Substance Abuse Counseling: A Guide to What, When, and How

What is substance abuse and how do you treat it?

Substance abuse is more than using; it’s a reaction to factors in an individual’s life. These factors don’t go away when a person quits using. There are many goals of substance abuse counseling, and one of the most important is to help a patient maintain their abstinence from mood altering substances for good. Let’s take a look at the goals and common stages for substance abuse counseling.

What Constitutes Substance Abuse?

Substance abuse occurs in all part of the population, regardless of gender, age, income or geography.  From illegal drugs to alcohol, to prescription medications, all members of society can be susceptible to substance abuse. Substance abuse is the dependence or active use of any mood-altering substance. Addictive behavior results when the patient is:

  • Preoccupied with the substance or the experience it provides
  • Feels symptoms of withdrawal when they aren’t using
  • Increases their use to achieve the same effect
  • Using even after suffering negative consequences from using

While substance abuse might have similar behavior, the reasons behind this behavior tend to be unique to the individual’s history. His or her patterns of use and the underlying causes of their substance abuse are important factors, also. Therefore, their treatment needs will vary according to these influences.

The Goals of Substance Abuse Counseling

The philosophy of substance abuse counseling is to address not only the symptoms of drug addiction but also the related areas that cause the addictive behavior. The therapist will determine the best structure and what content to include to address these areas.

The logical goal of substance abuse treatment is to end the addictive behavior and maintain this state. A less obvious or secondary goal of treatment is to repair the damage the patient’s addiction inflicted on his or her life.

For this to work, however, the patient must be willing to go through the pain of change. It is their task to change their behavior. The counselor is merely there to guide and facilitate this change. Patients also have more success when they have a support network (e.g., friends, family, group therapy participation) in place to help them affect lasting change.

Common Stages of Substance Abuse Counseling

Ending a patient’s addictive behavior for good uses many approaches. These can include individual or group therapy, couples counseling or family therapy, and individual psychotherapy, including cognitive behavioral therapy. While all treatment plans take into account the unique circumstances surrounding each patient’s case, there are some typical stages of substance abuse counseling that include:

Stage One: Recognizing the problem. Helping patients see the problem and how their cognitive processes affect their behavior is an important catalyst for change. Many times irrational thinking is too difficult to identify on one’s own. The counselor helps the patient see how his or her thinking influences the reaction to the problem.

Stage Two: Achieving abstinence. Now that a patient recognizes the problem, it is time to break the habitual behaviors.

Stage Three: Maintaining abstinence. After the initial stages of achieving abstinence (detox), the goal is then to maintain abstinence. The problem associated with the addictive behavior might also be the result of another condition, such as depression or anxiety, which are best addressed through psychotherapy. Additional treatment types might include group therapy, family or couples counseling, and medical or prescription drug intervention. A combination of therapy types is common for substance abuse counseling.

Stage Four: Developing necessary psychosocial and coping skills for lifelong recovery. What causes habitual behavior is a cycle of Cue, Routine, and Reward. When using, there is a trigger (cue) that causes the patient to use a substance (routine). The reward is how the substance makes them feel. However, after a patient stops the routine, the triggers can still be present — and in some cases, ubiquitous. It is essential that the patient learns new routines to respond to the inevitable triggers that occur. Recovery from substance abuse is a lifelong process; these skills facilitate success.

What is Cognitive Behavior Therapy?

Cognitive Behavior Therapy (CBT) is a treatment style that can be used to teach patients how to recognize the triggers in their thinking that cause a desire to use. These can be recurring moods, a line of thinking, or a situation that creates a craving. A psychologist trained in CBT can help the patient avoid these thinking patterns by teaching him or her to replace the automatic, often unconscious, negative thoughts and feelings with different, healthier ones. One of the benefits of CBT is that the skills obtained through it are retained, often for the patient’s lifetime. It is a complex style of treatment, but an effective one for substance abuse counseling.

What Makes Substance Abuse Counseling the Most Successful?

According to research from Education Resources Information Center (ERIC), an online library of education research and information sponsored by the US Dept. of Education, counseling is beneficial to most patients. Regardless of the variations in treatment style, which range from behavioral to cognitive, dynamic or experiential, the most successful relationships occur in those built on trust.  Successful substance abuse counseling also uses cognitive learning accompanied by feedback and the counselor’s insight. In addition, success is achieved when the counselor assists the patient with behavioral changes using “behavioral regulation, reality testing and successful experiences.” Most of all, substance abuse counseling is most successful when the therapist and patient engage in direct communication about the patient’s problems and the patient’s need to change his or her behavior.

To read more about what ERIC has to say about successful counseling, please click here.

Substance abuse counseling is a critical part of a patient’s success in changing their unhealthy behaviors. Treating substance addiction begins by recognizing the problem and breaking the habit. Often, stopping the behavior is not enough to avoid a relapse. For many patients with addictive behavior, ongoing substance abuse counseling helps them break the cycle of substance abuse. Instead of stopping merely for now, with ongoing counseling they can stop for good.

To learn more about how Achieve Wellness Group can help you or someone you love with substance abuse, please contact us.

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