When you are first ready to enter treatment for your addiction to illicit or prescription drugs or alcohol, detox is your first stop. Whether in a hospital setting—important for the medical supervision needed to safely detox from certain drugs and alcohol—or in an inpatient treatment facility, detox treatment is the process of allowing your body to safely rid itself of your drug of choice. This step is sometimes built in to the initial stage of inpatient or residential treatment programs; in other situations, you must complete your detox treatment before entering your next stage of treatment.
Following the successful completion of a detox protocol, you would most likely enter inpatient treatment, which is typically a 30-to-90–day intensive treatment program during which you live on-site. Some programs take place in a luxury hospital–type setting, while others are in large residential homes or estates—hence, the term residential treatment. On an average day, you will attend various therapeutic groups that focus on different aspects of addiction and recovery to both help you heal the issues that caused your addiction and prepare you for life after treatment. You also meet regularly with an on-staff therapist for individual counseling sessions for more in-depth personal therapy.
When you have both a substance abuse disorder and a mental health disorder, such as depression or anxiety, receiving treatment for both simultaneously is known as dual diagnosis treatment.
Medically Assisted Treatment
Many substance abuse disorders can benefit from the addition of medically assisted treatment at any stage (inpatient, outpatient, and aftercare), but it typically begins when you enter inpatient treatment and are assessed by a medical doctor and psychiatrist. If they determine your substance abuse has created a medical problem that needs treatment or diagnoses a mental health disorder or other physical or neurological disorder, medication may be deemed an appropriate component of your treatment plan.
If your addiction is less severe, you may move directly from detox to an outpatient treatment program. However, for many others, outpatient treatment is the next step after completing their inpatient or residential program. Less intensive than detox or inpatient, outpatient treatment takes place between 2 and 5 days a week for several hours at a time. During that time, you attend group therapy and educational classes, and continue to see your individual therapist regularly.
An important component of outpatient therapy is ongoing individual therapy, or meeting one-on-one with a psychotherapist. Meeting as many as three times a week in early recovery provides you the additional support you need during this sometimes-challenging time. Your therapist may use a variety of therapeutic techniques to help you continue to identify underlying causes to your addiction.
Partial Hospitalization Programs (PHP)
A step down from inpatient treatment, PHPs are still very structured and require you to meet five days a week for all-day programming in which you attend educational and therapy groups and work with treatment clinicians individually to further solidify your recovery efforts. You may live at home, but often attend your program at a hospital or healthcare office.
Intensive Outpatient Programs (IOP)
Also considered a step down from inpatient treatment programs and still a very structured treatment program, Intensive Outpatient Programs (IOP) typically provide two-to-three-day-a-week all-day programming that includes therapy groups and individual sessions with your therapist and other members of your treatment team.
Though a less-well-known phase of treatment, aftercare is nonetheless equally important as all the preceding phases—if not more so. Having received insight into the reasons for your addiction, worked through many of those issues, and been equipped with the skills you need to go back to regular life drug- and alcohol-free, you are now ready to reenter everyday life. But the pressures of actually transitioning can prove overwhelming and often lead to relapse. Enter aftercare treatment, where you may attend therapy on a regular, though less-frequent basis, receive practical-life support such as vocational training or job search tips, and become involved in a peer support group (such as AA).
These transitional living settings are another component of aftercare treatment that you may find useful in your transition to a clean and sober life. They provide a drug-free environment that is both supportive and structured.
One part of treatment that may be woven through nearly every stage of your recovery journey is group and social or peer support treatment. While you will participate in groups within your inpatient and outpatient treatment programs, what is most commonly meant by social support treatment is peer support groups. The benefit of this type of treatment is that you can attend for as long as you like for free and receive social connection and support, both critically important components of a successful long-term recovery. While group therapy is most often run by a licensed therapist or certified addictions counselor in a structured treatment program, peer support groups are run by peers who have worked that particular program for a significant amount of time.
The most familiar of peer support groups, 12-step groups such as Alcoholics Anonymous and Narcotics Anonymous generally work off of a spiritual philosophy and focus on one day at a time. Receiving additional support from sponsors, or other members who have worked the program longer, is another hallmark of traditional 12-step groups. They are typically free and widely available every day of the week.
Woven into all substance abuse therapy is behavioral health therapy, which specifically addresses the behaviors around your substance abuse or behavioral disorder (such as eating disorders or gambling addictions). In behavioral health therapy, you learn why you do the things you do and make specific plans to correct those behaviors by replacing them with healthier behaviors.
The most common model of psychotherapy used to treat substance abuse and behavioral disorders, CBT educates you about the link between your feelings, your thoughts, and your behaviors. You then identify faulty thoughts about your feelings and correct them, and learn healthier behaviors to choose when you have certain feelings or thoughts.
DBT is similar to CBT in that it acknowledges the link between emotions, thoughts, and actions, but it differs in that it focuses on developing four key skills in the course of treatment: emotional regulation; distress tolerance; mindfulness; and interpersonal effectiveness.
Motivational Interviewing (MI)
MI focuses on figuring out which things are personally motivating for you to make positive change, and then developing a plan to strengthen that internal motivation to help you sustain your commitment to sobriety.
A form of a token reward system, in Contingency Management you set specific, time-limited goals for yourself and then establish a reward for when you achieve them. This therapeutic model is meant to help you build momentum in your recovery and boost your self-confidence in your ability to achieve and sustain long-term recovery.
Family Behavioral Therapy
As the name suggests, Family Behavioral Therapy may be any form of treatment in which at least one member of your family also participates. Because belief systems and behavioral patterns are often learned and sustained within the family unit, treating you collectively strengthens you together and improves your chances of maintaining your sobriety.
The Matrix Model
This model of treatment is highly structured, time-limited, and results-focused. To do this, it may employ any number of therapeutic models to most effectively treat you, including CBT, Contingency Management, and MI. Its success relies on in its integrative, intensive, laser-focused approach.