Addiction treatment is delivered through various levels of care and through many different service delivery models. There are the inpatient levels of care including detox and residential. Then there are the outpatient levels of care which include partial hospitalization programming, intensive outpatient programming and general outpatient counseling. Additionally, there are independent practitioners or addiction counselors. No matter the level or care or model of service, all of these utilize the same or very similar clinical modalities which are the heart of addiction treatment. Modalities are approaches or methods that a therapist will use to help you reach your goals. Modalities fall into broad categories, such as cognitive and behavioral, somatic (body awareness), experiential (play or art therapy), and more. In this post we will discuss the various common clinical modalities.
Cognitive Behavioral Therapy in Addiction Treatment
Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on identifying and changing negative thought patterns and behaviors. It is based on the idea that our thoughts, feelings, and behaviors are interconnected, and that by changing our thoughts and behaviors, we can also change how we feel.
In CBT, the therapist works with the individual to identify and challenge their negative or irrational thoughts and beliefs, and replace them with more realistic and positive ones. This process is often done through various techniques such as cognitive restructuring, behavior modification, and problem-solving skills training.
CBT has been shown to be effective in treating a variety of mental health conditions, including depression, anxiety disorders, phobias, and post-traumatic stress disorder. It is also commonly used to help individuals manage stress, improve self-esteem, and develop coping skills for dealing with difficult situations.
CBT is typically a short-term, goal-oriented therapy that is focused on helping the individual make specific changes in their thoughts and behaviors. It is often conducted in weekly sessions over a set period of time, with the goal of helping the individual develop the skills they need to manage their symptoms and improve their overall well-being.
Acceptance Commitment Therapy in Addiction Treatment
Acceptance and Commitment Therapy (ACT) is a type of psychotherapy that focuses on helping individuals accept what is out of their control and commit to taking actions that are in line with their values and goals. ACT is based on the idea that trying to avoid or control painful thoughts and emotions only leads to more suffering, and that true psychological well-being comes from accepting these experiences and living a meaningful life despite them.
In ACT, the therapist works with the individual to help them develop psychological flexibility, which involves being present in the moment, accepting their thoughts and feelings without judgment, and taking action in line with their values. This process is often done through various techniques such as mindfulness exercises, cognitive diffusion (learning to see thoughts as just thoughts), and values clarification exercises.
ACT has been shown to be effective in treating a variety of mental health conditions, including anxiety disorders, depression, chronic pain, substance abuse, and eating disorders. It is also commonly used to help individuals improve their relationships, increase their self-awareness, and develop a sense of purpose and meaning in their lives.
ACT is typically a short-term therapy that is focused on helping the individual develop the skills they need to live a more meaningful and fulfilling life. It is often conducted in weekly sessions over a set period of time, with the goal of helping the individual increase their psychological flexibility and make positive changes in their thoughts and behaviors.
Dialectical Behavioral Therapy in Addiction Treatment
Dialectical Behavior Therapy (DBT) is a type of cognitive-behavioral therapy that was developed by psychologist Marsha M. Linehan in the late 1980s. DBT was originally created to help individuals with borderline personality disorder (BPD), but it has since been adapted to treat a variety of other mental health conditions.
DBT combines elements of cognitive-behavioral therapy with concepts from mindfulness and dialectics, which is the idea that two seemingly opposing ideas can both be true. The main goal of DBT is to help individuals build skills in four key areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness.
In DBT, the therapist works with the individual to help them learn how to regulate their emotions, improve their relationships, and cope with stress in healthier ways. This is often done through individual therapy sessions, group skills training, phone coaching between sessions, and consultation meetings for the therapist.
DBT has been shown to be effective in treating a variety of mental health conditions, including BPD, mood disorders, eating disorders, substance abuse, and post-traumatic stress disorder. It is particularly helpful for individuals who struggle with intense emotions, impulsive behaviors, and difficulties in relationships.
DBT is typically a long-term therapy that is conducted in stages, with the first stage focusing on stabilizing the individual and reducing harmful behaviors, and subsequent stages focusing on building skills and improving the individual’s quality of life. The ultimate goal of DBT is to help individuals create a life worth living by learning how to effectively manage their emotions and behaviors.
Rational Emotive Behavior Therapy in Addiction Treatment
Rational Emotive Behavior Therapy (REBT) is a type of cognitive-behavioral therapy developed by psychologist Albert Ellis in the 1950s. REBT is based on the idea that our beliefs about events, rather than the events themselves, cause our emotional and behavioral reactions. Ellis believed that by identifying and changing irrational beliefs, individuals can learn to better cope with life’s challenges and improve their mental health.
In REBT, the therapist works with the individual to help them identify and challenge their irrational beliefs, which are often characterized by rigid, absolutist thinking and unrealistic expectations. These beliefs are often expressed in the form of “musts,” “shoulds,” and “oughts.” Through a process of cognitive restructuring, the individual learns to replace these irrational beliefs with more rational, adaptive beliefs that are based on evidence and logic.
REBT also emphasizes the importance of accepting oneself and others unconditionally, as well as taking responsibility for one’s own emotions and behaviors. The therapist may use techniques such as disputing irrational beliefs, reframing negative thoughts, and teaching coping skills to help the individual change their thinking patterns and develop healthier ways of responding to stress and adversity.
REBT has been shown to be effective in treating a variety of mental health conditions, including anxiety disorders, depression, substance abuse, and anger management issues. It is often a short-term therapy that is focused on helping the individual develop self-awareness, increase their emotional resilience, and make positive changes in their beliefs and behaviors. Overall, REBT is a practical, action-oriented therapy that empowers individuals to take control of their thoughts and emotions, and ultimately live a more fulfilling and satisfying life.
While there are many modalities within the addiction treatment industry, Cognitive Behavioral Therapy, Acceptance Commitment Therapy, Dialectical Behavior Therapy and Rational Emotive Behavior Therapy are of the most common. These are the evidence-based models for providing therapy in all addiction treatment programs.
