There are a number of different schools of therapy and two major modes of therapy. Space limitations prevent mentioning every specific type of therapy, but there are several different major paradigms or schools of therapy that can be used in the treatment of substance use disorders. These schools include:
The psychodynamic paradigm of therapy: This paradigm was originated by the famous psychologist Sigmund Freud. Typically, the approach of this school of thought is to try and ascertain how the results of interactions during childhood relationships lead to problems in later life. Most often, this school looks at unconscious mental processes that are played out in everyday behavior. At one time, this paradigm was the most common school of therapy; however, over the years, it has generally lost a significant portion of its popularity. Part of the reason is that traditional psychoanalysis in the Freudian sense is very lengthy and expensive. Today, briefer forms of psychodynamic therapy are more popular, and there is evidence that they can be useful in the treatment of substance use disorders. Individuals who are interested in exploring how the early relationships may have affected their substance use and other issues, and who are interested in understanding their motivations, may find this type of therapy appealing.
The behavioral school of therapy: This school of therapy attempts to directly treat behaviors without trying to develop much insight into motivation as is done in the psychodynamic paradigm. For instance, the development of medications like Antabuse that result in a person becoming violently ill if they take the medication and drink alcohol is based on the principle of aversion therapy that comes directly from the behavioral school of psychology. Behavioral techniques are often combined with other forms of therapy to enhance their effectiveness. It is rare for anyone to engage in strictly behavioral therapy.
Cognitive therapy: This paradigm explores the individual’s thinking patterns, attitudes, and expectations as they relate to behavior. The cognitive paradigm of psychology has risen in popularity as a direct reaction to both the psychodynamic and behavioral schools of psychology. In addition, the style of therapy that is most commonly used in the treatment of substance use disorders and probably can claim the most research support for its use is known as cognitive Behavioral Therapy (CBT). CBT applies the principles of cognitive psychology and behavioral psychology.
The humanistic school of therapy: The humanistic school of psychology was originated by the famous psychologist Carl Rogers who believed that the principles of psychodynamic psychology and behavioral psychology lacked a sense of real understanding of people. Humanistic psychology and humanistic therapy strive to help individuals “be all they can be.” The paradigm views many issues, such as substance use disorders, as situations that occur because people have a false impression of what is important in their lives, what types of things are worthy of striving for, and they place too much emphasis on what other people think. Even though Carl Rogers was the first famous psychologist to actually allow formal research to be done on therapy, and certain humanistic principles have been demonstrated to be very important in the success of therapy, therapists rarely adhere to a formal humanistic approach in the treatment of substance use disorders. Instead, most therapists apply Rogers’s notions of being empathetic, being genuine with clients in therapy, and having unconditional positive regard for clients in therapy in their treatment of individuals with substance use disorders. These three qualities emphasized by Rogers have been demonstrated to be important in the success of any type of therapy.