Here’s the good news: addiction is treatable. Here’s the bad news: not all addiction treatments are equally beneficial. Some treatment modalities are measurably more effective than others.
Mental health and addiction treatment professionals often use the term “modality.” In plain English, it really just means a program’s method or approach.
When you’re exploring program possibilities, you can simply ask, “What type of treatment do you offer at your program? What’s your approach?”
Treatment Modality Might Be Hard to Find
Treatment modality is one of the key components of any rehab … but if you’ve been reviewing residential programs for any length of time, then you know that sometimes it’s tough to find the information you need.
Some programs don’t clarify what they actually do in treatment (much less what that treatment will cost). You’ll want to pick a program that spells out the treatment protocol in detail. Look for a clear statement of the modality, as well as daily schedules.
This might seem obvious, but if a program doesn’t provide specifics about their approach and its success rates, don’t waste your time, money, and energy attending!
12 Step vs Non 12 Step
One of the first and broadest choices you’ll need to make is whether to pursue a 12 Step or Non 12 Step treatment program.
If you have a dual diagnosis (an addiction coupled with a mental health issue), then you’re more likely to receive integrative care for both conditions in a Non 12 Step program.
(That said, most people with addiction do have a dual diagnosis! Substance abuse and mental health concerns go together.)
Non 12 Step programs tend to include more professional therapeutic hours and evidence-based counseling techniques.
By contrast, 12 Step programs often rely heavily on layperson-led meetings, which are not the same as professional mental health treatment.
As we wrote in our PsychCentral post Addiction and the Non 12 Step Approach: Why It Might Be Right for You:
“While 12 Step groups have done a lot of good for a lot of people, they are not the same as professional mental health treatment …. They were not designed to treat clinical depression, anxiety, post-traumatic stress disorder, bipolar disorder, or related issues.”
Plus, 12 Step program success rates are frighteningly low. Harvard psychiatrist Dr. Lance Dodes cites AA success rates as 5-10%. This means that 90-95% of people who go through the program do not recover.
Addiction Treatment Modalities: From Broad to Specific
Beyond 12 Step vs Non 12 Step, there are multiple ways to organize types of treatment. Princeton-based experts in the 1980’s broke them into three categories: Medical, Psychological, and Sociocultural.
These frameworks are still helpful in categorizing the wide variety of options available today. The Handbook of Alcoholism Treatment Approaches by Reid Hester and William Miller lists no less than 48 different types of addiction treatment modalities!
We did an in-depth analysis of the available approaches in our two-part Treatment Modalities series: Addiction Treatment Modalities, Part 1: What Are My Options? and Addiction Treatment Modalities, Part 2: Which Ones Really Work?
What to Look For
Here’s a quick summary of what to look for in an addiction treatment program:
You want an approach that is holistic, one that promotes healing on every level. Yes, you need to start with a safe, effective medical detox to address the physical level. And yes, you may need medication supports.
But once you’re physically stable, it’s time to dive into the mental and emotional reasons why you chose to start using in the first place.
In order to do that, you need lots of professional counseling hours. You need highly trained therapists to teach evidence-based self-counseling strategies you can use once you leave the program.
The Bottom Line
Here’s the bottom line question to keep in mind when considering addiction treatment approaches:
Does this treatment help people to heal the underlying core issues that drive substance abuse: the depression, anxiety, self-loathing, trauma, and hopelessness?
Put another way, does this modality put a metaphorical Band-Aid on a bullet hole, or does it involve skilled, professional, and proven interventions?
Find a program that does the latter, and you’ll be much closer to recovery.