Addiction therapy can be broken down into three main phases – assessment, treatment, and maintenance.
Addiction Therapy – Assessment
During the assessment phase there is a delicate balance between being thorough and precise. Some mental health agencies have assessments that are 40 pages long and can take weeks to fill out! In an office setting it is not realistic nor efficient to gather so much information. Rather, the assessment needs to target the presenting problems and identify maladaptive behavioral problems that are of primary concern.
Often for an addiction, the preferred approach is referred to as a “functional analysis.” A functional analysis ask questions such as “when and how did the addiction start?,” “what helped the addiction to continue and become ingrained?,” “has the addiction morphed over time and if so in what ways?,” “what attempts have been made to change the addiction and how successful have those attempts been?” Ultimately, a functional analysis should help the addiction therapist to understand the origin of the addiction, the factors that enable it to continue, and the depth/breadth of it’s existence (e.g. how deep does it go and how many branches does it have).
Addiction Therapy – Treatment
The correct treatment of an addiction will naturally flow from an accurate assessment. For example, if it is determined that an individual is addicted to alcohol because of social anxiety and that over time they started isolating themselves from relationships to drink alone then the focus of the treatment is likely to revolve around building social skills, confidence, and helping the client to form meaningful relationships.
Addiction Therapy – Maintenance
Making changes is hard. Maintaining changes is often even more difficult. With the help and guidance of a therapist many people can have short term successes. However, the majority of people in treatment will relapse at some point. Relapse should not be seen as a catastrophe. It is more productive for the client to 1) take responsibility for the relapse, and 2) use it as a learning opportunity. Why did the relapse occur? What can be done differently next time? Over time relapses should occur with less frequency AND less intensity (e.g. “relapse vs collapse”). Once a client has achieved some level of maintenance by consistently avoiding relapse and replacing addictive behaviors with more healthy alternatives then he or she is ready to end treatment. Note: many people with have to go through the treatment process more than once in order to fully recover from their addiction.