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Substance Abuse and Addiction Health Center

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Counseling and Addiction

Contingency Management Therapy

In contingency management therapy, a person in drug abuse treatment receives positive incentives for staying clean. Vouchers for goods and services, or privileges in a more rigid treatment setting are common incentives. Contingency management therapy is effective in drug rehab studies. But skeptics point out its high costs, and that when incentives stop, its positive effects decline.

Motivational Interviewing

Traditional therapies for drug abuse treatment involved confrontation. Addicts are masters of denial, the thinking went, and therapy should break down walls to force them to accept the reality of their addiction. 

While confrontation may still have a role, many therapists instead promote motivational interviewing, a newer counseling method. In motivational interviewing, a therapist seeks to understand and enhance an addicted person's natural motivation for change. For example, if the person reveals he is motivated by love of his family, or returning to work, these may become the focus of therapy.

Couples and Family Therapy

Prescription drug abuse and opioid addiction don't only affect the user's life; the whole family is transformed. Strong relationships with family and friends are essential for successful drug abuse treatment. Various counseling methods include the spouse and other family members of the addicted person.

There are several potential benefits of family or couples therapy:

  • Family members can act as a powerful force for change in the addicted person's life.
  • Including family members can increase the likelihood a person will stay in therapy.
  • Each family member can begin to heal the damage their loved one's addiction has caused in their own life.

Studies show family therapy results in lower relapse rates, increased happiness in the family, and better functioning in children of addicted parents.

Maintenance Therapy

Most experts today consider opioid addiction to be a chronic, relapsing illness. Just like other chronic illnesses such as diabetes or high blood pressure, opioid addiction treatment in some form must be lifelong.

Many people with opioid addiction will continue to take maintenance therapy in the form of methadone or Suboxone (buprenorphine/naloxone), sometimes for decades. By the same token, experts say, they should also continue some form of counseling.

This idea runs counter to traditional views of drug rehab, in which a person was considered "cured" after a relatively short period in treatment. However, evidence is mounting that lifelong treatment with counseling, maintenance therapy, or often both, should be standard drug abuse treatment for most people with relapsing opioid addiction.

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WebMD Medical Reference

Reviewed by Kimball Johnson, MD on August 02, 2012

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