Thursday, January 19, 2017

Members: Here is the next installment in our Educational Treatment Series. This piece is contributed by Dr. Dana Connolly from Sovereign Health. We hope that you will find it useful. Perhaps you can share with us your own experiences, positive or not, with your child and therapy for his or her addiction.
Therapy while in treatment:
As the vast majority of people who need drug and alcohol treatment never receive it, those who do are fortunate to have another chance at life. However, it is difficult to fully appreciate the opportunity while feeling sick, scared or ashamed. Detox and treatment are important steps in the journey from addiction to recovery, and knowing what to expect can help patients and their families relax and begin the healing process.
For friends and family members of those seeking treatment, rehab may seem like a place where people disappear for a month or more and come back looking healthier and happier. But what goes on behind those treatment center walls?
Therapy varies by treatment center, and most facilities use a combination of different modalities to help patients achieve their goals. Conventional treatment generally consists of “evidence-based” practices, which means that they have been tested in formal research studies and found to be safe and effective in sample populations. Health insurance rarely covers treatment that is not evidence-based.
The following are some widely used treatment modalities in the U.S. today:
Psychotherapy, or “talk therapy,” is the cornerstone of behavioral health care, and the term encompasses many different styles and settings. Psychotherapists can be psychiatrists, psychologists, specialized nurses, social workers and other types of mental health professionals. There are educational and licensing requirements to qualify as a psychotherapist (or therapist).
There are different approaches therapists can use, depending on the patients’ goals for treatment. Some of these include psychoanalysis, behavior therapy, cognitive therapy, humanistic therapy, and integrative or holistic therapy. Even within each of these categories, there are many more subcategories.
Pharmacotherapy involves the use of psychiatric medications. During detox, benzodiazepines, opioids and sleeping medications are commonly used to treat withdrawal symptoms and prevent seizures. Some leading centers also offer nutritionally assisted detox, which involves an intravenous infusion of essential nutrients to ease withdrawal symptoms and shorten the duration of the withdrawal process.
Most people in treatment have acute anxiety and depression from the effects of substance use and withdrawal. In addition, underlying or co-occurring conditions may be present, requiring medication. Stabilizing mood during early treatment helps some patients to get more out of their therapy by improving concentration, memory, sleep quality and symptoms of underlying mental illness. These medications can sometimes be tapered and/or discontinued after treatment.
While plant-based medicines or nutritional supplements are not used very much in the U.S., other cultures do incorporate these into drug and alcohol treatment and recovery.
Technology-assisted therapy
Technology seems to be everywhere these days, and addiction treatment is not any different. Patients are regaining brain function lost after excessive drug and/or alcohol intake by practicing computer-based cognitive rehabilitation exercises. Online therapy, peer support sites and social media also are being developed for the recovery community. Neuroscience applications help “re-train” the brain.
Neurofeedback, a form of biofeedback, is an interface between a computer program and electroencephalographic brain waves. While patients look and/or listen, the brain is unconsciously learning and developing new neural pathways. This form of therapy is particularly useful for improving concentration and promoting new habits to replace old ones.
Traumatized patients often benefit from eye movement desensitization and reprocessing (EMDR), which helps put painful memories out of the conscious mind by alternating the use of right brain and left brain. Although technology is not necessary to practice EMDR, some therapists find technological enhancements like sounds and visual cues help keep patients focused.
Lifestyle changes
As soon as the acute withdrawal period is over and patients begin to feel better, it is time to begin healthy habit formation. Learning to live clean and sober mandates adequate sleep, good nutrition, and daily exercise. Residential treatment is the ideal time and place to learn these basic habits that so many people affected by addiction have forgotten.
Experiential therapy
In addition to physical and social needs, humans also have emotional and spiritual needs that are equally important for health and sobriety. Experiential therapy elicits information from the unconscious that allows one to fill in perceptual, cognitive and emotional gaps in conscious memory. This information can then be processed in psychotherapy. Some examples of this type of therapy include equine, recreation, adventure and expressive arts, such as dance, art, poetry, music and song.
Community support groups
Modern society does not lend itself to the healthy social interactions that are so essential for mental and physical health. Support groups in the community provide an opportunity for friendship, cohesiveness, belonging, mutual support and networking. The recovery community had led the way in this regard, and now such groups exist that provide support for recovery or just about any other common struggle imaginable. Most treatment centers incorporate community support meetings into their programs as an introduction to take away any preconceived fears or notions that could prevent patients from trying them on their own.
Family involvement
Research has shown that family-centered care provides the best long-term outcome for individuals seeking treatment for drug and alcohol use disorders. Most centers include families in family psychotherapy, individual and group education and counseling, and some of the recreational therapy during weekend visits with their loved ones. Family members are also strongly encouraged to practice healthy lifestyle habits and participate in community support groups so that they can heal as well.
About the author:
Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University, received numerous research grants, awards, and appointments, and lectured at universities and scientific conferences around the world. More importantly, she is a mother of twin boys who will be starting middle school next year and are the joy of her life. Sovereign Health is a behavioral health information resource and Dr. Connolly helps to ensure excellence in our model.
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