sessions, but others might spend months in therapy until they have built up the skills that can allow them to function effectively. Thankfully, there are no time limits on this kind of therapy, so families can do what’s necessary in order to get better.

Changes with Time

As people continue to participate in therapy, the lessons they must learn can ebb and flow. In the beginning, for example, they might need to know more about how their issue began and how the body heals. In the middle of therapy, they might need to focus on the issues that can keep their specific addiction in play. As therapy draws to a close, they might need to develop an understanding of how to prevent a relapse from taking place. As a result, most therapy programs strive to change as the addicted person changes. New lessons are incorporated, groups shift and time spent in therapy can change. Sometimes, people even spend fewer hours in therapy each week as they learn, and other times, they’re asked to augment their time commitment in order to deal with a new issue.

Recovery Never Ends

While therapy can be vital for people who have drug addictions, the National Institute on Drug Abuse suggests that addictions are akin to chronic conditions that can result in repeated relapses and repeated needs for therapy.4 People who stay in their treatment programs for a long period of time—at least several weeks if not several months—have a more robust shot at long-term healing, but even so, some people may find that they have a few lessons to learn when their formal programs are complete. They might have relapse challenges in the community that they hadn’t planned for, or they may have new concerns that just didn’t appear when they first chose to enroll in care. Touchup therapy sessions can be vital in cases like this, as they can help people to further enhance their sobriety skills, and they might be able to maintain the gains they made in their original treatment programs.

Black Bear Rehab, provides integrated care for people who have substance abuse issues complicated by mental health concerns. Since aftercare is such an important part of the healing process, we provide all our clients with a lifetime of support. We even have a specialized treatment program for people who have chronic relapsing concerns.4 If you’re addicted to drugs, we might provide just the environment you need in order to get well. Please call us at our 24-hour, toll-free helpline to start the enrollment process today.

Treating Addicts Using Cognitive Behavioral Therapy

Of the facilities that participated in the 2012 National Survey of Substance Abuse Treatment Services, 91 percent used Cognitive Behavioral Therapy (CBT) either alone or in combination in order to help patients struggling with drug or alcohol addictions. This means CBT is one of the most accepted therapies available for people who have addiction issues, and it means that people who enroll in treatment programs are likely to encounter this type of treatment at least once. Knowing more about how the treatment works, and how people can get the most out of this type of care, could help families to prepare for the work that’s ahead of them.

A Targeted Solution

Rather than enrolling in therapy programs that might take months or years to complete, people who participate in CBT are often done with their work in a short period of time.

A Specific Set of Skills

CBT is designed to teach people a specific set of skills, according to the Association for Behavioral and Cognitive Therapies, and as a result, people participate in just six to 20 sessions.

But there’s a significant amount of work that goes on while a person is enrolled in CBT. Often, patients work in a one-on-one relationship with a mental health professional, such as a counselor, therapist or psychologist, and the professional and the patient meet several times each week in sessions that last for an hour or longer.

Here, the two have collaborative discussions about addiction, attempting to determine:

  • What prompted the person to use drugs
  • What thoughts or assumptions might keep the person using drugs
  • How changing an underlying thought or assumption might reduce drug cravings
  • What things the person might do instead of using drugs or alcohol

In the beginning of a CBT session, patients are encouraged to discuss the events that transpired between the last session and the current appointment. They might outline situations that seemed to prompt a craving for drug use or another destructive behavior, and they might discuss how their decisions either worked or did not work, in terms of keeping them safe. The counselor and the patient use those situations to help patients understand how a similar situation might be handled in the future.

Then, patients discuss one or two upcoming challenges they’re facing, along with their assumptions about how they might react and what might happen. The two might plan for that new situation, outlining how the patient might behave or what the patient might do in order to stay safe.

Dealing with challenges means developing a new set of skills, and that’s a big part of each and every CBT session. In some cases, patients are encouraged to develop skills related to mindfulness or meditation, so they can accept negative thoughts without feeling the need to act on them. Sometimes, patients are encouraged to explore other activities that bring them a sense of relaxation or pleasure, so they’ll be less likely to self-medicate with drugs. Sometimes, too, patients are taught to develop communication or assertiveness skills, so they’ll be less likely to seek out numbing with drugs.

Picking up new skills and changing old thought patterns isn’t easy, and homework plays a big role in CBT. When patients aren’t in therapy sessions, they might be reading educational materials, writing journal entries, trying out new techniques in controlled experiments and otherwise actively working on changing their lives. They might outline their experiences with the homework in the next session, and the course of treatment might change a little depending on how well the previous week was, but more homework is likely to follow each and every treatment session. Constant practice like this is mandatory.

At the end of each CBT session, patients are encouraged to provide feedback on how the therapy is working and how well things are progressing. This feedback is vital, and often, the therapy shifts and adjusts depending on the patient’s perception of the helpfulness of the therapy.

Making CBT Work

The rapid pace of CBT leaves little time for laziness or ambivalence. Patients who really want to get better with this method of care need to be willing to keep their appointments and perform each and every homework lesson, so they’ll be able to stay on track and really get better. Those who do stick to the program and remain dedicated to the idea of getting well stand the best chance of long-term improvement.

In addition to working hard and sticking to appointments, the Mayo Clinic suggests that people can get the most out of CBT by developing an open, honest, collaborative partnership with the person who is providing the care. Counselors need access to a person’s inner thoughts and feelings in order to provide help, and they need to understand how well the therapy is working as the sessions progress, so they can switch up the approach if something isn’t working well. Patients who clam up and keep secrets don’t provide their counselors with the information they need, and in the end, that hurts the patient more than it hurts the counselor. People really need to keep their goals in mind and stay open, in order to get the most from CBT.

Finding Comfort with CBT

Often, people who participate in CBT begin to see changes after just a few sessions. But sometimes, people who get CBT need just a little more assistance in order to reach a therapeutic breakthrough. For example, the National Institute of Mental Health suggests that people who have bipolar disorder often need to take mood-stabilizing medications in order to feel a real improvement in their mental health. CBT might help, but they might also need medications in order to reduce their symptoms.

Similarly, some people benefit from participating in a slightly modified version of CBT. For example, some people find that the rapid pace of change CBT demands leaves them feeling bullied or unaccepted. They may benefit from a modified version of CBT that uses a slower pace and emphasizes support and understanding over rapid change. They’ll still have the opportunity to understand their behaviors and amend their ways, but the slower pace of therapy might allow them to feel a little more comfortable.

There are some people who simply don’t benefit from CBT at all, according to an analysis on Psych Central, as these people might have vague problems they cannot name. They might be unable to target specific thoughts or behaviors with therapy, simply because they’re unaware of the specific situations that impair their mental health. People like this might benefit from global approaches, including general psychotherapy, so they can come to a deeper awareness of their motivations and their challenges. At that point, they might be prepared to heal with CBT.

But even people who do benefit from CBT are likely to utilize other therapies in a drug addiction treatment program, including:

These additional forms of therapy might provide lessons that are just a little bit different, and that might help to augment the education people receive in their CBT sessions and allow a deeper form of healing to take hold.

Therapy Choices at Black Bear Lodge

CBT is just one option we provide for patients at Black Bear Lodge. This technique allows us to really focus on the thoughts and behaviors that lie beneath a drug or alcohol abuse issue, and by using CBT, we can help our patients to make a number of profound changes in a short period of time. But we’re careful to ensure that our patients have an entire suite of therapies available to help them heal. Some of our patients aren’t ideal candidates for CBT, and we’re always able to provide an alternate therapy that could bring about big changes. If you’d like to know more about this, please call 706-909-9811. We’d love to help.

Sources

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