Choosing an alcohol treatment program is not a one-size-fits-all approach. What works for one person might not work for another. A treatment that does the job of getting one individual sober may resonate differently with someone else. The treatment world has come a long way from the notion that there’s one “best” way to get better and avoid relapse. Between medical models, holistic approaches and everything in between, there is something for everyone, but not until one does their research.
Naturally, wanting to learn about what’s available can be overwhelming while under the stress of admitting there’s a problem with drinking. However, the time it takes to learn how a program can resonate and stick makes the research time worth it.
The 12-Step Model
The 12-step approach is the most popular form of alcohol treatment across America. Originating in the 1930s with Alcoholics Anonymous, it’s based on accepting one’s powerlessness to alcohol, surrendering to a higher power for help and working through a series of steps to get back on track.
Many treatment facilities apply 12-step principles to their daily offerings, and many patients find themselves attending AA meetings for continued support and accountability after their more formal efforts end. This is because accountability from a sponsor and built-in community support is powerful.
However, not all people are comfortable with the spiritual element. Some don’t believe in a higher power, and some feel admitting they’re powerless is contrary to their experience. Additionally, even treatment professionals do not always subscribe to the idea of addiction as a “disease” in line with 12-step logic.
The Medical Approach/MAT
The medical model comes from an entirely different perspective, suggesting that dependence is a matter of brain disorder with the need for medical intervention. Medication-assisted treatment (MAT) has grown increasingly popular over the years with drugs used and approved by the FDA that minimize cravings and block the pleasurable feelings one gets from drinking.
Naltrexone, acamprosate, and disulfiram are three FDA-approved medications used for different purposes. Naltrexone helps suppress the brain’s opioid receptors that make drinking feel good. Acamprosate works to restore chemical balance to the brain when one has stopped drinking. Disulfiram does not work with the intention of abstaining but for when alcohol is consumed, it creates an aversive reaction that causes someone to become sick if alcohol is consumed while on the drug.
Drinking habits can lead to severe physical dependence. Thus, residential facilities provide comprehensive medical interventions in a controlled environment for optimal safety. Facilities that provide alcohol rehab in deerfield beach or similar seaside locations often combine medication management with therapeutically-based offerings in settings designed to ensure minimal stress during this transitional period.
This works best for people who can take this medical approach to cure their drinking problem before transitioning to other elements of rehab. Those who have relapsed many times or are facing co-occurring mental health disorders will benefit more from the medical model over alternatives.
Counseling Based Approaches: CBT & Motivational Interviewing
Counseling-based approaches include cognitive-behavioral therapy (CBT) and motivational interviewing.
CBT emphasizes cognitive thought patterns and changes that help reduce drinking efforts, whereas motivational interviewing focuses on exploring one’s ambivalence about quitting.
CBT does not necessarily care about why someone started drinking; it cares more about practical skills learned now that someone wants a change. Those who need structure generally respond well to CBT and can have measurable outcomes through different levels of assessment during different sessions.
Motivational interviewing recognizes that most people who want to quit have mixed feelings about doing so, this is normal, and therapists should work with patients during these sessions instead of confronting them about being in denial.
Evidence-Based Counseling for CBT also takes into account those who appreciate science over spirituality. Whether or not this is the only course of action depends on whether effective counseling is preferred.
Holistic (Alternative) Approaches
Holistic treatment programs take an all-encompassing approach and are meant for someone who needs more than just accountability or another intervention in which they don’t feel they’re fully participating.
Whether involving yoga, guided meditation, acupuncture, nutritional elements, art therapy and mindfulness exercises like hiking up mountains or walking on beaches, holistic approaches do more than just attempt to treat the underlying illness, the aim is to treat this illness through consideration of mind, body and spirit.
Where this is beneficial is that it treats someone as a person first instead of someone with a problem. Many people find that addressing underlying stressors/traumas/disconnections help keep them sober far better than abstaining from alcohol for fear of being judged as part of other therapies.
Exercise-based programs have proven effective in helping people manage stress as well as regain physical health after years of losing sight of themselves because they were stuck in addiction.
Alternative approaches seek to include options not necessarily grounded by science but by potential improvement backed by findings over time. Negative perceptions include that they’re not rigorous enough or lacking in empirical support, neither of which are necessarily true, but rather, problems occur when sites solely use holistic efforts instead of evidence-based ones as well.
Abstinence vs Harm Reduction: Philosophy
There is no greater philosophical divide than the idea between abstinence versus harm-reduction efforts; where some believe that only sobriety is an acceptable option, others feel that cutting down from dangerous levels is progress until someone feels ready to join others in sobriety.
Advocates for abstinence-based programs note how those with severe dependencies lack control when it comes to drinking; they cannot merely drink two glasses of wine a night – they inevitably fall back into bad habits at least based on studies offering high failure rates.
Advocates for harm-reduction efforts note how abstinence means many people fail to ever enter rehab due to preconceived notions about stigma. Alcoholics should naturally be able to reduce their consumption patterns and learn proper coping mechanisms before deciding that their previous efforts weren’t sufficient.
While some people over time find controlled drinking becomes a part of their lifestyle instead of moderation on steroids, others find that sobriety is the only option ever truly available to them.
Thus, finding a middle ground where these challenges won’t be seen as problematic from either direction but instead respected through each person’s journey is imperative.
Inpatient vs Outpatient: Treatment Intensity
Beyond philosophy, there exists a spectrum between treatment intensity levels across programs as well. Inpatient or residential programs offer 24/7 support in a confined space where people no longer have access to alcohol or triggering situations; they are removed from their locations and brought into safe spaces for 30-, 60-, or 90-day stints.
Outpatient programs allow people to live at home while receiving treatment several times per week, intensive outpatient efforts include those where 9-20 hours minimum are expected; standard outpatient programs require fewer hours per week.
The debate between inpatient vs outpatient has less to do with differences in philosophy than situational factors, work/home obligations, financial availability, severity levels, people undergoing homeless situations should seek immediate outpatient care; those with stable homes and moderate issues can remain outpatient.
Making Your Choice
Choosing an alcohol treatment method doesn’t mean there’s one that works for everyone; instead, through nuanced options, positive findings exist when people believe their needs are met and align with specific philosophies.
Essentially, what’s most important to anyone seeking help is determining what feels most comfortable. Peer support? A 12-step program may be best. Science? A CBT-based offering is where one can go before another fails. Medical professionals? The medical model will definitely provide psychiatric support beyond drinking.
Whatever works best isn’t always what seems right, success rates must also be determined, how success is defined, what happens if someone relapses during treatment, can family members participate, what’s the aftercare plan?
Ultimately, the best treatment method is the one that will stick. This means finding something that works, and if it doesn’t, trying again through different means down the road should occur without shame as recovery isn’t always a straight line but rather an experimental one where responsibility at least acknowledges a newfound desire to adjust course.
