Integrating Rehabilitation Psychology in the Treatment of Substance Use Disorders: Pathways to Recovery

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Imagine waking up every day trapped in a cycle you can’t seem to break—your mind, body, and emotions entangled in a battle with substance addiction. It's not just about willpower; it's a complex web of physical cravings, emotional turmoil, and psychological dependence. This is where rehabilitation psychology steps in, offering a path to healing by addressing the mind as much as the body. In this blog, we’ll explore how rehabilitation psychology transforms the lives of those struggling with addiction, offering hope and tools for recovery.


The study and use of psychological knowledge and skills to support people with disabilities and long-term medical conditions, to improve their overall health, independence, quality of life, and capacity for social interaction, is Rehabilitation Psychology. To help people overcome obstacles that prevent them from engaging in different activities of daily living, psychologists typically work in groups to address cognitive, emotional, and functional issues.


Trained psychologists play an important role in the treatment of people going through drug addiction and try to understand or figure out the underlying reason for their addictive and destructive behaviour and work on ways to overcome this behaviour. Through counselling and therapy, individuals can gain insight into their behaviour and can develop positive coping mechanisms that can help them in the future, they also get to know about the risks associated with drugs and how it affects everyone around them. 


What is Substance Use Disorder?
Substance Use Disorder or SUD, is a complex mental health condition in which a person has a problematic or destructive behaviour of substance use, it is to a certain point where the person is dependent on them for even their day-to-day tasks and feels distressed and has withdrawal symptoms when they aren’t able to use the substances. When these drugs are used frequently, people's attitudes, behaviours, and thought patterns may change. Repeated use of these substances can lead to changes in their thinking pattern, behaviour and attitudes. The main goal of people using substances is to be intoxicated: the feeling of calmness, intense pleasure, and euphoria for a short period. A few examples of these drugs are alcohol, cannabis, hypnotics, sedatives, cocaine, tobacco/nicotine 

People use substances or drugs for any reason, and this can be based on many factors such as circumstance, and environment which can be influenced, a few common reasons are as follows:

- coping with stress 

- social influence or peer pressure 

- experimentation 

- euphoria 

- self-medication 

- escaping reality


Although SUD and other mental disorders are caused by one another, a person with SUD can also have other mental disorders like anxiety, depression, bipolar etc. 

SUDs or any addiction not only affect the person's physical, and mental health, self-esteem, and finances but it also affects the family members, friends and social situations. In family relations, the children and partners of people dealing with SUD are affected most, and it also creates a strain on family finances. In a social setting, the change in behaviour and personality caused by the drugs leads to social isolation, and it also affects their work environment. So, rehabilitation psychology is not only needed for SUD patients but also for the people closest to them. 

Due to the serious nature of SUD, recovery usually consists of treatment to address both the physical and psychological components. Rehabilitation psychology plays a major role in addressing these psychological components as it focuses on understanding and betterment of the individuals affected by SUD. We understand what Substance Use Disorder (SUD) and rehabilitation psychology are, but how do they work?

It helps individuals with SUD develop healthier ways to cope with difficult situations, resist cravings, and modify maladaptive behaviour; in other words, it helps with Behavioural modification. 

- People dealing with SUD have trouble managing their emotions and end up using substances to deal with these emotions such as stress, trauma and negative emotions. Rehabilitation psychology helps people find ways to regulate anxiety, emotions and underlying mental health issues.

- Rehabilitation psychology helps develop skills and strategies to prevent relapse. Psychologists work to identify triggers and high-risk situations that may lead to substance use, instead, they teach individuals how to manage the craving. They also help build resilience and maintain long-term sobriety. 


A few types of psychological treatment used to treat SUD are:

Cognitive Behavioral Therapy [CBT] is one of the most commonly used therapy methods. It helps the client to understand negative and problematic patterns of behaviour, belief and thinking that contribute to substance use. Help to develop healthier coping mechanisms, and also try to fix the underlying mental health issues. Contingency Management [CM] is a behavioural therapy that uses a system of rewards to reinforce the desirable behaviour.

Dialectical Behavior Therapy [DBT] is a form of cognitive behavioural therapy focusing more on helping individuals manage intense emotions and improve personal relations. 

12-Step Facilitation Therapy is based on Alcoholics Anonymous and other 12-step processes, which encourage peer support and fellowship. It promotes psychological, behavioural, and spiritual growth through self-reflection. Family Therapy involves the client's loved ones in the process, it tries to address the dynamics in the family that might lead to the use of substances.   


While rehabilitation psychology has been highly effective in many cases, there are instances where it seems to have little to no impact. If the same treatment is used, why do the results vary so much?

The effectiveness is based on many factors 

  • The readiness of the person to engage in therapy and to make lifestyle changes. The social environment also plays an important role by being supportive and encouraging these positive changes in behaviour

  • Quality and attentiveness to the therapeutic relationship are needed to establish trust and promote change, not only these but also the availability and affordability of treatment options directly affect the chances of successful rehabilitation. 



Is rehabilitation psychology easy to implement and successful? Not exactly. There are several challenges faced in the field, including the following: 

  • Individuals dealing with SUD may also suffer from other mental health disorders such as depression, anxiety, and PTSD which can complicate the rehabilitation process 

  • There is always a risk of relapse in SUD cases, even during and after the process has taken place, which can be caused by triggers they haven’t been able to control such as peer pressure, family dysfunction, and stress. 

  • Even if psychological rehabilitation has helped the person , social stigma associated with addiction often leads to social isolation and can lead them to be reluctant to engage in talking about their feelings and seeking help. 

  • Cost and availability of the treatment and care sometimes pull the break from doing it. 


While challenges and stigma exist around rehabilitation psychology, and some cases show little visible change, the question remains: why pursue it? Despite the obstacles, the positives outweigh the negatives. Even in cases where full recovery isn't achieved, any progress — no matter how small — is a victory. In the journey of recovery, every step forward is valuable, and even the slightest improvement can make a meaningful difference in the lives of those struggling with SUD. Any help, however modest, is both impactful and necessary.


About The Author 


Meet Ria, a lively first-year student who's always buzzing with energy! She's super talkative and loves striking up conversations with anyone around. When she’s not chatting away, you’ll likely find her binge-watching the latest shows and movies. She’s the go-to person for recommendations! Fashion is another one of her passions, and she has a knack for effortlessly putting together stylish outfits. Always fun to be around, Ria brings a bright, enthusiastic vibe wherever she goes!




References: 

Brigette Torrise, M.D. What Is a Substance Use Disorder?

https://www.psychiatry.org/patients-families/addiction-substance-use-disorders/what-is-a-substance-use-disorder 


 National Institute of Mental Health. Substance Use and Co-Occurring Mental Disorders.https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health 


American Psychology Association. Rehabilitation Psychology.

https://www.apa.org/ed/graduate/specialize/rehabilitation 


Substance Use Disorder (SUD).

https://my.clevelandclinic.org/health/diseases/16652-drug-addiction-substance-use-disorder-sud 


Dr. Vishal Kasal

Written by Madappa P.S. Effective Rehabilitation from Substance and Drug Abuse: Journey Towards Healing.

https://www.cadabams.org/blog/substance-abuse-and-rehabilitation 


Centre for Substance Abuse Treatment. Substance Abuse: Clinical Issues in Intensive Outpatient Treatment. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2006. (Treatment Improvement Protocol (TIP) Series, No. 47.) Chapter 7. Clinical Issues, Challenges, and Strategies in Intensive Outpatient Treatment. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64101/ 


The 6 challenges for rehabilitation and clinical practice in 2021. Retrieved from 

https://rehand.net/en/6-challenges-for-telerehabilitation-and-hand-therapy-in-2021/ 

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