Counseling and Addiction
Outpatient vs. Residential Treatment
Residential therapy separates the addicted person from the environment that allowed him or her to use drugs, and teaches new habits or skills for sober living. A person goes away to a specialized facility for a period of weeks to months. While highly effective in the short term, there is debate as to whether residential programs lead to longer abstinence from prescription drug abuse than outpatient programs. Relapse is often higher if someone then goes back to a home environment where opportunities to resume drug use are in easy reach. Residential drug abuse treatment programs are expensive, usually costing tens of thousands of dollars and are not always covered by commercial insurance plans.
Outpatient treatment programs are the usual setting for ongoing prescription drug abuse treatment.
Cognitive Behavioral Therapy
Cognitive behavioral therapy -- or CBT -- teaches a person how to recognize moods, thoughts, and situations that stimulate drug craving. A therapist helps the person avoid these triggers, and replace negative thoughts and feelings with healthier ones that are more consistent with sobriety.
The skills learned in cognitive behavioral therapy can last a lifetime, making it a potentially powerful method of drug abuse treatment. However, not all therapists are trained in cognitive behavioral therapy techniques, which can be complex.
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.
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.