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Counselling and addiction therapy

Counselling, cognitive behavioural therapy (CBT), and other therapy approaches may be recommended for people recovering from drug addiction to help reduce the risk of relapses.

Why counselling is important

Drug addiction is more than a physical dependence on drugs. Even after detox, when physical dependence is cured, addicts are at high risk of relapse. Psychological and social factors are often powerful stimuli for drug abuse relapse:

  • Stress, especially sudden life stresses
  • Triggers in the environment, like visiting a neighbourhood
  • Social networks, like spending time with friends who continue to take drugs

These factors can create ongoing, nearly irresistible urges to take drugs. Drug abuse, including prescription drug abuse, counselling helps addicts escape craving and learn to cope with life, without taking drugs.

Several counselling therapies are available for drug abuse, and no method is known to be the best. The right drug abuse treatment plan is tailored to a person's addiction and the person’s individual needs.

Individual vs. group therapy

While any counselling therapy for drug abuse treatment is better than none, group therapy is generally preferred to individual therapy. In group therapy, a person is more likely to be both challenged and supported by peers who are also going through drug rehabilitation. Twelve-step programmes like Narcotics Anonymous are the most well-known group therapy organisations.

Individual therapy can be helpful in the case of a dual diagnosis: co-existing depression, bipolar disorder, or other significant mental health condition that requires treatment in its own right, separate from the drug addiction.

Outpatient vs. residential treatment

Residential therapy allows the addicted person to temporarily escape the environment that allowed them to use drugs. A person goes away to a specialised facility for a period of weeks to months. While highly effective in the short-term, there is debate as to whether residential programmes lead to longer abstinence from drug abuse than outpatient programmes. Residential drug abuse treatment programmes are expensive, usually costing thousands of pounds.

Outpatient treatment programmes are the usual setting for ongoing prescription drug abuse treatment. The largest and most well-known outpatient therapy organisation, Narcotics Anonymous (NA), is a 12-step programme modelled on Alcoholics Anonymous

Cognitive behavioural therapy

Cognitive behavioural therapy (CBT) teaches a person how to recognise moods, thoughts, and situations that cause drug craving. A therapist helps the person avoid these triggers, and replace negative thoughts and feelings with ones that are healthier.

The skills learned in cognitive behavioural therapy can last a lifetime, making it a potentially powerful method of drug abuse treatment. However, not all therapists are trained in cognitive behavioural therapy techniques, which can be complex.

Contingency management therapy

In contingency management therapy, a person having 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 rehabilitation studies. However, sceptics point out its high costs, and that when incentives stop, its positive effects decline.

WebMD Medical Reference

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