Addiction and Therapy

The terms “substance use” and “substance treatment” fall within the mental health ecosystem. We often treat them as separate entities (partly because of how we pay for things in our screwed up health system), but there’s a lot of overlap.

One of the hiccups is that treating more complex cases in either realm can be a “subspecialty” all on its own. As a result, not every practice will be the ideal fit for every part of the substance continuum.

Whether you are a mental health care seeker wanting to overcome an addiction or someone ready to support a loved one on their journey, remember to first bet on yourself. Seeking therapy of any form starts with believing in yourself. Know that we believe in you too! 🙂

Addiction is an extremely difficult topic to work through, but this doesn’t mean that it has to be scary, taboo, or impenetrable. Addiction can be overcome, and your willingness to commit to someone – whether it be yourself or someone you love – begins the journey. Dedication coupled with patience, kindness, honesty, and communication are keys to seeing breakthroughs with addiction. 

Addiction is a disorder

Let’s start with this simple notion: a person struggling with addiction does not mean they are a bad person. Addiction does not equal bad. The outcomes of addiction are negative and hurtful, and this is important to distinguish. Society often places blame on the person struggling with addiction as if it is a moral failure on their part. This is false, as it has nothing to do with morals; addiction is a disorder.

And this isn’t to say that responsibility should not be taken for actions; remember to separate the person from the problem and don’t see them as the issue. He or she is a flawed, imperfect human just like you. So be there for them just as they would for you.

Learning more about addiction can help you be there for someone who is struggling with substance use disorder, but be mindful:  just because you learn a lot of info about addiction doesn’t make you an expert. Every situation is unique, and maintaining humility and kindness helps the person feel supported and valued (and more importantly, not judged.)

The National Institute on Drug Abuse (NIDA) describes addiction as “an inability to stop using a drug; failure to meet work, social, or family obligations; and, sometimes (depending on the drug), tolerance and withdrawal.” Currently, people in the medical community more often use “substance use disorder” to refer to addiction. Obviously this is a multifaceted disorder that we’re talking about, so there will never be one direct checklist of things to say or do to “fix” the person. (Get that mentality out of your head…)

Support is the way to help

It is not an easy decision to choose to help someone you love who is struggling with addiction, but your commitment to them literally is the greatest thing you can do because support is proven to increase the chance of overcoming addiction. It will always be worth it to commit to a loved one as they work through an addiction. 

Start by building trust so that they will be more likely to listen. It is important here that you seek to understand and really listen, not accuse and threaten. This will only cause them to shut off or run away or hide their behavior. 

And it’s okay to be honest and let them know how the addiction is affecting your life and your relationship with them. But don’t blame them, or criticize them, and don’t make it all about you. Shame will only cause them to doubt their own ability to overcome addiction.

Also worth noting here is that respecting their privacy while being supportive boosts their autonomy. You can’t force them to quit or change, but you can be a source of strength and support to help them retake control of their life. Remember that these changes will not happen overnight; patience is so important as recovery takes time, and setbacks are part of the journey. 

Expect difficulties at first as sometimes people are in denial about an addiction, may be afraid to address it, may feel embarrassed, or may not want to hurt or inconvenience others.  In other instances, the addictive disorder could be a coping mechanism to deal with trauma or other mental illness. 

It may not be like a lightbulb moment where your loved one instantly wants to change. These things will always take time to work through, so remember to take care of yourself and get support when you need it, too. 

Some options for treatment

Once your loved one has accepted that they are struggling with addiction and is willing to commit to changing, avenues for treatment can be explored. 

A few options include:

• Community Reinforcement and Family Training (CRAFT): CRAFT is an evidence-based method for helping families get help for addicted loved ones. It has replaced traditional interventions as the preferred method of helping people with addiction get the help they need, such as therapy. 
• Medications: The Food and Drug Administration (FDA) has approved a number of medications—including Vivitrol (naltrexone), Campral (acamprosate), and Suboxone (buprenorphine and naloxone)—that can be effective in the treatment of alcohol dependence and other substance use disorders.
• Cognitive behavioral therapy (CBT): Addiction therapy that utilizes CBT focuses on helping people understand how their thoughts and feelings influence their behaviors. It works by helping people change the thought and behavior patterns that contribute to addiction.
• Online therapy: Research suggests that online therapy can also be an effective treatment option for substance use disorders. Such programs often incorporate elements of CBT and motivational interviewing, which involves using structured conversations to help people think about how their life will improve by ending their addiction.
• Support groups: Twelve-step and peer support groups can also be helpful during the recovery process. The groups are aimed at promoting sobriety and may take a variety of approaches. Some may promote total abstinence, while others focus on moderation. Many of these may offer in-person meetings, but online support groups are also available.

No matter what treatment option or variety is utilized, substance use disorders requires a life-long commitment to manage. Continue to provide support through trust, kindness, honesty, and patience. How you communicate in every step of the journey facilitates how they feel about and respond to your support.

Here are some tips to help you maintain your support for a loved one seeking therapy for overcoming addiction:

• Be kind and accepting
• Thoughtfully choose your words
• Continue to educate yourself on addiction
• Be consistent
• Listen more than you talk
• Set boundaries
• Don’t tell them what to do
• Believe them (and believe in them)

The mental health ecosystem is diverse and growing. Simply Psych is here to support clinicians as they provide treatment and care to those seeking it. If you or a loved one is struggling with any addiction and need help, check out the resources we have listed in our Mental Health Ecosystem page.