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The Different Types of Therapy Used in Dual Diagnosis Addiction Treatment

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Co-occurring disorders are mental health conditions accompanied by a substance use disorder. For example, an individual may have co-occurring bipolar disorder and opioid addiction.

According to the Substance Abuse and Mental Health Services Administration, 9.2 million American adults suffer from co-occurring disorders.[1]

People who struggle with co-occurring disorders must receive dual diagnosis addiction treatment to experience recovery. This form of treatment is referred to as “integrative care” as it combines addiction and mental health treatment. Unfortunately, 52.5% of people with both a substance use disorder and mental health condition never receive the help they need.[2]

Dual diagnosis addiction treatment centers use a variety of evidence-based therapies to facilitate individualized care for those struggling with co-occurring disorders. Some of the most widely used therapies in dual diagnosis treatment include:

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Cognitive Behavioral Therapy (CBT)

Cognitive-behavioral therapy (CBT) is the most common form of therapy used in dual diagnosis recovery facilities. This type of therapy focuses on changing harmful patterns of thinking under the belief that this will lead to a more positive behavioral pattern.

The core principles of CBT include:

  • Mental health problems and addictions are partially built on flawed patterns of thought.
  • Damaging patterns of behavior are also to blame for mental health and addiction issues.
  • Patients struggling with co-occurring disorders can be taught effective coping strategies, leading to a lessening of symptoms and a healthier life.

CBT works to change patterns of thought through mindfulness techniques and radical acceptance. Mindfulness is characterized by being in the present, preventing patients from focusing on the past or future. Additionally, radical acceptance teaches patients to accept their current situation no matter how much they dislike it, allowing them to begin focusing on managing their thoughts and emotions.

This type of therapy treats the following mental health conditions:

  • Depression
  • Anxiety disorders
  • Substance use disorders
  • Eating disorders
  • Obsessive-compulsive disorder (OCD)
  • Post-traumatic stress disorder (PTSD)

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy (DBT) was modeled after CBT, however, it expands on this method of therapy by including specific skill sets and techniques to replace negative coping mechanisms with positive ones.[3]

While DBT was mainly created to treat borderline personality disorder (BPD), it has been shown to improve the following conditions:

  • Depression
  • Bipolar disorder
  • Anxiety disorders
  • Self-harming behaviors
  • Bulimia
  • Substance use disorders
  • Psychotic disorders

Dialectical behavior therapy in dual diagnosis addiction treatment works by promoting:

  • Core mindfulness skills that teach patients how to live in the present rather than the past or future
  • Interpersonal effectiveness skills that teach patients how to maintain relationships, maintain self-esteem, and communicate their needs effectively.
  • Emotional regulation skills that decrease the intensity of negative emotions
  • Distress tolerance skills that teach patients to get through stressful situations without worsening the issue through negative coping mechanisms

Assertive Community Therapy (ACT)

Assertive community therapy (ACT) is an evidence-based therapy for co-occurring disorders. It helps patients by providing highly specialized and individualized care through 24/7 access to social workers, nurses, psychologists, drug abuse counselors, and case managers.

The main goal of ACT is to minimize or completely remove severe symptoms of mental health conditions and substance use disorders while improving the overall quality of life. This form of treatment is intended to create a community of support where patients can thrive.

Assertive community therapy is used in the treatment of all co-occurring disorders, but it is most commonly used in patients with severe mental health conditions.

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Exposure Therapy

Exposure therapy is a type of treatment that helps patients learn to confront their fears. When someone avoids their fears over a long period, it worsens and solidifies that fear. For example, if an individual is afraid of being in public spaces and avoids this, their isolation will make going into public spaces much more fear-inducing.

Exposure therapy involves a therapist creating a safe environment where the patient can interact with the things they fear and avoid. This is done with complete attention to the mental safety and comfortability of the patient to avoid furthering their fears. Over time, this exposure will lessen their fear and anxiety, leading to recovery from their phobias.

This type of therapy is traditionally intended to treat the following conditions:

In a dual diagnosis setting, treating anxiety disorders with exposure therapy could cause a significant improvement in their substance use disorder as well. Once their symptoms of fear and anxiety are lessened, so are the symptoms of their addiction.

Trauma-Informed Care

Trauma-informed care considers the effect that trauma has on the individual as a whole, including their thoughts, emotions, and behaviors. This type of therapy assumes that every patient has experienced some form of trauma in their lives. In a dual diagnosis setting, the trauma would have contributed to their substance abuse.

Trauma-informed care operates under 5 core principles, which include:

  • Safety – ensuring physical and emotional safety
  • Choice – the patient has a choice and control over their treatment
  • Collaboration – the patient and therapist works together to create a therapy plan
  • Trustworthiness – respectful professional boundaries are maintained in the patient to therapist relationship
  • Empowerment – emphasizes emotional validation, affirmations, and empowerment through skill-building

This type of therapy helps patients recover from past traumas and the effects it has had on their lives. This allows them to focus on their recovery from addiction and mental health issues without the heavy burden of past trauma weighing them down.

Evidence-Based Therapy and Dual Diagnosis Addiction Treatment at Woburn Wellness

If you or a loved one suffer from comorbid mental health and addiction issues, dual diagnosis treatment may be right for you. At Woburn Wellness Addiction Treatment, we place an emphasis on the importance of evidence-based therapies and positive behavioral changes. Contact us today for more information on how we can help you regain control of your life.

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Medically Reviewed By

Inessa Maloney, MS, LMHC Clinical Director
Learn about Inessa Maloney

Inessa Maloney, MS, LMHC has been dedicated to the mental health and substance abuse field for a decade, providing her expertise to guarantee quality and accuracy.

  • Specializes in outpatient services with a focus on substance abuse
  • Expertise in reality-based therapy, CBT/DBT, and motivational interviewing
  • Holds a Master’s Degree in Professional Counseling
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