Talking Therapies in Addiction Treatment

Too many people in need of addiction treatment don’t seek the help that they need, and often, they’re unaware of how their condition is defined medically.

So, before diving into how talking therapies can treat addiction [1], let’s briefly answer the question, “What is Substance Use Disorder?”.

People with addictions, whether they’re alcohol or drug dependent, cannot simply wake up one morning and stop using. They have a serious condition characterised by chronic relapsing, with worrying changes occuring in the brain.

While battling a drug or alcohol addiction, chemical processes and neural pathways in the person’s brain have been re-routed to become dependent on an addictive substance. This dependence can either be psychological, physical or (commonly) both.

Therefore, those suffering from substance addiction are wired to think that they need to consume drugs or alcohol.

The reward centre of the brain [2] has been rewired to crave an addictive substance above all else, and without it, victims are unable to experience pleasure or even function normally.

Repeatedly using toxic substances leads to a host of health problems, and this is exacerbated by increased tolerance.

Part of the cycle of addiction is that victims must increase their consumption to feel the same level of euphoria.

Worryingly, this elevates their risk of not only withdrawal symptoms when they try to quit, but of fatal overdose and other high-risk situations.

Why Treating Addiction is Crucial

To achieve abstinence from substances and stay sober, having a long-term treatment plan is vital. Without the help of an addiction specialist at an alcohol or drug treatment centre, the harrowing cycle of relapse will likely continue.

While a detoxification programme (removing substances from the body) is an essential start to treatment, it does little to tackle the underlying reasons behind addiction, typically mental health issues.

Unfortunately, many victims of addiction are also battling a comorbid mental health disorder and these psychiatric symptoms may drive them to seek solace in drugs or alcohol. Commonly experienced co-occurring disorders include (but aren’t limited to Borderline Personality Disorder, Bipolar Disorder, Post-Traumatic Stress Disorder, anxiety disorders and Obsessive-Compulsive Disorder).

With this in mind, SUD sufferers must undergo a comprehensive addiction recovery plan, complete with various forms of therapy [3]. This combination of therapies includes medicated assisted treatment, 12-Step programs, behavioural therapy sessions, and various talking therapies.

What are Talking Therapies?

Communication-based therapies are considered cornerstone treatments for Substance Use Disorders and for good reason.

Their application is far-reaching in the medical community and has been successful in treating behavioural addictions, substance addiction, and a range of psychological issues.

There are many different styles of talking therapies to treat such a plethora of behavioural and emotional issues: from group sessions and family workshops to individual therapy sessions.

What each of them has in common is the structure of patients talking about difficult thoughts or feelings with a trained therapist.

In the context of addiction, communication-based therapies [4] allow patients to address the underlying problems exacerbating their condition. From here, they can work towards removing negative thought processes and cultivating positive life experiences.

What are the Benefits?

Talking strategies have been shown to work for many people, helping them to break the cycle of addiction and relapse.

These types of therapy give people the tools to express the pain they’re going through and talk about the feelings they’ve likely been bottling up for a while.

Without further ado, the main benefits of talking therapies for addiction include the following:

1. Improving Self Awareness

Oftentimes, people with addiction have not only lost their way financially and socially, but they’ve also lost touch with themselves. At their core, addiction counselling sessions allow patients to discover more about themselves: why they feel a certain way and how this contributes to relapse.

By creating an honest dialogue with their patient about what causes them distress, therapists can help them pinpoint relapse triggers, and develop ways of coping. By knowing what makes you tick, and specifically what drives your substance abuse, you’ll be able to make healthier decisions moving forward.

Individual therapy styles [5] such as CBT and DBT emphasise the direct feelings of the individual: creating a safe space in which they can develop self-efficacy.

Because it’s just you and your therapist, the entire session will be spent exploring your inner world and ways that your thoughts impact how you view the external world.

While group talking therapies such as family therapy involve multiple people, it gives patients the chance to reflect on how their behaviours affect others.

This in turn increases their self-awareness and allows them to react in ways that benefit both themselves and their loved ones.

2. Creating a Safe Environment

Whichever treatment you undertake as part of your addiction recovery, it’s important to feel comfortable and supported in your surroundings. When performed by a professional in a clinical setting, talking therapies encourage open, non-judgemental conversations away from triggering influences.

It’s the job of each therapist to create a safe space for their client in which they can express their feelings without the fear of being judged.

The promise of confidentiality, clear boundaries, and a comfortable, quiet setting all contributes towards creating a safe environment for SUD patients.

3. Personalisation

Especially in one-to-one formats, talking therapies are incredibly individualised. During initial sessions, health professionals spend time getting to know their patients: their unique aspirations, preferences, and levels of motivation at this point in their addiction recovery.

During the patient evaluation, therapists gather important information about their client’s substance use history, mental symptoms, and any relevant past life events.

From here, they can start building tailored therapeutic techniques to suit the individual. This mean’s that, armed with personalised coping techniques and distress tolerance methods, they’re less likely to relapse.

For example, someone with a history of trauma, the symptoms of which are fuelling their addiction, may be referred for Dialectical Behavior Therapy. This style of talking therapy is specifically designed for people coming to terms with painful memories.

For these patients, a simple one-size-fits-all talking therapy wouldn’t suffice, and group therapy may also be detrimental.

4. Learning to Problem-Solve

Many SUD sufferers struggle with emotional regulation, and how to overcome stress and relapse triggers in the moment. As such, a major component of talking therapies is teaching clients how to manage “here-and-now” stresses through problem-solving skills.

During Cognitive Behavioral Therapy [6], counsellors work with their patients to identify problems (such as stress leading to substance use), evaluate them, and test different solutions.

Most importantly, the problem-solving process in therapy is carried out free from judgement; allowing patients to develop a clear understanding of each relapse trigger and not let their emotions cloud the situation.

Through methods such as relaxation exercises (a more holistic approach), and cognitive reframing, patients can begin to understand the role of emotions in the problem-solving process.

This encourages them to break free from restrictive and harmful ways of thinking and develop healthy coping skills.

5. Rebuilding Positive Relationships

Another benefit of talking therapy for addiction is how it can help you rebuild the relationships that were harmed during periods of substance use.

Oftentimes, the difficult memories that addicted individuals struggle with are related to past conflicts with friends or family members.

Individual talking therapies help patients understand how they can be better friends, partners, siblings, or parents by improving their self-awareness.

By interrogating how they view the world, and which thoughts/feelings have been holding them back, SUD victims can work through their problems and start rekindling trust in those they love.

While one-to-one therapies indirectly give patients the tools needed to strengthen relationships, group therapy methods emphasise communicating with peers and loved ones.

Family therapy, for instance, helps addicted individuals and their loved ones take accountability for their actions, work through resentments, and make amends.

Types of Talking Therapies

A broad range of therapies are used to explore the underlying causes and resulting effects of substance abuse. Each unique style of talking therapy uses psychological and behavioural treatments to help patients cultivate a healthy life.

Here’s a breakdown of the typical talking therapies found in addiction treatment programmes.

1. Cognitive Behaviour Therapy (CBT)

Pioneered in the 20th century, CBT is considered a cornerstone element of addiction treatment, and one of the original behavioral treatments.

Alcohol and drug treatment services include this style of talking therapy for its versatility, as it can be tailored to help a range of substance addictions.

CBT helps addiction sufferers pinpoint how thoughts and beliefs influence their substance abuse.

This involves their therapist helping them identify any cognitive distortions: or negative thought patterns that can hinder the process of recovery and fuel difficult experiences.

These distortions can cause us to feel back about ourselves, contributing to anxiety and depression in those already susceptible.

Common forms of irrational thought processes include mental filtering (draining the positives from a situation) and over-generalisation.

After recognising these patterns of negative thinking and how they can cause relapse, patients work with their therapists to develop healthier coping skills.

The goal of CBT sessions is to help people unlearn maladaptive behaviours and start to apply coping mechanisms to situations that would normally trigger substance use.

2. Dialectical Behavioral Therapy (DBT)

Similarly to CBT, DBT is a form of talking therapy that teaches new skills to unlearn negative thoughts and behaviours. However, psychiatrists have made various adaptations that make it more applicable to treating depression, trauma, and other emotion-based comorbidities.

The key difference between DBT and CBT is that the former focuses on the validation and acceptance of uncomfortable emotions.

Therapists using DBT [7] to treat addictive behaviours use talking-based methods to help their patients while teaching them various coping skills.

These treatment components are emotional regulation, mindfulness, distress tolerance, and interpersonal effectiveness.

During mindfulness for DBT, patients are taught how to bring awareness to the current moment as a way of overcoming difficult situations.

By tuning into their senses and inner world, clients can learn to slow down in moments of distress and implement coping skills to prevent relapse.

Practising mindfulness helps patients engage with another key area of DBT: distress tolerance. During this section, therapists encourage their patients to sit within the discomfort of their feelings.

This allows them to focus on coping skills such as self-soothing, distraction, and positive self-talk to diminish substance cravings.

DBT doesn’t only focus on the patient’s inner world, however. Interpersonal effectiveness helps addicted individuals improve their relationships with others: using techniques such as role-playing to help patients learn effective communication skills.

3. Acceptance and Commitment Therapy (ACT)

This psychological therapy takes elements of CBT, DBT and holistic therapies to help clients cultivate acceptance while committing to changing their addictive behaviours.

During ACT sessions, therapists use communication-based methods to improve someone’s psychological flexibility. This is the ability to cope with, accept, and adjust to problematic situations such as cravings and the stresses of daily life.

Talking therapies such as ACT can help people with addiction gain insight into their behaviours and accept cravings or other symptoms without needing to act on them (the acceptance component).

Alongside this is the commitment element: helping patients reduce their symptoms by confronting the present moment and changing actions based on their personal values.

They’ll work with their therapists beforehand to reconnect with these goals and values.

4. Motivational Interviewing (MI)

Achieving comprehensive abstinence is nearly impossible without having the motivation to do so. However, even during the process of recovery, it’s perfectly normal for someone’s motivation levels to rise and fall.

Motivational Interviewing (MI) [8] is a short-term talking therapy and an additional treatment used to help people commit to long-term sobriety.

Using a one-to-one format, an MI counsellor (also called the interviewer) asks their patients various questions about their addictive disorder and the driving forces behind their recovery.

This can be internal factors such as wanting to improve their physical/mental health, or external motivators like loved ones wanting them to quit.

Over a few sessions of exploring these motivating factors, it’s hoped that the individual can rekindle their commitment towards sobriety and ongoing treatment.

5. Group Therapy

While individual sessions allow patients to explore their internal landscape, group talking therapies allow people to connect with their peers and know that they’re not alone in their addiction.

Especially during early recovery, communal support sessions are utilised alongside the individual therapies mentioned above.

With the guiding presence of non-judgemental professionals, group therapy sessions usually run for 1-2 hours, with anywhere between 5-12 participants depending on the setting and nature of the group.

For example, group sessions held for rehab inpatients might have fewer participants, whereas therapeutic communities such as Alcoholics Anonymous are open to all.

Group therapy for addiction can be used to explore and process each person’s challenges and achievements while providing a space to practice coping skills learnt in one-to-one treatments.

Being part of a therapeutic community gives those in recovery the chance to practice important life skills, such as communication and critical thinking.

Oftentimes, the relationships established in these sessions carry over into the outside world, providing immense comfort and solidarity.

6. Family Therapy

Sadly, many victims of addiction may have gone months or even years without speaking to their loved ones. Oftentimes, their condition has strained the relationships they’ve built, but this doesn’t mean that there’s no hope of rekindling trust.

Family therapy is an important branch of talking therapy for addiction as it facilitates healing for each person involved in the recovery process: friends, family, and the SUD victim.

Because each situation is unique, there are many styles of family therapy, each geared towards a common familial dynamic. Popular forms used to treat addiction include Family Behavioural Therapy [9], Functional Family Therapy, Couples Therapy, and Multidimensional Family Therapy.

Regardless of the style being implemented, each form of family therapy involves a licensed counsellor encouraging open discussions and communication.

By talking about their issues as a family, participants can start working through their conflicts and begin acknowledging each other’s experiences.

A family therapist will also provide members with information and educational resources about the addiction treatment process.

By learning more about their loved one’s condition, friends and family can start building compassion and realise that addiction is an illness first and foremost.

Certain methods emphasise creating a home environment that’s conducive to recovery: giving patients the chance to communicate their relapse triggers and voice their sobriety goals.

When are Talking Therapies Appropriate?

In spite of their advantages, the effectiveness of talking therapies for addiction can be situation or person-dependent. While therapists will try to personalise the process as much as possible, there are some patients for whom talking therapy isn’t a great fit.

For example, some people have a hard time trusting others, which can affect how they perceive their therapist or other participants.

For these individuals, launching straight into talking therapy could be detrimental, and other treatment methods should be discussed first.

Moreover, talking therapies should only be implemented at a certain point in someone’s addiction recovery journey. Because they’ll be diving into some potentially painful issues and memories, they should have completed other forms of treatment first.

For instance, rehab clinics often start talking therapies after someone has completed detox to make sure they’ve overcome withdrawal symptoms and their physical dependence.

Accessing Talking Therapies for Addiction

Because talking therapies for addiction have been around for so long and in many capacities, there are a number of routes through which you can access them. However, the cost of therapy varies depending on whether you present as an inpatient, outpatient, or through your local NHS hospital.

For those with severe addictions, it’s advisable that you access talking therapies as part of a comprehensive rehab treatment plan.

Private rehab facilities, while requiring clients to pay for treatment, include a huge range of personalised therapies, depending on the type of addiction you’re battling.

If you’re considering entering rehab, you can contact the Rehab 4 Alcoholism team for immediate guidance and a list of recommendations for your area.

Alternatively, it’s possible to access talking therapies on an outpatient basis; many rehabs offer follow-up therapeutic care, and there’s also the option of NHS treatment [10].

As you likely already know, the NHS here in the UK is free of charge, and this includes talking therapies for addiction. However, the waiting lists can be incredibly long, and the care given is often less personalised.

Another option for those seeking affordable talking therapies is to join a local fellowship group or a 12-step programme.

Ubiquitous 12-step programmes such as Alcoholics Anonymous [11] and Narcotics Anonymous [12] are free at the point of entry and are located in abundance across the UK.

If it’s difficult for you to attend AA or NA meetings in person, online communities such as SMART Recovery [13] are a perfect way to access all the benefits of talking therapy without leaving the comfort of your own home.

SMART provides free access to group therapy sessions for those in recovery and is particularly useful for those who have already had some form of treatment for Substance Use Disorder.

The same goes for Alcoholics Anonymous and Narcotics Anonymous; these groups shouldn’t be someone’s sole form of treatment, as aren’t located in a clinical setting.

Instead, they’re an effective way to reduce relapse rates once someone has already undergone detox, medical treatment, and other forms of psychotherapy.

In Need of Guidance? Reach Out Today

Committing to the process of recovery can be a tough decision to make, but it’s by far the healthiest route to take, and can even save your life.

As we’ve explored in this article, you’ll have the help of various talking therapies to help you overcome addiction, whether this is as an inpatient or an outpatient.

To find out more about the treatment process and look into your options, don’t hesitate to reach out. Our expert team can be reached within minutes by calling 0800 111 4108 [15], and our confidential hotline is open 24/7.