Treatment options: Counselling

Counselling options for drug dependence

There are many different types of counselling techniques. Although they each have different theories and methods, they often address common issues.

Motivational interviewing

Motivational interviewing techniques concentrate on increasing motivation to change among individuals who have not yet made a decision to change or are not sure that they can change.

Motivational interviewing aims to make the client accept responsibility for their problems and the consequences of those problems and tries to help the client commit to particular treatment goals and strategies. Motivational interviewing is usually only done for a short timeframe and often incorporates feedback, advice and empathy.

Family therapy

Family therapy involves all family members in the treatment process. This is because drug problems are sometimes related to or involve your family and social network, such as teachers and friends. 

The goals of family therapies are to improve family communication, provide education about drugs and their consequences, enhance problem solving, identify parental substance abuse problems and improve family relationships.

Rational emotive therapy and cognitive behavioural therapy

These therapies aim to challenge and change the irrational and negative thoughts (cognitions) that are hypothesized to be responsible for drug taking and to change and reduce drug taking behaviours.

Skills training

This approach is based on the belief that substance dependence represents a means of coping with difficult issues and stress. The training of skills is thought to provide more functional and healthier options for coping with stress.

A variety of life skills are developed, including social skills, assertiveness, drug refusal skills, problem-solving skills, relaxation and managing crises. Training involves presenting the rationale for learning the skills, modelling, practicing and feedback.

Pharmacotherapy

Pharmacotherapy, which refers to drug therapies, can be used in a number of ways to treat drug dependence. Drugs are sometimes used for suppressing withdrawal symptoms and drug cravings, stabilising symptoms, and blocking the effects of specific drugs.

Pharmacotherapies are most commonly used for the treatment of coexisting psychological problems, such as depression and anxiety. The types of drugs used to treat coexisting psychological issues need to be selected carefully as they may be addictive and can affect recovery.

Pharmacotherapies are often combined with counselling. Combining drug therapies with counselling has been found to improve a broader range of problems, increase adherence to treatment and overcome many of the problems of each approach (Carroll, 1996).

Relapse prevention

Relapse prevention involves the development of strategies to help maintain drug abstinence. Various techniques are used to prevent 'relapse' or the re-initiation of drug use.

These techniques include the identification of high-risk situations for relapse, instruction and rehearsal of strategies for coping with those situations, self-monitoring, strategies for recognising and coping with cravings and thoughts about the drug, planning for emergencies and coping with lapses and relapses. Training involves rehearsing skills, role-playing and homework tasks.