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Addiction Treatment

What to Expect in Therapy

By

Updated June 12, 2014

Approaches to addiction treatment depend on the needs of the individual, and may include:

  • Detoxification to medically manage withdrawal from alcohol or drugs

  • Individual therapy to help the person reach a greater understanding of their addiction and how to overcome it

  • Group therapy to allow people with the same addiction problem to share understanding, support and encourage each other

  • Residential treatment to give people the chance to get away from their usual lifestyle into a safe supportive atmosphere with intensive therapy

Many people successfully overcome addictions without professional help through “natural recovery”.

Both natural recovery and addiction treatment can be enhanced through self help groups. The best known addiction self-help group is Alcoholics Anonymous or AA, which is a 12 step program, although there are many others which use different theories of addiction treatment.

How Do I Know Which Treatment Approach to Use?

In reality, people often use a combination of approaches to addiction treatment. It may take several different treatments to successfully overcome an addiction.

Quitting takes time, and involves several stages:

  • The decision to change –- you may not be ready to quit, but services exist to help you make this decision.

  • Preparing to change –- deciding on the best way to quit.

  • Withdrawal from the addictive behavior – can last a week or two.

  • Developing a lifestyle without the addictive behaviour.

  • Finding non-addictive ways of coping.

  • Maintaining a non-addictive lifestyle over the long-term – this will take the rest of your life.

Many different addiction treatments help people overcome addictions. The effectiveness of your therapy will depend on:

  • Your readiness to change.

  • How well you get on with your therapist.

  • How severe your addiction is –- it is dangerous to withdraw from some drugs, including alcohol, without medical supervision.

  • Your physical health –- you may have problems such as liver disease, which also need immediate treatment.

  • Your mental health –- your addiction may be co-occurring with another mental health problem, which will also need immediate treatment.

  • The amount of social support you have. Generally, family and friends who do not share the addictive behaviour can support your recovery, but people still engaged in the same addictive behaviour tend to make it more difficult.

  • Your financial circumstances –- you may need to take time off work, and if you have difficult financial circumstances, treatment services can connect you with financial and housing support.

How Do I Begin Addiction Treatment?

The best place to start is to discuss your addiction with your family doctor. Some ways that they help are:

  • Providing a long-term therapeutic relationship -– don’t underestimate the value of someone who can see you progress from being addicted to long-term recovery.

  • Diagnosing physical and mental conditions you may not even be aware of.

  • Referrals to other medical, psychiatric and formal addiction services.

  • Advice on addiction treatment approaches.

  • Medical management of your withdrawal –- they can explain how this will work, whether you need to go into a detoxification facility or hospital, and refer you to appropriate services.

You can also contact a helpline, to put you in touch with treatment services directly. Helplines provide immediate anonymous support and information, often 24 hours a day. You may still need a referral from your family doctor to get into a treatment program.

What Can I Expect From Addiction Treatment?

Addiction treatment services vary, but expect some or all of the following:

  • Confidentiality with very few exceptions.

  • Supportive professionals who will collaborate with you, accept you for who you are, empathize with your situation, encourage you to keep trying, and help you solve problems.

  • Individual counseling to discuss how you became addicted, your reasons for quitting, and what will help you quit.

  • Group therapy, where you will meet other people in addiction treatment, to support each other and learn about addiction and recovery.

Your addiction treatment service may or may not involve:

  • Drug testing -– only if abstinence from alcohol or drugs is one of the goals you agreed with your therapist.

  • Medication management by an on-site medical professional -– a great advantage if you are detoxifying, or if you have other mental or physical concerns.

  • Family support and/or couples counselling to give support to people in your life who could help your recovery.

  • Follow up –- to make sure that you are still doing OK after completing the treatment program.

Will I Be Judged?

Generally, healthcare providers take a nonjudgmental approach to treating people with addictions. Anyone working in the medical system should treat you with dignity and respect, and if they do not, you can make a complaint.

Sometimes people in group therapy are judgmental of others. A facilitator will prevent this from happening by setting ground rules for participants at the beginning of the session. It is part of their job to ensure that group members are respectful to each other.

The lack of facilitators is one of the difficulties of self-help groups. If you feel judged or uncomfortable with a self-help group you are attending, try a different group.

What if I Can’t Quit?

Successful recovery from an addiction takes time and patience. The most important factor is your commitment to quitting. Support is available, and if you relapse, you can always try again. It is common to have several attempts before you are successful.

Sources:

Miller, W.R., Brown, J.M., Simpson, T.L., Handmaker, N.S., Bien, T.H., Luckie, L.F., Montgomery, H.A., Hester, R.K. and Tonigan, J.S. “What Works? A Methodological Analysis of the Alcohol Treatment Outcome Literature.” In "Handbook of Alcoholism Treatment Approaches – Effective Alternatives" (2nd edition) Edited by R.K. Hester and W.R. Miller, Allyn and Bacon, Boston. 1995.

Orford, Jim. “Excessive Appetites: A Psychological View of Addictions” (2nd Edition). Wiley, Chicester. 2001.

Schulz PhD, William E. “Counselling Ethics Casebook.” Canadian Guidance and Counselling Association, Ottawa. 1994.

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