Psychosocial treatment approaches for substance use disorders

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Summary

When it comes to treatment for substance use disorders, there’s no silver bullet. Medications can be important to support people with their recovery goals, but psychosocial treatments can provide a different kind of support and ensure medications provide the most benefit possible.

In this episode, Christina Chant and David Ball talk with guests about psychosocial treatment approaches for substance-related harm. What do psychosocial treatments look like in practice, and how do they support people to improve their health in relation to substance use?
 

Lineup

In this episode, you’ll hear:

• 1:54 – Sarah Irving – Substance use counsellor
• 15:44 – Sekani Dakelth – Health Advocate

 
Pearls

Here’s what listeners can take away from this episode:

1. Psychosocial treatment options are diverse and include cognitive behavioural therapy, trauma therapy, contingency management and others. These treatment options may be effective alone and in combination with pharmacotherapy or community-based programs. The social determinants of health play a significant role in the access to – and effectiveness of – these diverse treatments.
2. While many psychosocial treatment options are offered by specialists, motivational interviewing is one effective option that can be delivered by primary care clinicians with appropriate training. Other psychosocial supports that aren’t delivered by clinicians may also support client recovery or healing goals, including 12-step programs or culture-based interventions. Culture-based interventions for Indigenous people, focus on cultural practices and Indigenous ways of knowing that provide a connection to and enhance cultural identity.
3. To support success around psychosocial treatment. It’s important first to centre the relationship of yourself and the client. From there, ask the client, “what are your goals?” How do these goals relate to substance use and other aspects of their life? From there, you can offer the relevant treatment opportunities that match those goals. Having an expansive idea about what recovery can look like is important in recognizing people’s full humanity.

 
Resources

De-centring western colonial approaches

• What is land-based treatment and healing?, a document from First Nations Health Authority
• Beyond counselling: community and culture as healing

Online learning

• Addiction Care and Treatment Online Course (Online, self-paced, free) — See Module 16, Psychosocial treatment interventions and recovery-oriented supports

Articles

• European Monitoring Centre for Drugs and Drug Addiction. How can contingency management support treatment for substance use disorders? A systematic review. Luxembourg: Publications Office of the European Union; 2016.
• Gaznick N., Judd P.A. (2020) Psychosocial Treatment of Substance Use Disorders. In: Marienfeld C. (eds) Absolute Addiction Psychiatry Review. Springer, Cham. https://doi.org/10.1007/978-3-030-33404-8_5
• Jhanjee S. (2014). Evidence based psychosocial interventions in substance use. Indian journal of psychological medicine, 36(2), 112–118. https://doi.org/10.4103/0253-7176.130960
• Rowan, M., Poole, N., Shea, B. et al. (2014). Cultural interventions to treat addictions in Indigenous populations: findings from a scoping study. Subst Abuse Treat Prev Policy 9, 34. https://doi.org/10.1186/1747-597X-9-34
• Smedslund G, Berg RC, Hammerstrom KT, et al. (2011). Motivational interviewing for substance abuse. Cochrane Database of Systematic Reviews. (5).

Additional resources

• MindmapBC, a database of outpatient mental health services focussed on services that are affirming of 2S/LGBTQ+ (Two-Spirit, as well as lesbian, gay, bisexual, trans, queer, and other gender- and sexually-diverse) people.