Category: Treatment Therapies

Therapy alone isn’t the only way to approach recovery. For some people, a combination of medication and therapy might be the best option. This is exactly what medication-assisted treatment (MAT) does—and it works incredibly well for certain substance use disorders.

However, this evidence-based treatment technique for substance use does have its risks. For example, some medications used in this approach are addictive. It’s important to inform yourself about potential consequences so you’ll feel empowered when making decisions about your treatment plan. While you’ll work with a medical professional to customize your recovery strategy, it’s ultimately up to you whether or not you want MAT to be part of it.

How Can MAT Help You Overcome Substance Use?

Medication-assisted treatment ((Medication-assisted treatment(Mat). (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment)) is effective at treating some types of substance dependency. It can also prevent relapse and overdose, increase survival odds, and make it more likely that people will stay in treatment.

MAT achieves this by making the following happen:

• stabilizing brain chemistry
• preventing euphoric feelings from alcohol and drugs
• alleviating the urge to use substances
• regulating body functioning
• relieving withdrawal symptoms

But while this all seems promising, MAT only treats specific substance use disorders.

Which Substance Use Disorders Does MAT Treat?

MAT is most effective ((Mat medications, counseling, and related conditions. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions)) for the following conditions:

• alcohol use disorder (AUD)
• opioid use disorder (OUD)
• opioid overdose

The FDA approves certain medications for each of these conditions. Which medication your doctor or psychiatrist prescribes you will depend on the condition you’re treating, as well as your medical and substance use history.

​​Disclaimer: The information below has been professionally reviewed but does not represent, nor should be mistaken for, medical advice. Please seek guidance from your doctor or qualified addiction treatment professional to fully review and understand the benefits, risks and side effects of the medications discussed.

Which Medications Treat Alcohol Use Disorder?

MAT medications are most effective ((Mat medications, counseling, and related conditions. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions)) when people participate in a MAT program. While they’re not a remedy for alcohol misuse, they do temper withdrawal symptoms and help normalize brain and body functions.

Acamprosate

This medication is best for people already in recovery from alcohol use disorder. ((Substance Abuse and Mental Health Services Administration and National Institute on Alcohol Abuse and Alcoholism, Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. HHS Publication No. (SMA) 15-4907. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.)) While acamprosate stops people from drinking, it won’t prevent withdrawal symptoms if they do drink alcohol. Acamprosate can be taken on the 5th day of sobriety, and it takes 5 to 8 days to be completely effective.

Pros:

• Acamprosate is not an addictive medication.
• There is almost no risk of overdose.
• Other medications won’t interact with acamprosate.

Cons:

• Patients may experience diarrhea, upset stomach, appetite loss, anxiety, dizziness, and difficulty sleeping when taking this medication. However, these are usually mild and often go away after a few weeks.
• In rare cases, acamprosate can cause suicidality.

Where can you find it? Patients must see a medical doctor to obtain a prescription.

Is acamprosate effective? While research suggests mixed results, most studies show that acamprosate decreases the likelihood of drinking ((Burnette, E. M., Nieto, S. J., Grodin, E. N., Meredith, L. R., Hurley, B., Miotto, K., Gillis, A. J., & Ray, L. A. (2022). Novel agents for the pharmacological treatment of alcohol use disorder. Drugs, 82(3), 251–274. https://doi.org/10.1007/s40265-021-01670-3)) and increases lengths of abstinence.

Disulfiram

Disulfiram causes an uncomfortable reaction to alcohol, ((Substance Abuse and Mental Health Services Administration and National Institute on Alcohol Abuse and Alcoholism, Medication for the Treatment of Alcohol Use Disorder: A Brief Guide. HHS Publication No. (SMA) 15-4907. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2015.)) which discourages patients from drinking. Because of this, only people who have stopped drinking alcohol should take this medication. It should also be avoided for 12 hours after alcohol use.

Pros:

• Because of the negative interactions with alcohol, patients are less likely to drink.

Cons:

• Disulfiram can cause dangerous side effects like nausea, chest pain, and difficulty breathing just 10 minutes after drinking—at severe levels, these can even be life-threatening. Because of this, it’s important that people avoid alcohol entirely while using disulfiram.
• People with impaired judgment or high impulsivity should not take disulfiram.

Where can you find it? Patients can take this prescription medication at home.

Is disulfiram effective? People are more likely to continue taking disulfiram for alcohol use disorder ((Burnette, E. M., Nieto, S. J., Grodin, E. N., Meredith, L. R., Hurley, B., Miotto, K., Gillis, A. J., & Ray, L. A. (2022). Novel agents for the pharmacological treatment of alcohol use disorder. Drugs, 82(3), 251–274. https://doi.org/10.1007/s40265-021-01670-3)) when doing so under supervision. This is because the unpleasant interaction with alcohol may deter people from taking this medication. Being aware of this consequence does stop some people from drinking.

Which Medications Treat Opioid Use Disorder?

MAT medications treat dependence on several different types of opioids, ((Mat medications, counseling, and related conditions. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions)) including heroin, morphine, codeine, oxycodone, and hydrocodone. You can use these medications long-term if necessary—some patients even do so indefinitely.

Methadone

The goal of methadone treatment is to reduce opioid withdrawal symptoms and desire to use. Patients can work with their prescribing doctor to determine the right dosage and frequency. Methadone is usually most effective when used for at least 12 months.

Pros:

• Methadone is safe and effective if taken properly. ((Methadone. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/methadone))
• You can begin using methadone anytime during recovery—even before withdrawal symptoms begin.

Cons:

• Uncomfortable and dangerous side effects may occur. These include, but aren’t limited to: intense sweating, slow or difficulty breathing, restlessness, chest pain, and hallucinations.
• Accidental overdose is possible. This is because methadone’s potency and benefits never plateau and its active ingredients are long lasting.
• Other medications can interact with methadone and cause serious health risks, like heart problems.
• People’s reactions to methadone are variable, and it may have very different effects on different people.
• Patients need to go to a specialized clinic to take this medication.
• It can take time to find the ideal dosage for patients, which may lead to higher rates of relapse.
• Methadone can cause dependency.

Where can you find it? Patients need a prescription for methadone, and must begin taking it in the presence of a medical professional. However, after a period of progress, patients can use it at home.

Is methadone effective? According to experts, methadone is the current “gold standard” in MAT for opioids. ((Spayde-Baker, A., & Patek, J. (2021). A comparison of medication-assisted treatment options for opioid addiction: A review of the literature. Journal of Addictions Nursing. https://doi.org/10.1097/JAN.0000000000000392)) However, this might just be because it’s been in use the longest (for the past 50 years). Regardless, research shows that methadone does work for many people. According to one study, methadone has a 60% success rate in helping people stay abstinent from opioids, ((Spayde-Baker, A., & Patek, J. (2021). A comparison of medication-assisted treatment options for opioid addiction: A review of the literature. Journal of Addictions Nursing. https://doi.org/10.1097/JAN.0000000000000392)) along with the “greatest results in retention rates” as compared to buprenorphine and naltrexone.

Buprenorphine

This medication stops or minimizes the desire to use opioids. ((Buprenorphine. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/buprenorphine)) It does this by mimicking some of the effects of opioids. However, these effects are weaker than drugs like heroin, for example.

Patients must stop using opioids 12 to 24 hours before starting buprenorphine. It’s possible to lower dosage from every day to alternate days after seeing improvements. Studies show that patients who use buprenorphine for longer amounts of time ((Abuse, N. I. on D. (–). How effective are medications to treat opioid use disorder? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder)) at a higher dosage (at least 16mg) are less likely to relapse.

Pros:

• Buprenorphine is safe if taken as instructed, and less likely to cause an overdose than opioids like heroin or oxycodone.
• Unlike other opioid use disorder treatments, people can take this medication at home.

Cons:

• The opioid-like effects are not as strong as those of methadone. While this doesn’t necessarily make it less effective (and many studies show that methadone and buprenorphine work equally well), ((Abuse, N. I. on D. (–). How effective are medications to treat opioid use disorder? National Institute on Drug Abuse. https://nida.nih.gov/publications/research-reports/medications-to-treat-opioid-addiction/efficacy-medications-opioid-use-disorder)) some people may prefer methadone for this reason.
• Buprenorphine comes with many different possible side effects, ranging from mild to serious. They can include dizziness, insomnia, fever, headache, nausea, vomiting, among many others.
• People can also become dependent on, or overdose from, buprenorphine.

Where can you find it? Patients can get a prescription for buprenorphine from a doctor, and take it in a clinic or the comfort of their own home.

Is buprenorphine effective? While experts consider buprenorphine the “second-best choice” in MAT after methadone, it’s still very effective for many people. For example, one study found that 60% of people remained abstinent from opioids when using buprenorphine ((Spayde-Baker, A., & Patek, J. (2021). A comparison of medication-assisted treatment options for opioid addiction: A review of the literature. Journal of Addictions Nursing. https://doi.org/10.1097/JAN.0000000000000392)) as compared to no medication or a placebo.

Do Any Medications Treat Both Opioid and Alcohol Use Disorders?

One medication, naltrexone, treats both alcohol and opioid misuse.  This newer medication was originally just for opioid use disorder. However, after 2 different studies determined that it also reduced the number of drinking days and relapse rates, the FDA also approved it for alcohol use disorder. ((Burnette, E. M., Nieto, S. J., Grodin, E. N., Meredith, L. R., Hurley, B., Miotto, K., Gillis, A. J., & Ray, L. A. (2022). Novel agents for the pharmacological treatment of alcohol use disorder. Drugs, 82(3), 251–274. https://doi.org/10.1007/s40265-021-01670-3))

Naltrexone

People won’t feel the euphoric effects of alcohol or opioids with naltrexone and it decreases their desire to engage in substance use. Because of this, people are less likely to drink or use opioids, and more likely to continue treatment. Patients taking naltrexone for opioid misuse need to wait 7 days after taking short-acting opioids and 10 to 14 days for long-acting opioids.

Pros:

• Naltrexone does not cause dependency.
• Patients don’t experience withdrawal symptoms when they stop taking this medication.

Cons:

• Naltrexone might elicit mild to severe side effects. Serious risks include liver damage, allergic reactions, pneumonia, and depression.
• People can accidentally overdose on naltrexone. Because it blocks opioid effects, people may take more to try and get the desired feeling. Naltrexone also lowers tolerance to opioids, meaning someone who’s relapsing can accidentally take too much.
• Starting naltrexone treatment may be more difficult since patients must complete medical detox beforehand. This is uncomfortable for most people, and may impact motivation and delay treatment.

Where can you find it? Healthcare providers prescribe naltrexone.

Is naltrexone effective? Naltrexone results vary. One study determined that naltrexone was the least successful overall ((Spayde-Baker, A., & Patek, J. (2021). A comparison of medication-assisted treatment options for opioid addiction: A review of the literature. Journal of Addictions Nursing. https://doi.org/10.1097/JAN.0000000000000392)) as compared to methadone and buprenorphine. Another study concluded that naltrexone only had a “moderate effect” on decreasing alcohol use. ((Burnette, E. M., Nieto, S. J., Grodin, E. N., Meredith, L. R., Hurley, B., Miotto, K., Gillis, A. J., & Ray, L. A. (2022). Novel agents for the pharmacological treatment of alcohol use disorder. Drugs, 82(3), 251–274. https://doi.org/10.1007/s40265-021-01670-3)) However, another study found that it significantly reduced the number of days of alcohol usage and relapse rates.

Do Any Medications Prevent Opioid Overdose?

Naloxone is a medication that reverses opioid overdose. ((Naloxone. (n.d.). Retrieved from https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions/naloxone)) This medicine doesn’t work for non-opioid overdoses. The patient may require more than 1 dose of naloxone ((Substance Abuse and Mental Health Services Administration. SAMHSA Opioid Overdose Prevention Toolkit. HHS Publication No. (SMA) 18-4742. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2018.)) if they used large quantities of opioids, or stronger opioids like fentanyl. While all naloxone devices are effective, ((Abuse, N. I. on D. (2022, January 11). Naloxone drugfacts. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/naloxone)) research suggests that FDA-approved units administer greater blood levels of naloxone.

Pros:

• Naloxone is usually safe, with little risk of side effects.
• Naloxone is not addictive.
• In many states, people close to someone at risk of an opioid overdose can learn to use naloxone with proper training. ((Take home naloxone. (n.d.). Retrieved from https://www.naloxonetraining.com)) A pharmacist or medical professional can either explain procedures or tell you where to go for instruction.
• Insurance may cover naloxone, making it more cost-effective. Some programs even offer it for free.

Cons:

• Although rare, people may experience an allergic reaction from naloxone, such as hives or swelling of the face, lips, or throat.
• The effects of naloxone only last 30 to 90 minutes, but opioids often stay in the body for a longer time. Because of this, people might still experience overdose effects after that time period, so it’s important to seek medical help immediately after using naloxone.
• Naloxone can also cause opioid withdrawal symptoms, like headaches, vomiting, and rapid heart rate. However, these are not usually life threatening.

Where can you find it? Naloxone is widely available, and most pharmacies carry it. Many states don’t require a prescription. Community programs and local public health organizations may also have naloxone.

Is naloxone effective? Naloxone is highly effective. ((Rzasa Lynn, R., & Galinkin, J. (2018). Naloxone dosage for opioid reversal: Current evidence and clinical implications. Therapeutic Advances in Drug Safety, 9(1), 63–88. https://doi.org/10.1177/2042098617744161)) Research shows that naloxone successfully reverses overdose in 75 to 100% of cases, even when it’s not administered by medical professionals.

Are MAT Medications Safe?

For the most part, yes—as long as they are used as directed. But unfortunately, it is possible to misuse them. People can take too much, or not enough, for them to be effective.

And, medications like methadone and buprenorphine can be habit-forming. Some people even take MAT medications for opioid dependency for their entire lives. This begs the question: is MAT just substituting one drug with another?

Does MAT Just Replace One Addiction With Another?

Unfortunately, the answer to this question is complicated. Addiction experts have widely different opinions on the matter. Alex Azar, the U.S. Health and Human Services Secretary from 2018 to 2021, was very much in favor of MAT. ((Kounang, N. (2018, February 26). FDA to broaden access to medication-assisted treatment for opioid addiction. CNN. https://www.cnn.com/2018/02/26/health/medication-assisted-treatment-opioid-azar/index.html)) According to Azar, “Medication-assisted treatment works. The evidence on this is voluminous and ever-growing.” He added that failing to offer MAT to patients is “like treating an infection without antibiotics.”

However, Tom Price, U.S. Health and Human Services Secretary in 2017, argued the opposite. According to Price, “If we’re just substituting one opioid for another, we’re not moving the dial much.”

Regardless of this dispute, many medical professionals believe that MAT is an essential part of the recovery process. Your answer will depend on your own personal beliefs and experiences—and what advice makes the most sense for you.

Is Medication-Assisted Treatment For You?

A good starting point for determining your course of action is to get an assessment. You can do this through your primary care physician or via a treatment center. Together, you can evaluate your options, weigh the pros and cons each, and decide what’s best for your situation.

Find out more about rehab facilities that offer MAT, including insurance coverage, reviews, contact information, and more.

Reviewed by Rajnandini Rathod

Relationships play important roles in our lives. We rely heavily on our partners, family, and friends, and when our relationships suffer, our lives do too. This is the idea behind interpersonal psychotherapy (IPT). With this form of therapy, the goal is to enhance relationships and social support networks to alleviate the symptoms of depression and other mood disorders.

What Is Interpersonal Psychotherapy?

Interpersonal psychotherapy takes into account that humans are social creatures. As such, our relationships are one of the most important factors in determining how we feel. IPT is primarily used to treat depression, but can also treat other mood disorders like bipolar and borderline personality disorder (BPD).

Myrna M. Weissman, Ph.D., Professor of Epidemiology and Psychiatry at the New York State Psychiatric Institute, describes IPT’s core principles ((What is interpersonal psychotherapy? (n.d.). Retrieved from https://www.youtube.com/watch?v=HrClyDVL43I)) this way:

“The whole idea behind interpersonal psychotherapy is: whatever causes depression (and we know that it’s partly genetic and many environmental triggers), it occurs in an interpersonal context. So when a person first develops symptoms, something usually has gone on in their life to trigger it. And [IPT] is based on understanding those particular triggers: disputes with people you love, grief, loss of someone you love; big changes in your life so that your social supports or family attachments have dissolved.”

Another hardship that contributes to depression, she adds, is difficulty forming and maintaining attachments.

IPT is based on the disease model, meaning it sees depression not as the patient’s fault but as an illness they can recover from. Its main focus is improving your interactions with people in your life.

Elements of IPT

IPT starts with an interpersonal inventory. ((Key IPT strategies | international society of interpersonal psychotherapy—Isipt. (n.d.). Retrieved from https://interpersonalpsychotherapy.org/ipt-basics/key-ipt-strategies/)) In this assessment, you and your therapist will take note of who is in your life, and whether they serve as a trigger or a source of support.

This therapy also emphasizes staying in the present and focusing on the issue at hand. Weissman explains:

“We realize that people have personalities. We know that their early childhood experiences formulate who they are and also trigger some of the events. But we try to deal with the current event that is the trigger in the here and now.”

A notable appeal of IPT is that it’s short-acting. It has a set beginning and end date, and can be applied in formats as short as 8 sessions.

What Happens in IPT Sessions

Typically, interpersonal psychotherapy takes place in 12-20 sessions over the course of 4-5 months. ((Rajhans, P., Hans, G., Kumar, V., & Chadda, R. (2020). Interpersonal psychotherapy for patients with mental disorders. Indian Journal of Psychiatry, 62(8), 201. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_771_19)) This shorter time period encourages patients to actively try to improve their situation. Unlike other methods, patients usually don’t do “homework.”

After an assessment, treatment occurs over 3 phases, each with specific goals.

Beginning Phase (Sessions 1-3)

During your first few sessions, you’ll identify areas to work on, tackle immediate problems, and set treatment goals. Your therapist will work with you to uncover how your diagnosis relates to your social interactions.

This is where you’ll perform the aforementioned interpersonal inventory. This looks at the following to better understand your social connections:

• current relationships
• relationship patterns
• capacity for intimacy

You’ll then decide on one of the following 4 problem areas ((Key IPT strategies | international society of interpersonal psychotherapy—Isipt. (n.d.). Retrieved from https://interpersonalpsychotherapy.org/ipt-basics/key-ipt-strategies/)) of focus during treatment:

• grief over the loss of a loved one, or loss of self
• role disputes: problems with an important person, like a significant other, family member, or friend
• role transitions: life changes like career transitions or moves
• skill deficits: difficulty communicating, keeping relationships, or other social shortcomings

IPT works on 1 issue at a time. Your therapist will usually treat the most upsetting problem first.

Once you and your therapist agree on the main issue, you’ll set goals for the duration of treatment. Then, you’ll move onto the middle phase—and start tackling the problems.

The Middle Phase

In the intermediate phase, you and your therapist will work together on your main interpersonal issue. Therapy focuses on the following to improve your relationships:

• your ability to state your wants and needs
• honoring angry feelings and learning healthy expression
• empowering yourself to take social risks

During sessions, you’ll share events from the last week. If you had a good social experience, your therapist will reinforce the healthy behaviors that worked. In this dynamic, your therapist is your cheerleader. They want you to succeed, and to acknowledge your successes! Stepping outside your comfort zone to change your habits is no small feat.

If you felt like your social interactions went poorly, it’s okay. Just like your therapist cheers you on when things go well, they’re also there for you when they don’t. They can help you pinpoint what you can improve next time. To do this, you might role play different scenarios. This way, you’ll feel prepared to handle similar situations in the future because you’ve already practiced.

At the end of each session, you’ll review what happened and discuss your achievements. Your therapist will help you stay focused on your goals for the duration of your time together.

The End Phase (Last 3 Sessions)

As your treatment episode draws to a close, you’ll spend the last few sessions reflecting on what you accomplished and discussing areas that still need attention. Hopefully, you’ll feel more empowered to tackle problems on your own. This is the time to celebrate all the hard work you put in and own your ability to move forward, armed with new tools.

Even if you’ve made significant progress, you may not feel ready to stop therapy. IPT doesn’t have to end abruptly. Your therapist may recommend continued sessions focusing on another problem area. Or, you may decide to shift to another type of therapy. In either case, your therapist can help you create a plan for long-term progress and maintenance.

Format and Follow-Up

Depending on your needs and your therapist’s availability, you may decide to continue working together. This often entails more sessions for issues that are actively disrupting your life, and lower frequency for maintenance under more “normal” circumstances.

Like other forms of talk therapy, you can attend IPT sessions in person, online, or over the phone. In fact, research suggests that IPT over the phone ((Miniati, M., Marzetti, F., Palagini, L., Conversano, C., Buccianelli, B., Marazziti, D., & Gemignani, A. (2021). Telephone-delivered Interpersonal Psychotherapy: A systematic review. CNS Spectrums, 1–13. https://doi.org/10.1017/S1092852921000948)) is just as effective as it is in person.

Should You Consider Interpersonal Psychotherapy?

Interpersonal psychotherapy ((Rajhans, P., Hans, G., Kumar, V., & Chadda, R. K. (2020). Interpersonal psychotherapy for patients with mental disorders. Indian Journal of Psychiatry, 62(Suppl 2), S201–S212. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_771_19)) might not be for everyone. While therapists can adapt IPT to a variety of mental health conditions, IPT is designed to target social issues. People whose primary concern is their interpersonal relationships will probably benefit most.

That there are many paths to healing, and IPT is just one. It may be incredibly effective for some people, and not work so well for others. As Weiss says, “There shouldn’t be holy wars about which is best. There should be available a range of evidence-based psychotherapies. Some people will do fantastically well on CBT and not IPT, and vice versa.” Even patients who are successful in IPT commonly choose to pursue other therapies after completing their first treatment episode.

Why Interpersonal Psychotherapy Works for Depression

Interpersonal therapy is beneficial for depression ((Markowitz, J. C., & Weissman, M. M. (2004). Interpersonal psychotherapy: Principles and applications. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 3(3), 136–139.)) since this disorder often follows a disruption in personal relationships. And according to research, close bonds with others help prevent depression ((Saeri, A. K., Cruwys, T., Barlow, F. K., Stronge, S., & Sibley, C. G. (2018). Social connectedness improves public mental health: Investigating bidirectional relationships in the New Zealand attitudes and values survey. Australian & New Zealand Journal of Psychiatry, 52(4), 365–374. https://doi.org/10.1177/0004867417723990)) —especially in the face of stressful situations. Because of this, it’s important to develop and nurture supportive social connections. They can help ease your depressive symptoms, or even erase them altogether if social issues are the root of your condition. And IPT is shown to improve these symptoms in various age groups. Studies show that interpersonal therapy improves depression ((Markowitz, J. C. (1999). Developments in interpersonal psychotherapy. The Canadian Journal of Psychiatry, 44(6), 556–561. https://doi.org/10.1177/070674379904400603)) rates in children, adolescents, adults, and older patients.

There are 2 main principles of IPT for depression:

• Depression is not the fault of the patient, and is treatable.
• There’s a clear link between a patient’s life experiences and their emotional state.

People with depression often blame themselves for things going wrong, but IPT reminds us that depressive symptoms are a natural result of stressful, life-changing events. This stress can also make relationships harder to manage. IPT aims to solve the problems caused by these social setbacks. And ideally, by doing so, you’ll feel less depressed.

Research suggests that IPT also improves recurrent depression. ((Markowitz, J. C., & Weissman, M. M. (2004). Interpersonal psychotherapy: Principles and applications. World Psychiatry: Official Journal of the World Psychiatric Association (WPA), 3(3), 136–139.)) With this type of depression, treatment is sometimes recommended for several years.

Nurturing Your Relationships Helps You Heal

IPT can be very supportive for those with depression, especially if that depression results from issues with your relationships or social skills.

As you look for treatment options, keep in mind that your road to healing might have some unexpected twists and turns—and it’s all a normal part of the recovery process.

But it is possible to find joy again—in your relationships, and in yourself. And reaching out for help is the first step towards getting there.

View rehab centers that offer interpersonal therapy to connect with treatment facilities directly and learn about programs, pricing, insurance, and more.

Reviewed by Rajnandini Rathod

No matter what challenges you’ve faced, you have many different strengths and skills that have helped you navigate and even overcome adversity. But we often don’t recognize our own strengths and successes.

This is partially because most traditional addiction and mental health treatments set out to help you analyze, “fix,” and avoid unhealthy habits, past mistakes and problems. Therapy that focuses on our failures and how to overcome them is referred to as deficit-based. This type of treatment is quite common and does in fact work for a lot of people.

But focusing on solving the root of your problems—from potential character flaws to past traumas—isn’t the only path to healing.

If you’re seeking recovery from a substance use disorder or a mental health disorder, strengths-based treatment programs could be a good starting point for your healing journey. Keep reading to learn more about what separates SBT from other types of treatments, plus how it works, what to expect during treatment, and how to find the right treatment for you.

What Makes Strengths-Based Different From Traditional Approaches

The main goal of most medical and psychological treatments is to stop you from hurting. And this goal is typically accomplished by treating the “bad” symptoms, which is reflective of the deficit-based approach mentioned above.

The Traditional Approach

One example of applying this method to simple physical illnesses is how when you experience a headache you might take a pain reliever like aspirin, ibuprofen (Advil) or acetaminophen (Tylenol) to stop hurting. Along the same lines, to treat a mental illness like depression you could take antidepressants or go see a therapist.

While these types of solutions, also called the medical model of care, work for some people, strengths-based therapy may be more effective for addressing complex conditions like substance use disorder or major depressive disorder. One study examining the impacts of strengths-based treatments on parolees, ((Prendergast, M., Frisman, L., Sacks, J. Y., Staton-Tindall, M., Greenwell, L., Lin, H.-J., & Cartier, J. (2011). A multi-site, randomized study of strengths-based case management with substance-abusing parolees. Journal of Experimental Criminology, 7(3), 225–253. https://doi.org/10.1007/s11292-011-9123-y)) discusses how part of the reason for this could be because a deficit-based model of treatment often views patients as “the problem” (e.g., one is a drug addict) which typically reinforces low expectations. Believing that you’re the problem can have an incredibly negative impact on your self-esteem, which in turn can make healing or recovery feel unreachable.

The Strengths-Based Approach

Strengths-based treatments often have similar goals to the medical model (i.e. to stop you from hurting) but this goal is accomplished in a much different way. As the same study mentioned above explains, “The strengths approach reinforces high expectations ((Prendergast, M., Frisman, L., Sacks, J. Y., Staton-Tindall, M., Greenwell, L., Lin, H.-J., & Cartier, J. (2011). A multi-site, randomized study of strengths-based case management with substance-abusing parolees. Journal of Experimental Criminology, 7(3), 225–253. https://doi.org/10.1007/s11292-011-9123-y)) by viewing the situation as ‘the problem’ (e.g., one has drug dependence) and by assuming that the client has many strengths and resources with which to handle the problem.” So, instead of treating negative or “bad” symptoms, or trying to “fix” any perceived “problems,” strengths-based therapy promotes “individual empowerment through the acquisition of resources and skills that help people manage their substance use disorder ((Loveland, D., & Boyle, M. (2005). Manual for Recovery Coaching and Personal Recovery Plan Development. https://chess.wisc.edu/niatx/toolkits/provider/FayetteManual.pdf)) or psychiatric disability,” writes David Loveland, the Director of Research for an addiction and mental health non-profit based in Illinois, in his manual on recovery coaching.

Simply put, sometimes we focus so much on the negatives of our situation and the mistakes we made that got us where we are, that we forget how capable we are and how much has actually gone right in our lives. SBT helps us remember and tap back into our existing resources and support systems so we can continue succeeding during recovery.

How Strengths-Based Treatment Works for Addiction

Focusing on how you handle and overcome difficulties instead of how or why those difficulties happened can increase your self-confidence, compassion, and resilience. This perspective promotes viewing your life, the situations you find yourself in, and the world around you with a positive mindset. That positivity is what makes strengths-based therapy an attractive alternative treatment option for many people.

Let Your Difficulties Fuel Your Recovery

With a strengths-based perspective, we don’t ignore the challenges we face in life. We just don’t let those challenges and the task of solving them be the driving factor during treatment. “Strengths-based therapy ((Strengths-Based Therapy. (n.d.). https://www.sagepub.com/sites/default/files/upm-binaries/53278_ch_1.pdf)) adheres to the belief that even the most challenging life stories that clients bring to therapy contain examples of their exercise of strengths in their struggle with adversity,” writes psychologist and President of the Strengths-Based Institute, Elsie Jones-Smith, in one of her textbooks on SBT. “For instance, the addict’s or substance abuser’s maladaptive responses may also contain within them the seeds of a struggle for health.”

So, the difficulties you’ve endured can even be harnessed as fuel for your recovery. “To fully understand the basis of the strengths perspective, ((Grant, J. G., & Cadell, S. (2009). Power, Pathological Worldviews, and the Strengths Perspective in Social Work. Families in Society, 90(4), 425–430. https://doi.org/10.1606/1044-3894.3921)) it is necessary to understand that it is possible—in fact, quite likely—to face adversity and to thrive, not necessarily in spite of it but often in great part because of it,” say social work experts Jill Grant and Susan Cadell. “Studies of those who have faced adversity suggest that it can be a transformative experience, with enduring positive effects on problem-solving abilities, sensitivity, relationships, coping skills, ability to set priorities, efficacy, and self-knowledge.” The key to SBT, then, is unlocking these strengths and fostering their growth.

Tap Into the Power of Positivity

Another quality that makes SBT both different and successful for some is that the therapy sessions have a much more positive tone and outlook. “Strengths and positive emotions create an enjoyable therapy experience ((Scheel, M. J., Conoley, C. W. (2017). Goal Focused Positive Psychotherapy: A Strengths-Based Approach. United Kingdom: Oxford University Press. Retrieved from https://www.google.com/books/edition/Goal_Focused_Positive_Psychotherapy/vYwtDwAAQBAJ?hl=en&gbpv=1&dq=strengths+based+approach+to+therapy&pg=PP1&printsec=frontcover)) for clients to embrace new possibilities and hope for their future,” explain psychology professors Collie Conoley and Michael Scheel in their book about Goal Focused Positive Psychotherapy, which uses the strengths-based approach.

They go on to explain that, “The science of positive psychology reveals that growth and flourishing occur under known conditions: involvement in meaningful activities; experiencing supportive, caring relationships; feeling competent; having goals; and experiencing positive emotions frequently.” So, focusing on your strengths can be good for your general recovery because it actually can increase your potential for positive change and growth.

Apply This Inclusive Approach

And finally, another attractive quality of SBT is that it has universal application. Anyone anywhere can potentially benefit from SBT because, as Elsie Jones-Smith writes, “no matter what culture you live in, individuals use their strengths to deal with adversities.” ((Jones-Smith, E. (2013). Strengths-Based Therapy: Connecting Theory, Practice and Skills. In Google Books. SAGE Publications. Retrieved from https://www.google.com/books/edition/_/6cggAQAAQBAJ?hl=en&gbpv=0)) The applications of strengths-based treatment ((Franklin, C. (2015). An Update on Strengths-Based, Solution-Focused Brief Therapy. Health & Social Work, 40(2), 73-76. https://doi.org/10.1093/hsw/hlv022)) across cultures and geographic locations is proven by the fact that SBT is being practiced and researched in many different countries, including “diverse European nations, Canada, Australia, Japan, Korea, China, Singapore, Taiwan, and Mainland China,” according to Cynthia Franklin, a licensed social worker and assistant dean for doctoral education at the University of Texas at Austin.

Before you decide to pursue SBT for your substance use or mental health disorder, keep reading for a closer look at what this therapy looks like in practice.

What to Expect During Strengths-Based Treatment

A strengths-based recovery program will mostly likely be a bit different from other types of talk therapy you may have experienced. Though your individual recovery process and exact timeline might differ, most strengths-based treatment programs include aspects discussed below.

Building a Mutual Working Relationship

One of the key differences with SBT is how the relationship between you and your therapist will be more collaborative rather than authoritative. In their article detailing how strengths-based cognitive behavioral therapy (CBT) can be used to build personal resilience, ((Padesky, C. A., & Mooney, K. A. (2012). Strengths-Based Cognitive-Behavioural Therapy: A Four-Step Model to Build Resilience. Clinical Psychology & Psychotherapy, 19(4), 283–290. https://doi.org/10.1002/cpp.1795)) Christine Padesky and Kathleen Mooney explain that “collaboration means that the therapist actively engages the client so each step of therapy is a mutual construction and exploration. Guided discovery is emphasized throughout therapy sessions to maintain client engagement and foster learning.” Not only should this collaborative mindset be reflected throughout all the different stages of your treatment, but it should also be ongoing and dynamic, evolving over time.

Finding and Listing Your Strengths

Strengths-based therapy is built on the assumption that everyone has strengths linked to their personalities, interests, and values. One of the first steps of your treatment will be to identify and list your strengths. This could be done by completing different kinds of assessment worksheets or through in-depth conversations.

Actually identifying these strengths, though, is one of the most difficult parts of SBT for both treatment professionals and patients. Experts explain that’s because counselors have been trained to assess and to base treatment services on peoples’ deficits and illness-related behaviors ((Loveland, D., & Boyle, M. (2005). Manual for Recovery Coaching and Personal Recovery Plan Development. https://chess.wisc.edu/niatx/toolkits/provider/FayetteManual.pdf)) (i.e., the addiction or mental illness). “Assessing strengths, on the other hand, requires a focus on capacities and positive learning experiences and healthy disregard for people’s diseases or diagnostic labels.” Because of this, most therapists have to “unlearn their patterns of service delivery and learn a new style of interactions with clients.”

Similarly, patients have also been conditioned within the same treatment culture to focus on their deficits and illness-related behaviors which sometimes makes them ill-equipped to even remember or recognize their own achievements. “For this reason,” say Padesky and Mooney, “therapists search for ‘hidden strengths’ ((Padesky, C. A., & Mooney, K. A. (2012). Strengths-Based Cognitive-Behavioural Therapy: A Four-Step Model to Build Resilience. Clinical Psychology & Psychotherapy, 19(4), 283–290. https://doi.org/10.1002/cpp.1795)) within common everyday experiences and bring these to client awareness.”

Much like your relationship with your therapist, this list of strengths is a starting point that will be built upon throughout your treatment.

Setting Goals for Treatment and Beyond

The strengths-based approach puts you in the driver’s seat. So instead of following along with your therapist’s suggestions and advice, you’ll be more involved in the overall goal-setting and treatment process. Experts of one strengths-based treatment study ((Prendergast, M., Frisman, L., Sacks, J. Y., Staton-Tindall, M., Greenwell, L., Lin, H.-J., & Cartier, J. (2011). A multi-site, randomized study of strengths-based case management with substance-abusing parolees. Journal of Experimental Criminology, 7(3), 225–253. https://doi.org/10.1007/s11292-011-9123-y)) explain that, instead of a counselor, case manager or other person setting goals for you, you would collaborate to set and achieve goals you identify as valuable and important.

According to recovery expert David Loveland, goals, assets, and barriers can be categorized into 8 life domains:

1. recovery from substance use or abuse
2. living and financial independence
3. employment and education
4. relationships and social supports
5. medical health
6. leisure and recreation
7. independence from legal problems and institutions
8. mental wellness and spirituality

Dividing our goals into more specific areas of life can “help people organize and prioritize their goals as well as to help them to see that recovery requires a holistic approach ((Loveland, D., & Boyle, M. (2005). Manual for Recovery Coaching and Personal Recovery Plan Development. https://chess.wisc.edu/niatx/toolkits/provider/FayetteManual.pdf)) that will impact all dimensions of their lives,” explains David. This multifaceted approach also helps people understand “how their addiction or mental illness has impacted multiple dimensions of their lives and that sustained recovery will require work in many, if not all of these dimensions.”

Applying and Refining Your Strengths

Once you know what your strengths are and what goals you want to work towards, both in recovery and in your everyday life, you’ll have the opportunity to consciously put them into practice. During therapy sessions you may talk through the specific, tangible steps you want to take to work towards your goals, and then check in on how you’re doing.

David Loveland describes that breaking down long-term goals into “a series of simplified behaviors,” helps patients maintain hope for achieving their goals. “Self-efficacy is a component of hope and can be defined as a belief in one’s own capacities or abilities. Compiling small victories, by achieving baby steps, enhances self-efficacy.”

Just as with goal-setting, you’ll also decide which individual, treatment, and community services you want to take advantage of to achieve your goals. Taking charge of the services you’ll seek out for support along your recovery journey can also help improve your self-sufficiency. As some experts point out, the therapist or treatment professional’s role ((Prendergast, M., Frisman, L., Sacks, J. Y., Staton-Tindall, M., Greenwell, L., Lin, H.-J., & Cartier, J. (2011). A multi-site, randomized study of strengths-based case management with substance-abusing parolees. Journal of Experimental Criminology, 7(3), 225–253. https://doi.org/10.1007/s11292-011-9123-y)) during this stage is to support your choices and to serve “as a ‘bridge’ between the client and an often fragmented and difficult-to-access service system.”

Finding the Right Strengths-Based Program for You

Healing is not a linear journey. It often takes trying different kinds of treatments and persisting with your goal to recover in order to find lasting change. If you want to try a new perspective and tap into your innate strengths more instead of dwelling on your past, strengths-based addiction treatment could be an option to consider.

To learn more about your treatment options, browse our directory of rehabs that offer strengths-based treatment to see reviews, facility photos and more, and reach out to centers directly.

Reviewed by Rajnandini Rathod

Addiction can hijack your behavior. This condition makes it easy to lose sight of your goals, values, and even immediate needs. Instead, many people prioritize drug use over the things that matter most to them.

In rehab, you’ll have space to take a step back and look at your life as a whole. That perspective can inspire lasting change. Acceptance and commitment therapy (or ACT, pronounced like the word “act”) shows people how to make those changes. This treatment empowers you to behave in ways that align with your own highest ideals.

In a rehab with acceptance and commitment therapy, you won’t work toward standardized goals, or fight against your own needs. Instead, you’ll start building a life that works for you.

What is Acceptance and Commitment Therapy?

ACT is a type of behavioral therapy founded by psychologist Steven Hayes in the 1980s. In some ways, it resembles dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT). All of these behavioral treatments include talk therapy, but focus on teaching you practical skills. Between sessions, you’ll put those skills into action. Then you can tell your therapist about your progress, and strategize ways to do even better.

Dr. Russell Harris, world-renowned ACT therapist, explains that acceptance and commitment therapy is based on mindfulness. ((Harris, R. (2006). Embracing Your Demons: An Overview of Acceptance and Commitment Therapy. Psychotherapy in Australia, 12(4), 2–8. https://www.sjsu.edu/people/jennifer.gregg/courses/c4/s1/act_article_russ.pdf)) He writes, “the goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it.” Therapists use metaphors and exercises to guide you toward your own values. The goal is to reach a state of balance, in which you can navigate life’s obstacles with grace.

This treatment gives you the tools you need to define your own personal values. Those values might be different from those of the people around you—including your therapist. And that’s okay.

In ACT, you’ll learn to do what’s right for you. Patients achieve this by focusing on a few core ideals.

The 6 Principles of ACT

ACT has 6 central principles ((Acceptance and commitment therapy (Act): An overview. (n.d.). Retrieved from https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT#section-six-core-principles-of-act)) that inform all the exercises you’ll do with your therapist. These concepts aren’t prescriptive—meaning, they’re not there to tell you what to do. Instead, they describe a general approach to living well. To quote Dr. Harris, the principles are as follows:

1. defusion
2. acceptance
3. contact with the present moment
4. the observing self
5. values
6. committed action

You’ll learn how to put these into practice during rehab. Then, once you complete initial treatment, you can use them to build a meaningful life back at home.

Defusion

Think of defusion as de-fusing with overwhelming emotions. This principle asks you to take a step back. You learn to see thoughts, feelings, and events as what they are. You can assign meaning to anything—that’s a natural human impulse. But it doesn’t mean that you should. It can be helpful to recognize that some things don’t have greater implications.

This idea can be life-changing for people with addiction and co-occurring disorders. It’s all too easy to get lost in self-doubt, judging yourself harshly for your own experience. Defusion illustrates that you are not your thoughts or your feelings. These are experiences you have. They don’t need to define your identity or your behavior. You can just accept what’s happened, and move forward.

Acceptance

In ACT, acceptance is just what it sounds like ((Acceptance and commitment therapy(Act). (2017, February 27). Recovery Research Institute. https://www.recoveryanswers.org/resource/acceptance-commitment-therapy-act/)) —accepting present reality just as it is. This includes external events, and your own thoughts and feelings. The act of resisting a feeling is usually exhausting, and rarely effective. These strategies teach you to save that energy, and focus instead on ways you can affect change.

Acceptance isn’t passive. On the contrary, ACT teaches you practical skills to accept what’s happening in your life. For example, people with OCD and addiction can both benefit from urge surfing. In this ACT technique, Dr. Harris says patients learn to “ride urges like a wave. ((Harris, R. (2007). Acceptance and Commitment Therapy (ACT) ADVANCED Workshop Handout . ACT Mindfully. https://www.actmindfully.com.au/upimages/Russ_Harris_-_Advanced_ACT_Workshop_Handout.pdf)) Let the wave crest and fall. Don’t resist it.” You can engage with your cravings as an observer, without acting on them. This mindfulness technique helps people stay present in their own lives.

Contact With the Present Moment

When we act mindfully, we stay in contact with the present moment. With this core principle of ACT, you’ll cultivate resilience. ((Hayes, S. (n.d.). The Six Core Processes of ACT: The Psychological Flexibility Model. Association for Contextual Behavioral Science. Retrieved July 9, 2022, from https://contextualscience.org/the_six_core_processes_of_act)) As Steven Hayes writes, the goal is for people to “experience the world more directly so that their behavior is more flexible and thus their actions more consistent with the values that they hold.”

To stay in touch with the present, you can implement a variety of mindfulness techniques. You might learn these from your ACT therapist, or from another treatment provider. For example, many rehab centers offer yoga and meditation. These strategies help you stay open and centered, even when you’re facing great challenges.

The Observing Self

This principle of ACT builds on the ideas established by defusion. ((Acceptance and commitment therapy (Act): An overview. (n.d.). Retrieved from https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT#section-six-core-principles-of-act)) Dr. Harris writes that these strategies let you access “a transcendent sense of self; a continuity of consciousness that is unchanging.”

This greater self is always observing your life. You can go to rehab, relapse, move to a new city, get promoted, or take up swing dancing. It doesn’t matter how much you change. Your observing self will always be there, with you and for you. Once you recognize this, you can learn to trust yourself again. This can be powerful for anyone, especially people in addiction recovery.

Values Guide Your Recovery Process

Early in ACT, your therapist will take you through the process of defining your values. ((Barney, J. L., Lillis, J., Haynos, A. F., Forman, E., & Juarascio, A. S. (2019). Assessing the valuing process in Acceptance and Commitment Therapy: Experts’ review of the current status and recommendations for future measure development. Journal of Contextual Behavioral Science, 12, 225–233. https://doi.org/10.1016/j.jcbs.2018.08.002)) There are a few different ways to achieve this. They might have you go through a deck of cards with different values, and rank them in order of importance. Or, you might do a writing exercise. Whatever method you use, you’ll end up with a list of core values that are unique to you.

Your values serve as a guiding light, informing every decision you make. These ideals may change over time. But in any given moment, you can know what your highest values are, and act in a way that honors them.

Committed Action

When you take committed action, you act in accordance with your personal values. This principle is the culmination of ACT’s other ideals—but it doesn’t have to come last. Healing isn’t a linear process. For example, you can act on your values while you’re still learning to stay in contact with the present moment.

Committed actions are creative ways to work toward the life you want. You can examine your impulses, and reframe them in light of your ideals. For example: do you really value drug use? Or do you actually value feeling emotionally stable? If it’s the latter, you can achieve that by going to therapy, meditating, or engaging in a healthy hobby. And by doing those things instead, you can honor your values in a more sustainable way.

ACT Makes Healing Sustainable

In acceptance and commitment therapy, you’ll learn to experience your feelings safely. You can act in accordance with your values even when you’re triggered.

It may seem counterintuitive, but when you stop trying to change how you feel, you take back control of your life.

According to Steven Hayes, ACT is uniquely helpful for people in addiction recovery. ((Act: Addressing addiction. (n.d.). Retrieved from https://www.youtube.com/watch?v=BZp6XGzbY1s)) As he explained in one interview, the very word “addiction” explains how it can leave patients feeling out of control. “That dict part of ‘addiction’ is ‘being spoken to,’ like a dictator. Having the rule laid down. And who’s laying down that rule? It’s your own mind. And part of what our perspective is, is trying to back up and catch how it is that your own mind could become your own dictator. Your own body can become your own dictator. And you can find yourself involved in patterns that lead you farther and farther away from what you really care about.”

ACT interrupts the spiral Hayes describes. This treatment teaches you how to move toward the things you care about. But it emphasizes that those things are philosophical and emotional. They might even be spiritual. And because of that, there is no finish line.

Escaping “The Happiness Trap”

Dr. Harris talks about a common behavioral pattern he calls “the happiness trap.” ((Harris, R. (2008). The happiness trap. Robinson Publishing.)) In this pattern, people run themselves ragged trying to achieve happiness. They think of this emotion as an end goal. But feelings aren’t permanent. And when you act like they can be, you set yourself up for failure.

If you value security, for example, you can look for a stable job and living situation. That’s all well and good. But it’s not the end of the story. If you get promoted, you might have to move to a new city. You’ll have more job security, but you’ll need to find a new home. Only you can decide which option aligns with your values. By using the mindful techniques you learn in ACT, you can make the best possible decisions for you.

Actively Engage With Recovery

ACT skills aren’t only a way of processing your feelings. It’s more accurate to call them a way of life. And during addiction recovery, you can use these tactics to build a life that meets your needs, in a fulfilling and meaningful way.

To find a rehab program that offers acceptance and commitment therapy, browse our directory of treatment centers to learn about what therapies they offer, compare your options, and reach out directly.

Reviewed by Rajnandini Rathod

Depression is debilitating, and finding adequate treatment is a deeply personal experience. Because every person’s experience is unique, what works for some may not work for others. Mindfulness-based cognitive therapy (MBCT) is one promising treatment method that may work for you. This form of therapy takes elements from mindfulness training and cognitive behavioral therapy and combines them to combat depression.

Depression is downright exhausting, and the symptoms can be difficult to manage—especially if they interfere with daily life. You may even decide to attend rehab to help you learn to manage your condition. And fortunately, there are many rehab centers that offer mindfulness-based cognitive therapy to treat your depressive symptoms.

What Is Mindfulness-Based Cognitive Therapy?

Mindfulness-based cognitive therapy (MBCT) ((Tickell, A., Ball, S., Bernard, P., Kuyken, W., Marx, R., Pack, S., Strauss, C., Sweeney, T., & Crane, C. (2020). The effectiveness of mindfulness-based cognitive therapy (Mbct) in real-world healthcare services. Mindfulness, 11(2), 279–290. https://doi.org/10.1007/s12671-018-1087-9)) is a group-based therapy originally developed to prevent depression from recurring. Because it was so effective, therapists now use it to treat active symptoms, too.

Mindfulness

Mindfulness techniques ((Parmentier, F. B. R., García-Toro, M., García-Campayo, J., Yañez, A. M., Andrés, P., & Gili, M. (2019). Mindfulness and symptoms of depression and anxiety in the general population: The mediating roles of worry, rumination, reappraisal and suppression. Frontiers in Psychology, 10, 506. https://doi.org/10.3389/fpsyg.2019.00506)) teach people to focus on the present moment. You learn to notice your thoughts, emotions, and experiences without judgment. Mindfulness is beneficial for overall health and well-being, and it reduces depression. And practicing mindfulness ((Hey, health coach: What is mindfulness and how can i do it? (2021, November 30). Forbes Health. https://www.forbes.com/health/mind/how-to-practice-mindfulness/)) can help you learn how to take life’s curveballs in stride. As Jon Kabat-Zinn, founder of the Stress Reduction Clinic and the Center for Mindfulness in Medicine, describes it, “You can’t stop the waves, but you can learn to surf.”

Cognitive Behavioral Therapy

Just like mindfulness, cognitive behavioral therapy is also effective in treating depression. ((Gautam, M., Tripathi, A., Deshmukh, D., & Gaur, M. (2020). Cognitive behavioral therapy for depression. Indian Journal of Psychiatry, 62(Suppl 2), S223–S229. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_772_19)) People with depression usually have automatic negative thought patterns, which can trigger or worsen their symptoms. CBT shows people how to identify and reframe these negative thoughts and behaviors into positive ones. This empowers people to do something about their symptoms, which gives them a sense of control.

Connecting Mindfulness and CBT

MBCT fuses aspects of mindfulness and CBT ((Wang, J., Ren, F., Gao, B., & Yu, X. (2022). Mindfulness-based cognitive therapy in recurrent mdd patients with residual symptoms: Alterations in resting-state theta oscillation dynamics associated with changes in depression and rumination. Frontiers in Psychiatry, 13. https://www.frontiersin.org/articles/10.3389/fpsyt.2022.818298)) to create a hybrid treatment model. Just like in CBT, patients learn to notice and free themselves from negative thought patterns. The therapist teaches patients to instead observe their thoughts and emotions in a compassionate, non-judgmental manner. MBCT incorporates mindfulness techniques, like meditation, alongside CBT.

What to Expect During MBCT Sessions

MBCT usually lasts for 8 weeks, ((Seshadri, A., Orth, S. S., Adaji, A., Singh, B., Clark, M. M., Frye, M. A., McGillivray, J., & Fuller-Tyszkiewicz, M. (2021). Mindfulness-based cognitive therapy, acceptance and commitment therapy, and positive psychotherapy for major depression. American Journal of Psychotherapy, 74(1), 4–12. https://doi.org/10.1176/appi.psychotherapy.20200006)) with weekly sessions of about 2 hours. MBCT is administered in a group setting of 8 to 12 people. During meetings, patients participate in attention training activities for mindfulness. These may include body scan exercises or meditations. The goal is to help you become more aware of your thoughts, feelings, and physical sensations. Patients learn to recognize negative thought patterns and practice acceptance, and complete homework assignments around these concepts. These activities help alleviate symptoms from depression.

How Does This Therapy Work for Depression?

MBCT can reduce depression and decrease the risk of relapse (meaning, it reduces the likelihood that symptoms will come back after treatment). In fact, evidence shows that in some cases, it works just as well as antidepressant medication. According to one study on the effects of mindfulness-based cognitive therapy on depression symptoms, ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892)) “There is evidence from at least nine clinical trials… that MBCT reduces the risk of relapse to depression when added to usual care, and demonstrates comparable efficacy to maintenance antidepressant medication.”

There are many reasons why MBCT is so effective at treating depression. ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892)) People learn skills that they can use in the real world, and empathize with each other. The following are concepts that MBCT can teach people to set them up for success in life after rehab.

A Greater Sense of Control

MBCT helps people feel more in control of their depression—and their lives. Learning how depression works gives patients a better understanding of their overall experience. And practicing the techniques to counteract their symptoms is empowering. It helps people feel like they have more power over their thoughts and feelings.

Mandy, a patient in an MBCT study on recurrent depression, ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892)) said she learned “how the mind works” which gave her a better insight into her depression. She found the MBCT sessions “so liberating” because they gave her the tools to take control of her mental health. This “toolbox” included things like meditation, recognizing depressive symptoms, and reaching out to social contacts.

Other patients in the same study echoed Mandy’s sentiments. Some participants described it as “a shift from being a ‘helpless victim of circumstance’ to having more ‘control of my feelings and my life.’”

More Incentive to Manage Well-Being

Mindfulness practices are one way to engage in self-care. The techniques that MBCT teaches you serve as important ways of giving back—to yourself. And because people now have this toolbox, they’re more likely to use what they’ve learned to take care of themselves.

Some patients in one study noted that gaining more control over their thoughts, emotions, and behaviors gave them a greater sense of responsibility to manage their overall well-being. ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892)) They felt they could actually do something about it. They mentioned that self-care was no longer an option—instead, it became a necessary component of their routine.

Peer Interactions Are Beneficial

Patients can benefit from being around peers in MBCT group therapy They can share experiences and receive advice. And realizing that other people have the same feelings as them can decrease the shame they feel about their condition.

Some people in the MBCT study were ashamed of their depression and antidepressant use. ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892)) One participant felt “‘inadequate’ or unable to cope with life compared with other people because of their recurrent depression, treating it as a ‘guilty secret.’” Some patients were too embarrassed to admit to their depression or that they were taking medication.

Participants agreed that meeting other people in the group helped normalize their experiences. One participant said that being around others with depression ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892)) “confirmed that I am a human, worthwhile person.” And another said, “I don’t feel any more when I take my pill every morning that there’s something wrong with me.” These interactions with peers helped participants accept their condition—and themselves.

Participating in Hobbies Improves Quality of Life

MBCT sessions teach people the importance of engaging in activities they enjoy. Therapists encourage patients to try new hobbies and pursue old interests. But this isn’t just for fun—it’s backed by science. People with hobbies have overall better mental health, ((Li, Z., Dai, J., Wu, N., Jia, Y., Gao, J., & Fu, H. (2019). Effect of long working hours on depression and mental well-being among employees in shanghai: The role of having leisure hobbies. International Journal of Environmental Research and Public Health, 16(24), 4980. https://doi.org/10.3390/ijerph16244980)) and reduced rates of depression.

Participants in one study said that MBCT reminded them to do what they enjoy ((Tickell, A., Byng, R., Crane, C., Gradinger, F., Hayes, R., Robson, J., Cardy, J., Weaver, A., Morant, N., & Kuyken, W. (2020). Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: A qualitative study with illustrative case studies. BMJ Open, 10(2), e033892. https://doi.org/10.1136/bmjopen-2019-033892))—and to feel excited about life again. One person said, “I rearranged my life so that the things I do now are things that I enjoy and want to do.” And another continued, “I am now making bigger future plans to make my life better and introducing new ventures.”

Better Understanding of Relapse (and How to Prevent It)

In mindfulness-based cognitive therapy, patients learn how to recognize the early warning signs of a depressive relapse. And how to employ MBCT strategies to avoid it.

Some MCBT participants mentioned that they felt less panicked when they did experience negative feelings. They were able to accept their sad feelings, and not immediately assume it was a relapse. One said they felt better equipped to handle mood fluctuations. Instead of getting upset when they felt negative emotions, they told themselves, “Okay, this is how you’re feeling today.”

Limitations of MBCT

MBCT might not work for everyone. Because MBCT is typically a group therapy, you may find it overwhelming if you have severe social anxiety. And for some people, MBCT works best in combination with antidepressants. MBCT alone might not work well enough for everyone—and that’s perfectly alright. The idea here is to try different methods to find what will work best for you.

Healing Your Depression, Mindfully

You are worthy of care, in whatever way works best for you.

This might look like attending rehab, or just seeking MBCT on your own. It’s up to you to determine what your recovery process will look like. If you decide to go to rehab, this could be your chance to take a step back and give yourself much-needed time to heal.

Explore treatment centers that provide MBCT to contact rehab facilities directly and ask about pricing, insurance, virtual tours, and more.

Reviewed by Rajnandini Rathod

Talking about trauma isn’t easy—it’s often emotionally draining, and it can even be retraumatizing. That’s why alternative therapies like EMDR can be a helpful part of your treatment plan.

Eye Movement Desensitization and Reprocessing (EMDR) uses eye movements to reframe traumatic memories. While that might seem unusual, this therapy works for many people and can be effective in a short amount of time. Rehabs often use EMDR as a supplemental therapy to ease the intensity of trauma symptoms.

What is EMDR?

EMDR is a trauma treatment technique ((Landin-Romero, R., Moreno-Alcazar, A., Pagani, M., & Amann, B. L. (2018). How does eye movement desensitization and reprocessing therapy work? A systematic review on suggested mechanisms of action. Frontiers in Psychology, 9, 1395. https://doi.org/10.3389/fpsyg.2018.01395)) that helps you process disturbing memories. It was developed by psychologist Francine Shapiro, who got the idea while walking in a park. She noticed certain rapid eye movements decreased the intensity of her intrusive thoughts. Then she realized something important: if she controlled her eye movements while thinking about an upsetting memory, it reduced her anxious feelings.

Since then, EMDR has gained popularity. More clinicians are becoming certified to practice it, and more people are trying it.

Tony Tan, CEO of 180 Sanctuary At PuriPai Villa, explains its premise:

“Basically, we are using eye movement to desensitize and reprocess traumatic memories. We don’t erase the memory, but we can reduce the impact of the response.

Usually with someone who’s traumatized, their behavior seems to be paralyzed. When they can’t overcome certain kinds of strong emotions or flashbacks, that affects their daily functionality.

“So EMDR is mainly administered in treatment to help the person reduce their response to traumatic memories, to help them function better day-to-day. They can coexist with their memory, but we dull the traumatic response.”

How Do EMDR Sessions Work?

EMDR sessions usually last for about 50 to 90 minutes. Your therapist will help you determine how many sessions are necessary. This usually depends on the severity of your trauma.

According to standard treatment protocol, EMDR treatment should take place over 8 phases: ((

Phase 1: History Taking

In this phase, your clinician will review your trauma history and create a treatment plan. This plan determines which memories and situations to focus on during EMDR, and in what order. For example, you may focus on childhood trauma first, and move onto adult issues later.

Phase 2: Preparation and Stabilization

Your therapist explains how treatment works and addresses any concerns you have. You’ll decide on a stop signal if you need to take a break from processing. You’ll also work together to develop coping mechanisms like stress reduction techniques, which you can practice using between sessions.

Revisiting traumatic experiences can be emotional, so it’s perfectly alright if you need to pause.

Phase 3: Assessment

In this phase, you’ll visualize the traumatic event. Your therapist might ask you to write down all of your memories related to the trauma. Then, you’ll rate how uncomfortable each event made you feel, usually on a scale of 1 to 10. After that exercise, you’ll discuss any feelings, thoughts, or sensations it brought up. You may choose one memory to focus on in future sessions.

Phases 4-6: Reprocessing

This is the heart of EMDR, where you’ll learn to reprocess your trauma and become less sensitive to it. You’ll do this using what’s known as bilateral stimulation:

• eye movements (following a light or your therapist’s finger with your eyes)
• auditory tones
• tactile taps (alternating tapping movements)

Your therapist will use one of the above techniques while you focus on an image, thought, emotion, or sensation related to the trauma. At the end of each set, they’ll ask you to let your mind go blank, and to notice whatever comes to mind. During this stage, you might experience the following:

• new insights or understanding about the trauma
• a positive change in your emotional response
• reframing negative thoughts to positive ones

Throughout the session, your therapist might use techniques like these to bring you back to the present moment if you start to feel overwhelmed:

• prompting you to focus on a positive belief
• doing a body scan to check in with yourself physically

Phase 7: Closure

Before you leave a session, your therapist will guide you through relaxation techniques to help reinstate emotional stability. You can also use these in between sessions. Your therapist might ask you to keep a log to record any related thoughts, feelings, or sensations that arise the week after your session.

Phase 8: Reevaluation

Each session may start with a follow-up from the prior one. Your therapist can use this time to ask for feedback and evaluate your progress. This helps determine if you need to keep working on the same issues, or move on to new ones.

Which Conditions Does it Treat?

EMDR is often recommended for PTSD, ((Recommendations | Post-traumatic stress disorder | Guidance | NICE. (n.d.). Retrieved from https://www.nice.org.uk/guidance/ng116/chapter/recommendations)) but can also be used to treat the following conditions:

• post-traumatic stress disorder (PTSD)
• anxiety disorders
• panic disorder
• depression
• addiction
• obsessive-compulsive disorder (OCD)
• eating disorders

“My Traumatic Thoughts Don’t Come to the Forefront of My Everyday Life”

People with PTSD often experience flashbacks resulting from triggers related to a traumatic event. EMDR helps patients reprocess memories ((World Health Organization. Guidelines for the management of conditions specifically related to stress. Geneva: WHO, 2013.)) so they’re not as easily distressed when faced with those triggers.

Roger Rodriguez, a senior flight nurse who often went into life-threatening combat war zones, was diagnosed with PTSD ((Ptsd eye movement desensitization and reprocessing therapy | aboutface. (n.d.). Retrieved from https://www.ptsd.va.gov/apps/aboutFace/therapies/emdr.html)) after years in the field. Rodriguez said that after each session, he felt a “little weight” lifted off his shoulders. Eventually, he went from spending hours alone in his room to once again being the family man that everyone knew and loved.

“My traumatic thoughts don’t come to the forefront of my everyday life and consume my thoughts,” he said. “They have been processed and placed into long-term memory where they belong.”

Discover EMDR in Trauma Treatment

Trauma recovery has its challenges, but life on the other side of healing is so worth it. And in rehab, you’ll be surrounded by professionals who can help you see those challenges through in a safe and supported way.

Discover rehab centers with EMDR treatment to compare programs and speak with experts about trauma therapies that can help you.

Reviewed by Rajnandini Rathod

If you’re trying to help a child who’s experienced trauma, it can be hard to know what to do. They may suffer from post-traumatic stress symptoms like nightmares, anxiety, or behavioral issues. It can feel like neither of you has control over their trauma responses. And that can put more stress on your child and your family.

Thankfully, trauma-focused cognitive behavioral therapy, a family-focused type of talk therapy, can help your child heal from their trauma. They get to relearn that the world is a safe place full of trustworthy people—namely you.

TF-CBT may be offered as part of family therapy at rehab. This therapy, along with others, can give you tools, space, and support to work through your child’s healing journey.

What Is Trauma-Focused Cognitive Behavioral Therapy?

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based treatment for families looking to heal a child’s past trauma. ((Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused cognitive behavioral therapy for traumatized children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005)) It’s a form of CBT designed specifically for children and adolescents, and focuses heavily on caregiver involvement. Treatment takes place over the course of 8-25 sessions, which both you and your child attend.

During individual sessions, your child will work on dealing with negative thoughts, feelings, and behaviors resulting from trauma with healthy coping skills. They’ll also be able to process their trauma in a safe, supportive environment.

Caregivers’ individual sessions are designed to teach positive parenting strategies. You’ll learn how to best support your child when they feel the need to talk.

During joint sessions with your therapist, you’ll work on practicing those skills to strengthen your relationship and encourage more open communication. There is a lot of flexibility in how quickly you move through TF-CBT, so you can work at your pace.

Who Can TF-CBT Help?

Treatment professionals use TF-CBT to help children aged 3-18 overcome trauma symptoms and learn healthy coping strategies. It can also address depression or behavioral issues stemming from childhood trauma. Children don’t need a post-traumatic stress disorder (PTSD) diagnosis to benefit from TF-CBT.

Both the caregiver(s) and child take part in therapy sessions. Abusive or otherwise traumatic caregivers are excluded from participating. ((Ramirez de Arellano, M. A., Lyman, D. R., Jobe-Shields, L., George, P., Dougherty, R. H., Daniels, A. S., Ghose, S. S., Huang, L., & Delphin-Rittmon, M. E. (2014). Trauma-focused cognitive behavioral therapy: Assessing the evidence. Psychiatric Services (Washington, D.C.), 65(5), 591–602. https://doi.org/10.1176/appi.ps.201300255))

Is it Effective?

TF-CBT is shown to be effective in improving PTSD symptoms. Components of TF-CBT can also effectively reduce the frequency and intensity of nightmares ((Levrier, K., Marchand, A., Belleville, G., Dominic, B.-P., & Guay, S. (2016). Nightmare frequency, nightmare distress and the efficiency of trauma-focused cognitive behavioral therapy for post-traumatic stress disorder. Archives of Trauma Research, 5(3), e33051. https://doi.org/10.5812/atr.33051)) among children who have suffered trauma.

It can also lessen the symptoms of other mental and behavioral issues in children with trauma. In TF-CBT, children gain important emotional regulation strategies. ((Farnia, V., Naami, A., Zargar, Y., Davoodi, I., Salemi, S., Tatari, F., Kazemi, A., Basanj, B., Jouybari, T. A., & Alikhani, M. (2018). Comparison of trauma-focused cognitive behavioral therapy and theory of mind: Improvement of posttraumatic growth and emotion regulation strategies. Journal of Education and Health Promotion, 7, 58. https://doi.org/10.4103/jehp.jehp_140_17))

Studies also show that TF-CBT can increase caregivers’ ability to parent positively and lessen their emotional distress. ((Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused cognitive behavioral therapy for traumatized children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005))

How Can You Access TF-CBT?

Treatment is done via weekly sessions with a therapist.

Some rehabs cater specifically to young people. If you’re interested in TF-CBT and other trauma-specific therapies, ask potential treatment centers about their clinical staff qualifications and how they involve family in your child’s treatment process.

What to Expect: TF-CBT in 3 Phases

TF-CBT takes place in 3 stages ((Cohen, J. A., & Mannarino, A. P. (2015). Trauma-focused cognitive behavioral therapy for traumatized children and families. Child and Adolescent Psychiatric Clinics of North America, 24(3), 557–570. https://doi.org/10.1016/j.chc.2015.02.005)) to gradually increase exposure to trauma reminders. This way, your child isn’t confronted with their trauma without skills necessary to safely address it.

1. Stabilization:

This phase helps children and caregivers understand trauma in general.

Your therapists will explain to your child what trauma is and how it can show up in their lives after it’s over.

Meanwhile, you’ll learn important safety information. For example, if your child has been sexually assaulted, you’ll learn to communicate with them about appropriate vs. inappropriate touches. Your therapist will also teach you to identify cues that might trigger your child.

Trauma Narration and Processing

In this phase, therapists work with your child to describe their trauma in detail.

Because TF-CBT builds up your child’s resilience in the previous stage, they’ll be better prepared to handle their trauma using healthy coping strategies. This stage helps them reclaim their own experience.

During the session, you’ll hear your child’s trauma narrative read by your therapist. While this can be extremely difficult, your therapist will be there to support you and help you move through feelings that arise.

Integration and Consolidation

During this phase, you’ll begin joint sessions. Your child will share their trauma narrative with you face-to-face. Then, you can ask questions and share feelings. This phase improves the connection and understanding between you and your child.

The Goals of This Therapy

TF-CBT works on 8 key components to improve the lives of children and their caregivers:

• education about trauma and positive parenting skills
• techniques for relaxation
• emotional regulation skills
• understanding of the connection between thoughts, feelings, and behaviors
• mastery over past trauma through recounting exercises
• gradual exposure to reminders of trauma
• improved communication and connection between caregivers and child
• personal health and safety skills

Limitations of TF-CBT

TF-CBT has not been studied for effectiveness for children who have intellectual disabilities. Not only are these children more at risk for exposure to trauma, ((Mevissen, L., Didden, R., Korzilius, H., & de Jongh, A. (2016). Assessing posttraumatic stress disorder in children with mild to borderline intellectual disabilities. European Journal of Psychotraumatology, 7, 10.3402/ejpt.v7.29786.
https://doi.org/10.3402/ejpt.v7.29786)) they’re also at a higher risk of developing PTSD. It’s an area that needs more research.

If you are the caregiver to a neurodivergent child, read more about how to find neurodiversity-affirming treatment.

Rehab Can Help You Reconnect With Your Child After Trauma

As a caregiver, you want to protect your child from anything bad that could ever happen to them. That’s why it’s so hard to handle when something does.

Trauma-specialized rehabs use treatments like trauma-focused cognitive behavioral therapy to allow both you and your child to make peace with the past and move forward.

Visit our searchable directory of treatment centers offering family therapy to learn more about their programs, facilities, pricing, insurance, and more.

Reviewed by Rajnandini Rathod