Research shows that several different treatment programs are effective in helping people overcome addictions, with surprisingly little difference in how well people do after the program. Many programs are available to choose from, but there are several issues to consider prior to choosing an approach to treatment.
Can You Afford the Program?
Programs range greatly in terms of cost, from being completely free to everyone (for example, 12 step programs), to those covered by insurance, to those that are completely private. Many people with addictions are financially limited, but it is worth exploring whether there is any financial support available for you to attend the program. If you call the program, they should be able to provide you with this information.
Do You Have Time to Attend the Program?
Some programs require a small commitment of time, such as an hour a week. Others require a commitment of several sessions a week, so it is possible to attend while still working full time. Still others require a similar commitment to a full-time job, so you would need to take time off work or school, or make alternative arrangements if you have other commitments, such as looking after children.
Residential programs are among the most effective approaches to overcoming addictions because they take you out of the environment where the addiction has been happening, and put you in an environment which is supportive to your recovery 24 hours a day. However, you have to be able to commit to living on-site for the duration of the program (for example, one month).
Are You Ready For This Program?
Many programs require that you are already abstinent from alcohol or drugs when you begin the program. This may even be the case with residential programs. This is because your needs are different when you are going through detoxification (when they are mostly medical), than when you are going through therapy (when they are mostly psychological).
It is important to check any requirements with the treatment program prior to signing up, particularly if you are on a wait list, so have time to complete detoxification before going in.
How Angry Are You?
In a large scale study comparing different treatment approaches, one factor that did make a different to how well the therapy worked was how angry the person was before treatment.
People who had the highest levels of anger did best in Motivational Enhancement Therapy (MET), whereas those with the lowest levels of anger did best with Cognitive Behavior Therapy (CBT).
Do You Agree With the Philosophy of the Program?
All treatment programs have a treatment philosophy. This is a central understanding about how people can be helped to overcome addictions, that will affect everything about how you are treated, how you are expected to behave, and whether there are any restrictions to what you can do.
It is important that you accept and are willing to work with the philosophy of the program, prior to starting. If you fundamentally disagree with the way that they operate, or if you are not willing to at least go in with an open mind, not only will you have a hard time benefiting from the program, but you may also disrupt the program for others.
Here are some examples of different program philosophies and expectations that people sometimes take issue with. They would never all be shared by a single program:
- Belief in God or a higher power
- Expectation that you will be abstinent from your addictive behavior for life
- Expectation that you will not need to be abstinent from your addictive behavior for life
- Belief that people can change
- Willingness to take breathalyzer or urine screen tests
- Willingness to share your story
- Willingness to disclose personal details, such as a history of abuse
- Willingness to listen to feedback from other group members
- Willingness to keep detailed written records of your thoughts and feelings
- Willingness to keep detailed written records of your addictive behaviors
- Limited or no contact with friends and family for the duration of the program
- Commitment to follow up, for example, attendance at 12 step group meetings
Are You Willing to Look At Yourself In an Honest Way?
No matter what the therapy, you will only be able to change your behavior if you are willing to look at it honestly, and consider doing things differently. This might seem like stating the obvious, but many people with addictions have deep denials about themselves, their addictions, and their behavior. This makes it difficult for the program to be effective.
Are You Ready to Follow Advice?
When you enter a treatment program, understand that no magic bullet will make your addiction just go away. You will have to do all the work yourself, while enduring a certain amount of frustration, cravings, and difficult insights into yourself.
It can be annoying to have professionals or group leaders tell you what to do, but in order for the program to be effective, you will have to be willing to follow their advice. For this reason, it is important that you accept the program philosophy (discussed above) and respect the professionals or group leaders. If you feel unable to do this, you may need to look for another program that is a better fit with your own belief system.
Do You Need Other Treatment?
If you have a concurrent mental health problem, such as depression, it is important that this is treated as well as the addiction. Some programs provide psychiatric support at the same time as addictions treatment, which is ideal. Others may have an issue with you taking medications.
It is best to discuss your dual diagnosis needs with your family doctor prior to committing to a treatment program.
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