- Counselling Therapies
- Cognitive Behavioural Therapy (CBT)
- Supportive Expressive Therapy
- Interpersonal Therapy (IPT)
- Psychodynamic Therapy
- Mindfulness Based Cognitive Therapy (MBCT)
- Couples or Family Therapy
- Person Centred Therapy – PCT (Rogerian Therapy)
Counselling Therapies are an integral part of recovery. The road to recovery is dependent on facing your ’demons’ and looking at the reasons why you became addicted in the first place. Counselling equips you with the understanding and tools to help to fight the addiction.
Whatever form of counselling you engage in, it requires commitment and hard work from you. The therapist is there as a guide to help you to achieve your recovery goals.
Don’t feel disheartened if you try a particular therapy and can’t relate to it; it may not be the right type of therapy for you or maybe even not the right therapist so don’t give up but try different therapies or therapists. Likewise, it is worth noting that engaging in group therapy as well as one-to-one is highly beneficial although it may be difficult at first.
Counselling will hold you in good stead not only during your initial recovery but also long-term. Even when ‘recovered’ there will be new stress-factors to deal with in your life and the tools that you learn in counselling will help to keep you on the right path and help you not to revert to your old ways.
The following therapies have been found to be some of the most effective in dealing with addiction and are listed to give you an overview of the different forms of counselling available.
We hope that this is of some help to you
Cognitive Behavioural Therapy (CBT)
What is CBT?
CBT is a talking therapy that can help you to manage your addiction and associated emotional health issues by changing the way that you think and behave. Unlike other treatments, CBT concentrates mainly on your current problems but acknowledges the past. It is used to treat anxiety and depression but is also successful for treating other mental, emotional and physical health problems.
How CBT works
CBT focuses on helping you to find ways to change how you react or think in response to certain events or stimuli. It works by interrupting the ‘vicious cycle’ in which you have become trapped because of your addiction. As substance abuse affects the brain, it is important that certain negative thought processes and patterns of behaviour are changed to help you break your addictive habits. Certain beliefs, feelings and physical reactions to stimuli must also be addressed. All of these are interconnected, and the concept of CBT recognises this and helps you to understand how and to learn different ways of reacting or thinking.
What happens during CBT sessions?
You need to commit yourself to the process to get the most from it – the therapist can help and advise you, but only you can make the changes.
You will usually have a session with a CBT therapist once a week or once every two weeks. Treatment usually lasts for between five to 20 sessions, lasting 30 minutes to an hour each time.
The CBT therapist will work closely with you to:
- Look at your problems and break them down into separate parts – negative thoughts, feelings, how you behave and physical signs
- Analyse the areas that you have discussed to determine how they affect one another and ultimately how they affect you as an individual
- Your therapist will then work with you to address how you can change your reactions to negative or unhelpful thoughts and patterns of behaviour
- After putting in place new thought processes in response to events or stimuli, your therapist will ask you to practice these changes in your daily life
- Your therapist will ask you to record your progress outside of your therapy session, perhaps by asking you to record responses in a notebook and to record when the new thought processes have worked or when they haven’t. You’ll then discuss how you got on and why the new thought processes sometimes worked and why sometimes they didn’t at your next session
- Your therapist will give you the coping skills to recognise ‘triggers’ that are associated with your addiction and to provide you with methods to help you to steer yourself away from them by using what you’ve learnt in your sessions
What are the benefits of CBT?
CBT has been used successfully in addiction programs around the world. It is an adaptable treatment tool that can be used in either individual or group sessions. CBT has been found to be highly effective in the treatment of addictions and addictive behaviours.
Some advantages of CBT are:
- It is an evidenced-based practice, recovery-focused and produces short and long-term benefits to those committed to it
- CBT may help where medication alone hasn’t
- The structured nature of CBT means that it can be provided in different formats depending upon the needs of the individual – individual/group sessions, self-help books and APPS etc.
- It teaches you how to put useful and practical strategies in place to help you to cope with becoming free from your addiction in your everyday life
- CBT can be completed in a relatively short space of time compared to other therapies
Even after your treatment has finished, CBT can be used to help and support your everyday life and continue your commitment to remaining drug/alcohol free.
- CBT may not be suitable for individuals with more complex mental health needs
- CBT may not be suitable for individuals with learning disabilities as it requires structured sessions
- CBT only addresses current problems and focuses on specific issues (such as addiction). It does not address possible underlying causes of mental health conditions
Supportive Expressive Therapy
This is an evidence-based therapy (psychodynamic psychotherapy). It is based on Freud’s psychoanalytic theory which claims that psychological problems originate in early childhood.
It is usually a short-term treatment based on a set programme which is generally used for addicts with more severe substance abuse disorders (such as opioid, heroine & cocaine).
The therapist will decide what should be the focus of the sessions and a course of treatment typically involves between 16 to 30 one-hour sessions. The therapist will help you to identify interpersonal and conflictual relationship issues and will work with you to understand and resolve such issues. During the therapy, you and your therapist will explore, and gain insight into, conflicts that perhaps developed within you in early years and discuss how they are represented in current situations and relationships.
The aim is to help you to master your difficulties and to gain an understanding of your inner thought processes which will help you to begin to practice self-control over your substances-abuse problems. It will give you support whilst providing you with a safe environment to express yourself.
Supportive Expressive Therapy has the best outcomes when combined with drug therapy, especially if there are existing mental health problems.
Interpersonal Therapy (IPT)
IPT is not primarily used for addiction but it may be useful when a person suffers from a mental health disorder and an addiction, known as ‘dual-diagnosis’.
It has been shown to be very effective in treating children and young adolescents. It can help you to resolve conflict and improve relationships. It can also help you to understand the impact that life events can have on our interactions. By addressing interpersonal relationships and associated issues, IPT puts emphasis on the way that the symptoms of depression are related to relationships with family and friends.
IPT can help with life changes by addressing interpersonal deficits including social isolation and unfulfilling relationships, unresolved grief (e.g. if the onset of distress is linked to the death of a loved one), life transitions i.e. retirement, change in role, divorce, moving to another city, interpersonal disputes between partners, family members, close friends or co-workers. IPT examines current, rather than past, relationships and recognises, but does not focus on, internal conflicts.
IPT aims to change relationship patterns and target relationship difficulties that make associated depressive symptoms worse rather than focussing on the depressive symptoms. It is a manual-based treatment and is a short-term treatment course of 12 to 16 weekly hourly sessions. IPT can also be applied in a group setting during recovery from addiction. However, it is usual for patients to have a couple of individual sessions before going into a group session. In a group setting, patients learn by listening and observing others and contact with other members of the group helps in adjusting reactions to others.
Psychodynamic therapy differs from other therapies in that it aims for deep-seated change in personality and emotional development.
This type of in-depth psych-analysis will focus on revealing unconscious thoughts. Past experiences, such as unresolved conflicts or problematic relationships, can manifest in the present without you consciously realising it.
Psychodynamic therapy is helpful for people battling substance abuse because it helps to identify the underlying reason for addiction. In this technique, you will simply speak for yourself about whatever comes to mind, especially issues about which you feel strongly. This helps to build a trust between you and your therapist.
During the process of speaking openly about such issues, unconscious emotions such as anger, shame, sadness or dependency are transferred to the therapist instead of remaining deeply buried in your psyche. This is a unique approach that allows you and your therapist to analyse and explore emotions together. Once the defence mechanisms are identified, the therapist will help you to work through them and learn how to cope with triggers.
The ultimate aim of the therapy is to provide you with a skillset to eliminate the unconscious connection between past experiences and current triggers for substance abuse, the goal being to get you to a point where you do not feel the need to use drugs or alcohol. It may take many sessions before improvements are seen, but this is all part of the process to enable you to fully understand and overcome your addiction.
Mindfulness Based Cognitive Therapy (MBCT)
Learning to be mindful is a key element in mindfulness-based cognitive therapy. Mindfulness is being aware of your feelings, thoughts and actions in the present moment. The aim is to allow negative or unwanted thoughts to come and recognise them as transitory and allow them to pass. It combines a variety of mindful techniques including breathing exercises and meditation. Sometimes people use drugs or alcohol to numb or escape painful feelings or to quiet troubling thoughts and the idea is that mindfulness will replace these methods and help to ease the suffering.
Combining MBCT with other treatments, for example CBT, creates a powerful formula for helping those struggling with mood disorders, anxiety disorders and many other disorders and problems which includes many people with substance abuse disorders. It has been shown to be effective in treating chronic drug and alcohol abusers, especially those who are likely to relapse. This is because MBCT reinforces relapse prevention, assists in managing the feeling of anxiety and aids trauma recovery.
As part of a well-rounded treatment program it will compliment other therapies to aide recovery from addiction.
Couples or Family Therapy
Drug abuse and addiction don’t only affect the addict; relationships with family and friends are totally transformed too.
Successful treatment very often requires strong relations with family and friends, and this can play a major role in recovery and freedom from drugs. Including them in the recovery process can be a powerful force.
Studies have shown that this type of therapy results in lower relapse rates, increases family happiness and helps children of addicted parents to manage their situation better.
This therapy gives everyone a better understanding of what addiction is and how it affects behaviour. It improves communication and helps to rebuild trust. During family therapy, a parent or spouse may learn that they also need help and they may be directed to a support group or an individual therapist.
Person Centred Therapy – PCT (Rogerian Therapy)
Person Centred Therapy recognises that our self-concept can become displaced if we are striving too hard to belong and to be accepted by those around us.
Over time, a person’s identity, personal judgement and experiences can be unknowingly distorted by other people’s ideas. PCT will help you to ‘self-actualise’ and achieve your personal goals. Through the provision of a supportive environment, you will be able to strengthen and expand your true identity and begin to separate yourself from the developed notions of how you should be.
PCT can help addicts in recovery in many ways. It moves the emphasis away from substance abuse and its associated behaviours by broadening the focus to look at you as a whole and highlighting what your perception really is. Instead of looking at the addiction, it requires you to analyse how you have battled with the addiction/are still battling with the addiction and why you, as an addict, engage in certain behaviours when abusing substance.
This kind of therapy is invaluable during recovery because it will change how you view yourself as you work to improve self-image and increase self-esteem. You must be prepared to cope with difficult feelings, emotions, thoughts and motivations that may reveal themselves during these sessions as you will have to face the possible causes of the addiction/substance abuse.
The process will enable you to discover your own solutions and the therapist acts as a facilitator, listens without judgement and acknowledges your personal experiences.
The theory believes – “that all of us have the power to find the best solutions for ourselves and make appropriate changes in our lives”