Therapy, also known as psychotherapy, is the exercise of working with a trained therapist or psychologist to address mental and/or emotional problems you are struggling with. You can participate in therapy in many different ways, such as individually, as a couple, as a family, or as part of a larger group focused on processing similar issues.

No matter which form of therapy in which you engage, the therapist is tasked with establishing a safe, nonjudgmental environment where the client and the therapist build a trusting and caring rapport. Through this relationship, personal exploration and healing take place.

The American Psychological Association explains that there are many approaches to therapy. Cognitive behavioral therapy, person-centered therapy, and psychodynamic therapy are just a few of the well-known approaches.

The goal of all therapy, no matter which approach is being used, is to help clients live healthier, happier, and more productive lives. While therapists are trained to listen well to their clients and provide a safe space for them to share difficult experiences, they will also help them to develop new skills so they can lead better lives.

The Role of Therapy in Substance Abuse Treatment

The National Institute on Drug Abuse (NIDA) explains that the three goals of addiction treatment are to help individuals stop using drugs, to remain substance free, and to return to being productive members of their families, at work, and in society. No single treatment is effective or suitable for everyone, but a comprehensive approach to treatment will give people in recovery the best chances for achieving and maintaining sobriety.

Personal therapy is one of the main components of addiction treatment. Participation in individual, family, and group therapy helps individuals recognize harmful beliefs and behavioral patterns that lead to drug use, identify and implement healthy life skills and coping strategies, and remain committed to the recovery process and complementary forms of treatment.

Therapy is generally incorporated into a comprehensive treatment program. A successful treatment program, according to NIDA, includes the following components:

  • Detoxification
  • Behavioral therapy
  • Medication, if necessary
  • Treatment for any co-occurring mental illnesses
  • Aftercare planning and relapse prevention planning

How Effective Is Therapy?

According to NIDA, addiction treatment is an ongoing process that must be continuously adjusted over time for individuals. For people who successfully complete a treatment program, the relapse rate is as high as 40 to 60 percent. Care models need to support people in their sobriety long after official treatment programs end.

Therapy can play a beneficial role in aftercare. Recovery is a lifelong process, and participation in therapy often lasts for many years. Therapy helps people remain honest with themselves, process difficult situations, and find relief as they move forward with their lives. Mental health professionals have understood the benefits of psychotherapy for many years.

Through personal exploration, clients can find solutions to many of their problems themselves. Therapists may pose questions to get clients thinking, but it is up to clients to draw their own conclusions. This approach provides a sense of empowerment to clients, often leads them to have realizations, and allows them to experience healing in other parts of their lives as well, not just the situation at hand. Studies have found additional benefits to participating in therapy.

  • Clients gain a global understanding of themselves.
  • Skills learned in therapy promote personal growth long after participation in therapy has ended.
  • Relief can be felt quickly and continues to grow over time.
  • Clients become comfortable facing a broader range of emotions than they were before therapy began.
  • Clients learn skills to help them cope with difficult emotions that may come up in the future.
  • By engaging in therapy and establishing a trusting relationship with the therapist, clients form healthy relationships. This skill can be applied to developing relationships outside of therapy as well.

There has been a growing amount of support from researchers and mental health professionals to use therapy as the first line of treatment before medication for the treatment of certain disorders, such as anxiety, depression, and obsessive-compulsive disorder. Many of these conditions co-occur in individuals struggling with substance use as well. Decades of research has been building to support the use of behavioral and interpersonal therapy methods as the most effective forms of treatment for many conditions.

Evidenced-based research has found that medications do little to treat addiction on their own. Medications are useful for managing symptoms and certainly have their place in the treatment process. Enough evidence has been collected, however, to support the use of therapy even before prescribing medications. Psychologists have found that many of their clients display significant improvements with therapy alone. Through therapy, clients learn how to handle their emotions and gain relief from the disorder that is afflicting them, not just manage the disorder’s symptoms.

What Happens During Therapy?

If you’ve never been to therapy before, you might be nervous about what to expect. It can be intimidating or exciting, depending on how you look at it, to enter a room with a licensed professional or mental health expert who is there to work with you and what you bring to the session.

Therapy is a highly individual process, so there is no exact way it must be conducted, but there are a few things you can expect to happen. In your first session, the therapist will likely focus on getting to know you and your situation through a series of questions. They will be interested in why you are coming to therapy and what you hope to get out of it. They will likely conduct an intake that covers your personal history as well as current symptoms and presenting issues.

While the therapist may drive the conversation in the first session with their intake questions, it is important that you are also an active participant. You must be open and honest about your feelings and expectations; however, you shouldn’t force anything. With time, a relationship will form between you and your therapist that will prove to be a strong tool in the therapeutic process.

After the first session, what happens in therapy depends much on you and your therapist. You are in charge in the therapy room, so it is up to you to explore what you are ready to address. The therapist-client relationship will develop over time based on your goals and expectations for therapy and how well you respond to one another. The therapist may provide insights or pose questions based on their theoretical orientation, but therapy will progress based on your level of comfort and your ability to process what comes up.

Participating in therapy can be compared to peeling back the layers of an onion. The tough outer layer is often hard to break through, but once it is peeled away, real progress can be made. As each layer of the onion, or your personal internal experiences, is explored, you can progress to deeper and more sensitive issues.

Therapy is a process, however, and not all layers can be peeled back at once. Over time, the client and therapist work together to address each layer at a time at a speed and intensity that the client responds to best.

Therapy and Drug Abuse

Therapy plays an important role in the treatment of substance use disorders. Substance abuse treatment is multifaceted, as it is a complex disease, but therapy can dissect the individual’s experience with substance misuse. Through therapy, individuals gain insights about their personal history, the issues which led to substance use, triggers for use, and how to move forward and maintain a life free of substance abuse. Medication can be an essential resource in getting someone through detox and the initial phases of treatment, but they will do little to ensure long-term sobriety. Therapy equips individuals with the tools needed to lead sober, happy, and productive lives.

If you are in search of treatment for drug addiction, SAMHSA offers a free online treatment locator, as well as a national helpline that is available 24 hours a day, seven days a week: 1-800-662-4357 or 1-800-487-4889 for TTY.

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