WHAT IS TREATMENT?
❝ there is no best treatment for addiction
but there are a lot of good treatments ❞
Treatment implies something being done to help improve a disorder or condition of some kind. In addiction the notion of treatment can be traditional, such as taking medication, or much broader, such as help with housing.
What is the best addiction treatment?
There is no best treatment for addiction - there are many good treatments. What works best depends on many factors which all interact together. These are things to do with:
- The treatment itself
- The therapist
- The person on the treatment journey
Most people get over addiction problems without treatment.
What makes for a good treatment?
Many different treatments have been described. Broadly they divide into 'talking therapies' and 'prescription therapies'. Some treatments depend upon their environment, residential rehabilitation for example. Some treatments depend on physical contact with a therapist, acupuncture or massage for example. Most treatments can be accessed face to face with a therapist or online with or without therapist - it is a matter of preference. Prescribing therapies can be helpful and normally strengthen, rather than replace, talking therapies - these treatments only work for as long as medication is prescribed.
Apparently dissimilar talking therapies often turn out to have crucial ingredients in common. Importantly, the ingredients that are most effective are well known:
- Set and keep checking goals
- Provide encouragement to achieve goals
- Provide rewards as goals are achieved
- Set tasks to do outside the therapy sessions
- Involve family and friends
- Find alternative activities unlikely to trigger substance use
- Rehearse ways of dealing with risky situations
- Create flexibility to suit the individual
What does self directed treatment mean?
Many people prefer to sort out their addiction problem themselves. It often improves the chances of success to join a mutual aid group or get help online. Here is a brief introduction to the kind of interventions that you are likely to find online to guide you through self directed treatment or to assist you and your therapist working together on your treatment (3:53):
What makes for a good therapist?
The characteristics of the therapist are a really important part of how successful a treatment is going to be. There are charismatic therapists with few treatment skills who simply inspire people to do well but the best therapists:
- Make the other person feel important
- Understand the other person's situation
- Are optimistic about change
- Have expert knowledge of addiction and ways out of it
- Convey their wish to help
- Stick to a treatment plan
What matters about the person setting out on treatment?
The one thing that makes the most difference in treatment is the person setting out on the treatment journey. Quite simply where the person is starting from varies enormously. Things that are going to be a good influence on the outcome are:
- Having supportive family and friends
- Being ready to make lifestyle changes
- Feeling able to move away from others with addiction problems
- Having employment or satisfactory occupation and income
- Having housing or at least reasonable accommodation
- Believing that dependence can be eliminated
- Being in reasonably good mental health
How good is treatment?
Anybody entering a treatment programme is going to ask 'How good is it?' 'Is it worth the time and effort, the cost, and what risks are there?' All very reasonable questions. In many disorders, take cancer as an example, pretty good estimates of survival and cure rates are available and routinely discussed with anybody setting out on treatment. Not so in the addictions field.
There are a large number of factors, least important of which is the particular treatment, that influence the outcome of treatment. Many of these may change, for better or worse, quite independently of the treatment and so predicting outcomes is difficult.
The available evidence to answer the question 'How good is treatment?' can be found in the treatment section of RESULT where selected research is also used to benchmark key developments in clinical practice. A benchmark is a standard or point of reference against which things may be compared.