When dealing with addiction, as with any psychological affliction, a generalized, systematic approach must be used in order for a supporting industry to be able to develop around it. However, we also know that individualized treatment is most effective due to the personalized nature of mental illness. This overview will cover, then, the infrastructure of the treatment industry followed by the various approaches based in the respective schools of psychological thought.
There are two main types of treatment that are employed in order to help the person suffering with addiction. They vary widely in terms of commitments of time, energy, and money, not only of the patient but also of the parties involved with the administration of the treatment. Each of these main types utilizes the same treatment modalities on differing scales. The two main types are inpatient and outpatient treatment.
For the most entrenched forms of addiction, a more demanding type of treatment is available provided by entire groups of professionals under the employ of one facility. These various facilities will refer patients to one another if they can’t accommodate a unique case or they know another treatment center can better deal with the specific problem.
These inpatient facilities require the patient to live on the premises. This means that the patient will encounter orderlies, who maintain the facility’s cleanliness, cook food, and ensure that no behavioral problems escalate further than necessary. The patient will also meet with a psychiatrist who will write prescriptions for medications that will help during recovery, along with a psychologist who will guide the person towards growth and healing through counseling sessions. There may also be vocational instructors and school teachers, depending on the age group and depth of the facility’s efforts.
People seeking or being court-ordered to inpatient treatment will discover the following options:
Residential treatment centers are highly organized living quarters staffed by professionals that teach patients new ways of living, coping, and resisting triggers and possible relapse. Every moment of the day is structured with a positive activity while restricting access to the usual environment and social circle that provided access to drugs and temptations to use. Hospitalization occurs when a person is an extreme danger to themselves and the magnitude of their illness requires constant supervision and medical support. Detoxification centers may be standalone operations or contained within a residential treatment center or hospital.
The options for outpatient treatment include many featured within the inpatient facilities and are often used for less severe cases or after being discharged from inpatient treatment for continued support. The key difference is that they do not require the individual dealing with substance abuse to reside temporarily in any other premises than their own homes.
People seeking outpatient treatment will find the following options available:
Most people are aware of organizations such as Alcoholics Anonymous, Narcotics Anonymous, and other similarly named clubs. These all generally follow the 12 Steps of recovery as developed by the founders of A.A and may also include the 12 Traditions among other itemized lists that ease memorization and recall. The Self-Help groups one will find are analogous to the 12 Step Programs but may not include the steps themselves. They can be associated with church organizations, businesses, or just be a non-formal gathering of individuals sharing similar plights. The key difference between these types and the professional counseling groups is that a member of the group leads the prior and the latter is led by a licensed and certified professional. Professional counseling tends to be far less casual as well. When specifically dealing with addiction, the patient may see a substance abuse specialist versus a generalized counselor.
It will be beyond the scope of this article to delve deeply into each of the approaches, but a concise summary will be provided. The differences between these various approaches are related to the various schools of thought and their philosophical emphases on the primary of causative factors. To put it plainly, some feel that neurochemistry is to blame, while others blame habitual thought patterns, negative behavioral actions, or humanistic attributes such as perception and experience. Others, often called Integrative or Holistic, consider them all important and attack the problem from every angle.
While there are many sub-approaches, the main categories can be understood as follows:
Behavior Therapy is a broad term that can be misleading in terms of scope. It refers not only to the physical actions taken by a person, but the mental actions as well. You will find mention of behavioral therapy, cognitive therapy, and the all-encompassing cognitive behavioral therapy. This approach involves developing and maintaining a state of awareness in which you observer your actions to gain insight and identify troubling associations and then act to slowly correct these behaviors over time. This school largely arises from the teachings of B. F. Skinner and John B. Watson.
Psychoanalysis was founded by Sigmund Freud and further carried into the transpersonal realms by his student Carl G. Jung. This school and approach is concerned with the hidden subconscious that we are not able to control directly but can influence or dissipates its power over our egos by gaining insight into it. It is a very guided style of counseling that might include hypnosis, language analysis, deconstructing and reconstructing cognitive frameworks, dream analysis, and more. The sought after goal is to discover that which lies deep within the mind that inspires addictive and destructive behaviors.
Pharmacotherapy is a form of biology studies that has no particular set of founders. It is a strictly scientific approach that seeks to understand the brain functioning on the macro and micro scales. Research is performed on the impact of physical abnormalities, neurochemical imbalances, increased or decreased synaptic activity, and more. For addiction research, emphasis is placed on the interaction and effects of varying levels of neurotransmitters, such as dopamine and serotonin, but digs as far as genomic influences as well.
Humanistic therapeutic approaches, influenced by Abraham Maslow and Carl Rogers, concern themselves with the present condition of the client and the potential condition of self-actualization. This requires the patient to enter into an existential journey to find or create freedom from the everyday stressors of life in order to create meaning for oneself within life. This eventual harmony is beyond just the label “healthy,” whereas people can learn to function and contribute within any tier personal and social interaction with the world. One will find depth therapy, animal-assisted therapy, and interpersonal therapy as sub-types of the humanistic approach.
The integrative and holistic approaches see the problem of addiction and any psychological illness as arising from all of the above causative factors and seeks to use all of the approaches in order to drive an individual toward a feeling of wholeness.
As a whole, the treatment industry has converged upon what it feels to be the most effective modalities for treating addiction. These include the inpatient and outpatient infrastructures that guide a patient through detoxification, education and healing, and then continued support of recovery and relapse. Each of these stages may be approached from various schools of thought or any mixture thereof.