Finding Addiction Treatment That Works: What to Look For and Questions to Ask When You Need Evidence-Based Treatment

This is the first in a five-part series. When you or a loved one suffers from a drug or alcohol addiction, you can’t rely on wishy-washy promises of recovery. You need treatment that will work—treatment with results—and your best chance of getting it is by finding a rehab center that employs “evidence-based treatments.” Evidence-based treatment, as its name suggests, comprises approaches to treating addiction that have been tried, tested and proven effective in clinical trials. The problem is that families and individuals in today’s treatment climate still often find themselves in the dark when it comes to finding evidence-based treatment that has been proven to work. This weekly, five-part series will help. Here you’ll get tips on what to look for and questions to ask when it comes to finding your best chance of recovery from a drug or alcohol addiction.

Evidence-Based Treatment Is Harder to Find Than You’d Expect 

That evidence-based treatment should drive standards of care in drug and alcohol rehab centers across America would seem like a no-brainer. But a look at the on-the-ground reality suggests this is not the case. A June 2012 report published by the National Center on Addiction and Substance Abuse at Columbia University (CASA) finds, for example, that “the vast majority of people in need of addiction treatment do not receive anything that approximates evidence-based care,” and adds that “only a small fraction of individuals receive interventions or treatment consistent with scientific knowledge about what works.” Moreover, even those treatments that have stood up to clinical testing, proving themselves a successful mode of treatment for substance use disorders, are not always routinely applied in clinical settings. Cognitive behavioral therapy (CBT) is one such example, as a study published in Behavior Research and Therapy suggests. Having demonstrated itself an effective treatment for psychiatric disorders like addiction, CBT is still often “unavailable” and “poorly delivered” in therapy settings, the study finds. Getting evidence-based treatment for addiction may be hard at least in part because of a training gap in evidence-based practices. The National Institute on Drug Abuse (NIDA) has found, for instance, that while 90 percent of privately funded substance abuse treatment programs offer CBT, one-third of these do not provide their counselors with formal training in CBT intervention and still fewer offer them guidance on how to adhere to standards of proficiency and accountability in CBT. Similar findings have pertained to other less well-known evidence-based practices for treating drug and alcohol addiction, such as motivational interviewing, contingency management and family therapy.

Tips for Finding Evidence-Based Treatment

Finding addiction treatment that works thus depends to a great degree on finding a drug and alcohol rehab program that delivers evidence-based clinical care to people with addictions. How do you go about doing this? The following tips can help: 1. Familiarize yourself with the key elements of evidence-based treatment and know what look for in a prospective program in each of these areas. Over the next four weeks, this series will unpack these elements in greater detail and equip you with questions to ask of any prospective treatment program’s intake specialists and clinical team. These elements of evidence-based treatment include:

  • A comprehensive assessment and individualized approach to care, as well as personal case management (week two of our series)
  • Medical best practices in the areas of detox, acute psychiatric care and nutritional health (week three)
  • Therapies proven effective in substance abuse treatment, namely, CBT, motivational interviewing, contingency management, a community reinforcement and family therapy (week four)
  • A developed aftercare program that provides ongoing support and services for chronic disease management (week five)

2. Know the latest research regarding evidenced-based treatment. There are plenty of resources that can help. Here are just a couple to get you started:

  • This NIDA fact sheet summarizes research findings on effective treatment approaches for drug abuse and addiction.
  • This quarterly bulletin Alcohol Alert put out by the National Institute on Alcohol Abuse and Alcoholism provides the latest updates on effective treatments for alcohol abuse and alcoholism.

3. With any prospective treatment program, inquire about the credentials of the clinician(s) in their given area of expertise. Don’t assume that just because someone says they do CBT that he or she is adequately trained in it and familiar with evidence-based standards for proficiency. Ask the therapist what these standards are and where he or she received training. Ask about the ways in which the highest clinical standards of excellence are met. Next week, Part Two of our series “Finding Addiction Treatment That Works” will explore two common buzzwords in the world of addiction recovery and tips for discerning whether they do, in fact, connote treatment that will work. By Kristina Robb-Dover @saintplussinner

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