Addiction Therapies for Treating Alcoholism

Addiction is considered a brain disease that has both emotional and physical manifestations. It interferes with a person's daily life and has multiple social and behavioral consequences.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) publishes that at the time of the 2015 National Survey on Drug Use and Health (NSDUH), over 15 million adults battled an alcohol use disorder (AUD). Alcoholism is a treatable disease, and the National Institute on Drug Abuse (NIDA) reports that counseling and behavioral therapies are the most common methods of treatment for addiction.

As a complex disease, addiction impacts each person in their own way; therefore, treatment is highly individual. What works for one person may not work the same for someone else. There are several forms of addiction therapy used to treat alcoholism that can help treatment providers tailor a specific program that will be optimal for the person seeking care.

The Importance of Behavioral Therapies for Alcohol Addiction

Some of the most commonly used therapies for addiction treatment are behavioral therapies. Behavioral therapy serves to help a person change the way they act, often by modifying the way they think. Negative actions often stem from maladaptive thoughts.

Alcohol abuse is a type of self-destructive behavior that can be addressed through behavioral therapy. During individual therapy sessions, trained professionals work to uncover the root of why a person drinks and what things may trigger negative reactions. Group therapy sessions teach, and then allow participants to practice, healthy coping mechanisms and ways of managing stress and common triggers. Therapy sessions can be performed around a person's existing obligations on an outpatient basis or as part of a residential addiction treatment program.

Common forms of behavioral therapies used to treat alcoholism are outlined below.

Cognitive Behavioral Therapy (CBT)

Designed as a method for preventing relapse and minimizing problematic drinking, CBT is a popular form of therapy for alcoholism, NIDA publishes. CBT helps individuals to recognize thoughts that are negative and may lead to self-destructive actions, such as alcohol abuse. CBT focuses on the connection between thoughts and actions, and aims to change negative behaviors by modifying thought patterns. Individuals learn how to recognize potential triggers as well as how to manage stress and develop healthy coping strategies. Relapse prevention strategies are explored and practiced during CBT sessions for alcoholism.

CBT has been shown to positively change the brain's wiring, Science Daily publishes. Some of the damage to the circuitry in the brain, caused by prolonged alcohol abuse, may be able to be reversed via CBT.

It is essential for a person to continue to attend CBT sessions in order to ensure that the new thought and behavior patterns are fixed. Tools and skills learned during CBT can be helpful long into recovery.

Dialectical Behavior Therapy (DBT)

A research-based form of Cognitive Behavioral Therapy, DBT was initially created to treat borderline personality disorder (BPD). It has many applications today, including treating co-occurring mental health and addiction disorders. DBT focuses on helping individuals accept themselves as well as on instituting positive change. A delicate balance must be formed between change for the better and accepting oneself as worthwhile.

The relationship between the therapist and individual is important, and the therapeutic environment is to be supportive and encouraging. Both group and individual therapy sessions are components of DBT, Psych Central reports. Individual sessions prioritize concerns, typically addressing suicidal and self-harming behaviors first, and then moving on to things that may interfere with treatment. Finally, sessions focus on working to improve quality of life overall.

Group DBT sessions focus on four main components:

  • Mindfulness: Individuals learn how to self-monitor their thoughts in a nonjudgmental and observant way, and better understand how thoughts impact behaviors and actions. This self-awareness can aid in learning how to control emotions and self-destructive actions in the future.
  • Interpersonal effectiveness: Communication is important to all relationships. This component improves upon this vital life skill while also encouraging people to remain true to themselves and their own personal objectives.
  • Emotion regulation: Recognition of the connection between emotions and actions, and thoughts and behaviors, can help to modify potentially harmful patterns. Individuals also learn how to take care of their minds and bodies in order to better equip themselves mentally and emotionally.
  • Distress tolerance: There are bound to be tough times no matter what, and this aspect of DBT helps individuals learn how to cope with, and distract from, potentially stressful situations. Tools for managing stress and dealing with possible triggers are learned and practiced.

Generally, individuals are asked to do "homework" and practice skills in between sessions. The therapist is usually available by phone for help as well. DBT helps individuals learn to regulate powerful emotions and intense mood swings that often accompany co-occurring disorders.

Motivational Interviewing (MI)

A patient-centered approach to help individuals who may not see the need for change, MI can aid in improving a person's willingness and motivation to change. Trained professionals guide individuals through MI sessions in a nonjudgmental manner. Instead of insisting on change, the individual is able to decide for themselves that change is necessary and then take measures to change.

Motivational Interviewing is helpful for treating alcoholism, as many times a person may not believe that a problem actually exists and may be in treatment due to family, work, or court-ordered pressure. During MI, a person will be able to come to terms with how alcohol may be impacting their life in a negative way and then decide to move forward. Internal motivation, or a willingness to change, can go a long way toward improving a person's life, resulting in lasting positive change.

Contingency Management (CM)

Contingency Management is a form of therapy that uses small incentives to help people who wish to remain sober and avoid relapse. Clean drug tests result in rewards, which can help to build up motivation to remain sober. CM can help people to avoid relapse while working toward small and attainable goals. Over time, it can help them gain motivation to remain abstinent.

The Importance of Family and Peer Support

The National Council on Alcoholism and Drug Dependence (NCADD) reports that more than 7 million children live in house with a parent who has abused alcohol or is dependent on it. Alcoholism impacts entire families, and family therapy can help to improve the overall family unit and functionality.

Caregivers, spouses, and even whole families can attend family behavioral therapy sessions together to learn how to communicate more effectively and how to manage stressors and help to prevent relapse. Families can learn about the disease of addiction and how to recognize triggers as well as ways to minimize relapse and enhance recovery.

Family therapy sessions may occur at a residential treatment facility where a family member is staying during an addiction treatment program, or they may be part of an outpatient treatment program. There are also intensive family systemic therapy programs that typically occur over a weekend and involve a highly structured workshop in a short period of time. NIDA publishes that family behavior therapy (FBT) is beneficial for both adolescents and adults battling addiction as well as those who suffer from co-occurring mental disorders.

Healthy peer support is also important to recovery and something that 12-Step programs, such as Alcoholics Anonymous (AA), can provide. AA is an international fellowship group that accepts all people who wish to remain abstinent from alcohol as members. The group focuses on 12 Steps to recovery. As members “work the steps,” they basically admit that they are powerless over alcohol, turn themselves over to a higher power, seek to understand their own shortcomings, make retributions for those they have wronged as a result of alcohol abuse, and then strive to help others in recovery. AA hosts meetings all over the world that individuals can attend anonymously, without previously signing up, and for free; they will generally pass an optional collection plate around at the meetings.

There are different types of meetings. Some work through the Big Book and its doctrine; others have guest speakers; and some focus on discussion. Meetings are either open or closed. Open meetings include everyone, such as family members, loved ones, and treatment providers, while closed meetings are just for those who struggle with alcohol abuse and/or addiction. Meetings are generally 60-90 minutes, and they are regularly followed with a coffee hour, or fellowship time, for people to mingle.

AA provides a welcoming and safe environment as well as support, encouragement, and tools to prevent relapse and enhance recovery. New members are often paired up with a peer mentor who is accessible any time of day or night to help in times of crisis.

People who participate actively in AA are twice as likely to remain abstinent over those who don't, a study published by the  Journal of Addictive Disorders reports. Support and 12-Step groups are often integral parts of an addiction treatment program that can help sustain long and lasting recovery.

Alternative and Holistic Therapies

There are many alternative forms of therapy that can be helpful during the treatment of addiction, many of which are used in addition to traditional methods. Holistic refers to whole body wellness, and these types of therapy can address all aspects of healing, from physical to emotional to spiritual. Examples of holistic and alternative therapies include:

  • Equine therapy: This therapy involves the care of horses. It can help to improve self-esteem and provide a nonjudgmental environment where an individual can learn to recognize cues and emotional states to promote personal growth and self-awareness. It can also be all-encompassing to care for such a large creature, meaning that the person will not be able to think of much else during the session, therefore minimizing emotional and physical discomfort.
  • Pet or animal therapy: Animals are often brought into therapy sessions, as they can help people to feel more relaxed and open up more. Animal therapy can also help to build a person's self-confidence as they care for another creature and learn how to attend to the needs of others. Animals are also sensitive to emotions, which can help people to recognize their own moods and learn how to control them.
  • Art or creative therapy: Creative expression can be a healthy outlet for individuals to get their feelings out and better understand themselves and their emotions. It can also relieve stress and promote self-confidence.
  • Mindfulness meditation: This type of holistic therapy improves upon the connection between body, mind, and soul, and teaches individuals to be more in tune with their physical bodies in order to better control their emotional selves and enhance spiritual growth. By turning inward, individuals can gain a better awareness of themselves and learn how to effectively manage stress, control cravings, and cope with external and internal pressures.

    Mindfulness meditation has been shown to help improve symptoms of depression and anxiety, Scientific American It can help to reduce stress and teach a person how to successfully calm down, thereby helping to reduce relapse. Mindfulness meditation can be used anywhere, at any time, to avert a crisis, making it handy tool for recovery.

  • Massage therapy: Massage can alleviate physical pain and tension, and therefore aid in reducing stress. Massage therapy can help to promote relaxation and improve sleep patterns, too. When a person feels better physically and gets enough sleep, they are more likely to be better able to manage emotional strain as well.
  • Chiropractic care: The art of body manipulation can help to reduce tension and pain, and help a person relax. Alcohol withdrawal often includes difficult withdrawal side effects that chiropractic care may be able to help manage holistically.
  • Acupuncture: An Eastern medicine technique, acupuncture strives to improve a person's chi, or energy flow, by placing needles along strategic pressure points in the body. This is thought to improve the overall manner in which a body functions as well as reduce emotional distress in the process. Acupuncture may also help to eliminate toxins from the body and improve blood flow, making it an adjunct therapy type that may be used during detox and alcohol addiction treatment.
  • Nutrition therapy: Just as getting a healthy dose of sleep is important to healing, so is eating right. A nutritional therapy program can help to replenish the body's nutrients that may have been depleted through excessive alcohol use. Alcohol can dehydrate the body and just serves as empty calories. A healthy nutrition plan that provides balanced meals at structured times can help restore the body.
  • Exercise programs: Physical fitness can promote a strong body, improve self-esteem, and provide an outlet for stress. Exercise can be a healthy aspect of an addiction treatment program that can help people clear their minds. It may also be beneficial in minimizing relapse. There are many different forms of exercise, and a fitness program can be tailored to each person's specific physical abilities and circumstances.
  • Neurofeedback: By using maps of the brain, neurofeedback can help people to retrain the way they think and therefore come up with new and improved thought processes. It can also help to spot triggers and high stress levels, and teach people how to cope with and manage these going forward to minimize and reduce relapse.

In general, holistic and alternative therapies are considered to be most beneficial when they are used as complementary treatment techniques. Ideally, they should be included as part of a complete addiction treatment program, which often includes medications and behavioral therapy.