It is important to understand the role of counselling as a vital part of addiction treatment.Counselling is also known as talking therapy (NHS, 2017). It embraces the power of vocalisation to face the problems of addiction. Rather than considering medication, counselling focuses on the physiological, mental, and emotional aspects of addiction.
Counselling is an umbrella term for various therapy frameworks. These programmes can be used exclusively or as part of a wider treatment plan. The role of counselling is to offer a listening ear and allow an individual the opportunity to work through their issues.
Why Counselling Is Important in Addiction Treatment
Counsellors have been educated and trained specifically to help people suffering from addiction. They know the different frameworks of addiction treatment and guide people down the path that works best for the individual. Alongside expertise, counselling offers a therapeutic alliance with the patient (Gurton). Collaboration and partnership help the patient feel supported and respected throughout their recovery. Guidance and understanding offer balance and assistance during a difficult struggle.
Individual vs. Group Therapy
Individual therapy is between a single patient and at least one counsellor. It allows for one-on-one attention, more intense feedback, and a more adjustable counselling schedule for the individual. However, some patients might miss identifying with others sharing their experience, as they would in group therapy.
Group therapy embraces the concept that people support one another through a shared experience. Sizes vary but always contain more than one patient and at least one counsellor. This method uses the principle of universality to remind individuals that they are not alone (Cherry, 2018). However, some extremely shy or socially anxious individuals might not get the level of attention they need.
Different forms and types of counselling
There are many different forms and types of counselling. One of the key roles of counselling in addiction treatment is finding the framework that works best for the individual.
Cognitive Behavioural Therapy
Cognitive behavioural therapy (CBT) is a therapy to change patterns of thinking and behaviour (NHS, 2016). Commonly used to treat depression and anxiety, it aims to improve a patient’s daily mind-set. Rather than addressing past issues, CBT deals with current problems and negative cycles of thinking. A counsellor will talk through problems, break them down into smaller parts, and teach the patient how to apply practical positivity methods to their daily life.
Contingency Management Therapy
Contingency management therapy uses motivational incentives to treat addiction. Tangible rewards can encourage individuals to embrace healthy behaviours. It sets up positive goals through regular lifestyle changes. The therapy helps the brain experience pleasure and reward in sobriety. A physical incentive, like a gift voucher, supports patients to choose a healthy lifestyle behaviour over an addiction-based one.
Motivational Interviewing helps an individual resolve their ambivalent or contradictory feelings. In terms of addiction, it can motivate a patient to recognise their behaviour and choose to change it. This therapy can also prepare a person for future counselling frameworks. By using careful phrases, its aim is to inspire and encourage the motivation needed for the individual to face their addiction.
Maintenance therapy is a treatment of medication and behavioural therapy to help patients recovering from addiction. It was created fifty years ago to help opioid addiction by using a maintenance drug like methadone (Porticonetwork). The minimised cravings and withdrawals make the addiction easier to manage and overcome. Alongside additional therapy, medication maintenance is a well-rounded treatment and often a long-term practice.
12-Step Facilitation Therapy
12-step facilitation therapy is a strategy to encourage individuals to become actively involved in self-help programmes that promote abstinence. Its structured format and group therapy set up both a clear treatment plan and collaborative support. Three key ideas of the therapy include acceptance (realising your addiction), surrender (agreeing to follow recovery strategies), and active involvement (attending the 12-step meetings) (Drugabuse, 2018).
Behavioural therapies is a term that covers multiple forms of therapy that aim to identify and change unhealthy behaviours. They focus on adapting learned behaviours and applying practical techniques to make healthier choices. Specific types include cognitive behavioural therapy, cognitive behavioural play therapy, system desensitisation, and aversion therapy. But they all focus on similarly modifying behaviour through forms of conditioning.
Alternative & Holistic Therapies
Alternative and holistic therapies consider your wellbeing as a whole and the interconnectedness of your mind, body and spirit. They look beyond traditional, modern, western treatments to those such as ancient or eastern healing techniques. Examples like herbal remedies treat your body holistically, rather than focus on individual symptoms. They consider the energies of emotional and physical wellbeing over the confines of clinical evidence.
Couples and Family Therapy
Couples and family therapy invites those closest to the individual into their recovery process. It is a form of therapy that focuses on relationships, and often brings to light how a patient’s problems affect others. Addiction frequently disturbs domestic life. So this form of therapy helps maintain healthy and functional relationships. Through various methods, individuals work on their behaviours of communication and collaboration.
Motivational therapies focus on motivating the patient to realise that they are the source of their change and recovery. Rather than explicitly promoting behavioural change, counsellors support the patient empathetically on their individual journey. They encourage the patient to recognise the negatives of addiction and assist their desire to change. Rather than dominantly guiding the process, they aim to inspire inner motivation within the patient.
Family Counselling and Therapies
Family counselling addresses issues affecting the functionality and health of a family. Others have the ability to enable or trigger unhealthy behaviour in an individual. So this form of group therapy focuses on the structure of relationships and cohabitation. Specific types of family therapies include strategic, structural, systematic, and Bowenian (Ackerman, 2017). All of them aim to heal the physiological and mental issues putting strain on family dynamics.
Group therapy is a type of counselling where at least one therapist works with several people at one time. Some individuals use it alone, while for others, it is part of a wider treatment plan. The inspiration of meeting others with a shared experience can encourage personal recovery. It helps people realise that they are not alone. Within a safe and supportive space, social reassurance and collective advice can also boost confidence and hope for the future.
Individual therapy offers supportive guidance in the environment of one-on-one counselling. It gives the patient a safe and non-confrontational space in which they can talk about their problems and receive professional advice. Often, it offers a sense of release to talk about repressed feelings and establishes a trusting therapeutic relationship throughout the recovery process.
Outpatient vs. rehabilitation counselling
Outpatient counselling is when a patient undergoes addiction treatment outside a medical environment. The individual stays at home but undergoesa regular programme. This allows a more ordinary daily routine where they can still work or study. It is often more affordable and the best option for those with a mild addiction. However, due to its lower level of intensity, outpatient counselling is also statistically less successful than rehabilitation.
Rehabilitation, or inpatient, counselling means that the patient stays in a medical facility. They have access to 24/7 emotional and medical support in a controlled environment. Without the distractions of everyday life, recovery is often more successful. Patients can fully focus on their treatment, and it is designed to help with serious addictions. However, it is a more expensive option and disrupts an individual’s daily life as they cannot continue their usual routine.
Benefits of counselling
Counselling is the opportunity to talk to somebody who will listen to you without judgement, and that simple act has many benefits. Counselling helps a person confront their problem, recognise it, and consider its potential sources. Talking can bring to focus many things an individual has avoided thinking about, including the reasons behind their behaviour.
Counselling also introduces techniques on how to treat addiction. It puts the individual in an environment where dealing with their problem is encouraged and supported in practical ways. Discussing future goals motivates changes to current behaviour and encourages positive thinking and behavioural patterns. When an individual vocalises their personal story, it can trigger a new sense of perspective, a motivation for change, and a hope for the future.
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- Ackerman, C (2017). What is Family Therapy? + 6 Techniques & Interventions [online] Positive Psychology Program. Available at: https://positivepsychologyprogram.com/family-therapy/[Accessed 10 May 2019].
- Cherry, K (2018). An Overview of Group Therapy. [online] Very Well Mind. Available at: https://www.verywellmind.com/what-is-group-therapy-2795760[Accessed 10 May 2019].
- Drugabuse.org, (2018). 12-Step Facilitation Therapy (Alcohol, Stimulants, Opiates). [online] Available at: https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioural-4[Accessed 10 May 2019].
- Gurton, A (n.d). Understanding the Therapeutic Alliance. [online] Mental Help. Available at: https://www.mentalhelp.net/blogs/understanding-the-therapeutic-alliance/ [Accessed 10 May 2019].
- Nhs.uk, (2016). Cognitive behavioural therapy (CBT). [online] Available at: https://www.nhs.uk/conditions/cognitive-behavioural-therapy-cbt/[Accessed 10 May 2019].
- Nhs.uk, (2017). Counselling. [online] Available at: https://www.nhs.uk/conditions/Counselling/ [Accessed 10 May 2019].
- Porticonetwork.ca, (n.d). Overview of methadone maintenance treatment. [online] Available at:https://www.porticonetwork.ca/web/knowledgex-archive/amh-specialists/overview-mmt[Accessed 10 May 2019].
- Stevens, E (n.d). Counselling and the Law. [online]. Counselling Tutor. Available at: https://counsellingtutor.com/professional-practice-for-counsellors/counselling-and-the-law/[Accessed 10 May 2019].
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