Researchers have developed effective behavioral and pharmaceutical
therapies to treat addiction — but addiction treatment practice hasn’t
caught up with the science. What can psychologists do to help?
BY LEA WINERMAN • Monitor staff
For more than five years, David Sheff watched his son Nic battle methamphetamine addiction. By age 25, Nic had been in and out of rehab and tried half a dozen
treatment programs. Some helped, temporarily. But always, he
had relapsed, ending up back on the streets, terrifying himself
and his parents.
might involve wilderness camping, abusive tactics labeled
“tough love,” and, most commonly, Alcoholics Anonymous and
Narcotics Anonymous, peer-support models that have helped
many addicts but failed many others.
It’s a brew of “pseudoscience, tradition and the best guesses
of people who are sincere, but that doesn’t mean they know
how to help,” as Sheff puts it.
There are many interrelated reasons for the science-practice
gap in drug treatment, including a long history of treating
drug addiction as a moral failing rather than a disease; a health
insurance industry that rarely covers substance abuse treatment;
and a fragmented state-by-state licensing system that doesn’t
always require addiction counselors to have adequate training.
To solve these problems, addiction experts say, our health
system has to move past saying that addiction is a disease,
and actually treat it like one, integrating it into the health and
mental health care systems.
And psychologists, who have helped to develop many of the
evidence-based behavioral treatments, have a role to play in that
There are many forms of evidence-based behavioral treatments
for substance abuse. Some of the most strongly supported
• Cognitive-behavioral therapy. CBT can help addicted
patients overcome substance abuse by teaching them to
recognize and avoid destructive thoughts and behaviors. A
cognitive-behavioral therapist can, for example, teach a patient
to recognize the triggers that cause his or her craving for drugs,
alcohol or nicotine, then avoid or manage those triggers.
• Motivational interviewing. This therapy technique
involves structured conversations that help patients increase
their motivation to overcome substance abuse by, for example,
helping them recognize the difference between how they are
living right now and how they wish to live in the future.