Thursday April 24th 2014

Can counseling alone for addiction treatment cure addicts?

The mental health model of addiction

Given that chemical dependency definitions can not wholy or sufficiently classify addiction, we may feel compelled to classify addiction as a mental health issue, an illness of the mind. If that were our conclusion, we would be getting slightly closer to a better understanding of addiction, but wed still be left with a plethora of inexplicable facts. Most pointedly, why hasn’t modern psychology developed an effective method for curing addiction or, at least, treating it into remission? Addicts have been thrown into asylums since asylums first existed. They’ve been given medication, electroshock, psychotherapy, and a multitude of other treatments. Yet, the typical addict will continue to confound mental health professionals with relapse after relapse despite having benefited from even the most prodigious and harrowing efforts that the field of mental health has to offer.

Psychiatric or psychological treatment can work (for some addicts)

We should be honest in fully disclosing that there certainly are people for whom psychiatric or psychological treatment has been effective in curbing their substance abuse problem. Indeed, there are people for whom completely physical means of treatment are effective as well. But then there is that curious and peculiar lot who cant seem to keep sober for any significant period of time no matter what medications they are prescribed, no matter what kind of therapy they undergo, no matter how long they’ve been clean, no matter this, no matter that, no matter what. They change jobs, change cities, change spouses. They try to work more, work less; relax more, relax less; be more assertive, less assertive; more expressive, less expressive. They try anything and everything, and eventually are right back where they left off only, in almost every case, even worse off.

Your experience with addiction counseling

What have you experienced with psychotherapy treatment for addiction?  Can counseling work to cure addiction in a vacuum?  Or are other interventions required as a complement to working with the mind?

Photo credit: oldcouch

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4 Responses to “Can counseling alone for addiction treatment cure addicts?
Steve
10:08 pm January 28th, 2011

Great post! Great concern!

I personally use a variations of the medical model with a Christian emphases with my clients. I have found for those who really want to change and are willing to get help, that most can get to the other side (Sobriety).

But I agree, I have had a few clients who did all they were asked, but eventually went back to acting out. I had one client who tried everything and relapsed time and again. Eventually, he went to prison, and now is clean and sober (4 years in prison – 2 years out)

I guess I believe it really comes down to making choices. God is not going to force His ways on us. He will compel us to change, but ultimately we have free will to make the wrong choices.

Jon Penoi
4:19 am January 31st, 2011

As a counselor I think one question must be discussed is what is the “will” of the client. Many times the person’s will is ignored or bypassed and we begin with the problem at hand. But the person’s will must be addressed in the beginning. We need to ask, “What is your will? What do you want from this interaction.

Another question would be, “If your problem was suddenly and miraculously solved, how would that effect what you are going to do today? Next week, Next week? It is not so much what therapy we use as have we considered what the client really wants? Are you happy that way things are or do you want an encounter with the truth?

Shais Taub
12:55 am February 1st, 2011

Jon, great point. Thanks for the comment. What I like about the 12-Steps as a therapeutic model is that I believe your question is implicitly asked (and answered) right in the first Step.

In other words, if you still feel like you can figure out a way to manage life AND keep your addiction, then you can’t even start on the Steps. In counseling, however, professionals are willing to start talking with someone who has not yet come to such a decision. Imagine the frustration! (Actually, Jon, you don’t have to imagine. I’m sure you’ve “been there/done that.”)

And I guess this is why I will always return to the spiritual approach to treatment as the basis and foundation for any other helpful measures. In order to undergo a spiritual change, there must be willingness. We may also call it humility or surrender or teachability, but whatever it’s called, it all boils done to getting out of the way so that something greater than you can happen through you. And that is basically the definition of spirituality.

Maureen
6:26 pm February 1st, 2011

Counseling alone cannot cure/solve anything, but counseling as a piece of a more holistic-type program is essential. Just as addiction does not have only one specific cause, neither can the “cure”.

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About Rabbi Shais Taub

Rabbi Shais Taub is one of today's most respected young scholars of Jewish spirituality and practice. National Public Radio called him "an expert in Jewish mysticism and the Twelve Steps." He is the author of God of Our Understanding: Jewish Spirituality and Recovery from Addiction.