The Science Behind Addiction Therapy: Why Therapy Works for Some and Not Others

Addiction therapy has helped many recovering people escape from the life-shattering devastation of substance abuse, giving them the tools they need to reach and maintain sobriety beyond rehab.

Therapy, in conjunction with detoxification, can become two foundational pillars of support as a person rebuilds their life. Yet, not everyone breaks free from addiction through therapy. This article explores the science behind addiction therapy and explains why a personalised approach can be the key to recovery.

What is addiction therapy?

As a goes through addiction recovery, therapy is often intertwined into treatment programmes to address the psychological aspects of substance use. While detox links mostly to the physical effects of withdrawal, therapy helps people manage the psychological strains felt as they recover. Addiction therapy strives to support people in building coping skills, preventing relapses and laying the foundation for permanent sobriety.

There is no silver-bullet therapy programme that works for all. Each type of therapy can be beneficial for people in different ways. The most commonly employed types of therapy in addiction treatment include:

• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT)
• Motivational Interviewing (MI)
• Contingency Management (CM)
• Holistic Therapies (e.g. 

The recovery process is laden with challenges for the body and mind. While a therapist may not be able to help with physical symptoms directly, they may be able to help you manage the psychological struggles.

What are the scientific principles used in addiction therapy?

Addiction therapy shares many core principles with general therapy, like working through troubling thoughts and developing healthy coping mechanisms. Both an addiction therapist and a general therapist aim to help their clients work towards the life they desire.

However, addiction therapy incorporates some techniques that target the neurological and psychological damage caused specifically by long-term substance abuse. Some addiction-specific aspects of these therapies include:

• Neuroplasticity: Neuroplasticity is the way the brain changes and adapts to experiences. As a person develops an addiction, the brain doesn’t crack or shatter. It adjusts to the new reality. Addiction is often called a “disease of neuroplasticity,  and addiction treatment focuses on helping the brain adapt to changes in recovery.
• The role of dopamine: Many commonly abused drugs like opioids, cocaine, and nicotine affect the brain’s natural reward system over time. Research shows that taking a drug to satisfy a craving causes dopamine to flood the brain’s reward pathway, as much as 10 times more than a natural reward. Addiction treatment strives to help people regain the ability to experience reward with the substance.
• Social support and community: The way the brain handles social situations is deeply intertwined with addiction and recovery. Isolating oneself is one of the most frequent roadblocks that hold people back from reaching full recovery. Addiction therapy generally promotes group support and working with peers as you recover.

While there are more addiction-specific principles used in assisting a person recovering from a substance use disorder, we can generally understand that addiction therapists work in much the same way as general therapists, with special care towards the neurological impact of addiction.

Why does addiction therapy work for some but not others?

Entering rehab does not guarantee that a person will reach sobriety and remain there.  In the same way, a course of addiction therapy might not work for some people.

There can be a multitude of reasons why addiction therapy might not work, some of which can include:

Therapy type doesn’t suit the individual

Treating someone’s addiction can be an extremely personal process. In general, different therapy methods work better for different people, but when addiction therapy doesn’t align on some level with a person’s struggles, key problems can remain unaddressed. For example, someone with deep-rooted trauma can benefit most from “trauma-informed therapy,” and without it, unprocessed pain can reemerge later in the programme.

Frameworks of therapy that may implemented into addiction treatment include:

• Cognitive Behavioural Therapy (CBT): This therapy may be most beneficial for people struggling with recurring negative thought patterns or “cognitive distortions.” CBT helps a person develop their own coping strategies.
• Motivational Interviewing (MI): A person struggling with a severe lack of motivation or self-worth may find that MI therapy instills a sense of confidence that supports staying sober. Emphasis is placed on motivation and a deep commitment to change.
• Family Therapy: For a person with a history of substance abuse and addiction in their home lives, family therapy can be the crux for complete recovery. Developing a healthier home and family life can greatly reduce the risk of relapse.

Lack of participation

As a person enters rehab, they’re likely at one of the worst points in their lives. Their defences may be higher than ever, or they may have only agreed to rehab as a promise to a partner or relative, not as a promise to themselves. At such a time, it’s understandable that a person struggles to participate in the practices designed to help.

Reaping the benefits of addiction therapy requires a willingness to engage and interact deeply with the course’s therapeutic materials. Patients need to self-reflect and apply what they learn outside of sessions. If they apply themselves passively, therapy functions like a parent’s berating speech, falling unheard into their child’s ear.

Not enough time is given to treatment

Like any achievement in life that fills someone with a sense of pride, recovery from an addiction takes time. Addiction treatment usually lasts an average of 30 days, but many people benefit from more than a month to bring such drastic life changes into their lives.

Throughout recovery, addiction therapy sessions will take place at times and dates agreed between the therapist and client. It is critical to remember that recovery is a gradual process. It takes time to learn new skills, replace old habits and get settled into living life free from a substance. Insufficient time is an unfortunate reason addiction therapy cannot ring true for many people.

Not enough support outside of rehab and at home

One of the gravest mistakes a person can make when battling addiction is thinking they can traverse the journey alone. Addictions can often be devastating for a person’s self-worth, but as they start to recover, a newfound sense of courage can make them feel they should carry the burden alone. Yet without a support system, the world can eventually feel like a dark and hostile place, where triggers for your urges wait around every corner.

Seek and lean into support groups to keep you on the road to lifelong sobriety. Research where to connect with groups like AA and SMART Recovery when you feel loneliness becoming overwhelming. Make sure people dear to you help create an atmosphere conducive to sobriety, applied to as many areas of your life as possible. If you’re going through outpatient treatment, people who live with you should make sure your environment supports you in staying sober.

I need help managing my addiction

Entering recovery and getting help with an addiction may be life-saving for a person caught in the grips of substance abuse. If you or a loved one is battling with an addiction and you need help, we want to let you know we’re here for you.

At UKAT, we provide comprehensive addiction treatment that includes evidence-based therapies, holistic care and relapse prevention strategies. Our expert staff deliver tailored rehab programmes and continued aftercare, so you’re supported every step of the way.

The help to save yourself from addiction could be one phone call away. Contact UKAT to start your journey toward a healthier future, free from addiction.