If you or a loved one is struggling with a substance use disorder (SUD) or addiction, you are likely wanting treatment that you know will work – one that will provide the person struggling with a SUD the best opportunity for a full recovery. Evidence-Based Practices could be the best solution for you.
Evidence-based practices (EBP) are those that are empirically-backed. In other words, there is research to support their effectiveness in treating SUDs and at producing positive outcomes in recovery. For this reason, when looking for a rehab or treatment center, it is essential that the center offers programming and interventions based upon EBP. 
This isn’t to say that EBP does not come with its challenges when being applied to real-world clinical settings. For example, highly-structured or manualized EBP, such as Cognitive Behavioral Therapy, may be difficult to tailor to individualized needs or the clinician implementing these strategies may not be well-trained in that EBP and thus weaken the intervention’s effectiveness.
Because of these limitations, it is essential to keep in mind that individualized treatment along with the implementation of EBPs by clinicians who are adequately trained are also important when considering positive treatment outcomes. [1, 4]
Current Evidence-Based Practices
Currently, the following treatment modalities are considered EBP for SUDs.
Please note that different modalities may be more or less effective given the type of substance use disorder, the population served (for example, adults versus adolescents), therapeutic setting (for example, inpatient or outpatient treatment settings, group or individual counseling settings), or if there are co-occurring disorders (for example, SUD along with depression or anxiety).
Additionally, the following list is not exhaustive, yet represents the most well-known and commonly used EBP in SUD treatment: [1, 2, 3]
- 12-Step Facilitation Therapy
- Cognitive Behavioral Therapy
- Dialectical Behavior Therapy
- Contingency Management
- Community Reinforcement Approach Plus Vouchers
- Motivational Interviewing
- Motivational Enhancement Therapy
- The Matrix Model
- Relapse Prevention Therapy
- Behavioral Couples Therapy
- Family Behavior Therapy
- Multidimensional Family Therapy
- Prized-Based Contingency Management
- Seeking Safety
- Pharmacological Therapies:Acamprosate (Campral®) for Alcohol Use
- Buprenorphine (Suboxone® and Subutex®) for Heroin or Opiate Use
- Nicotine Replace Therapy for Tobacco Use
- Methadone Maintenance Therapy for Heroin or Opiate Use
- Naltrexone for Alcohol or Opiate Use
- Bupropion (Zyban®) and Varenicline (Chantix®) for Tobacco Use
- Disulfiram (Antabuse®) for Alcohol Use
Finding a rehab that uses Evidence-Based Practices
When vetting a rehab or treatment center, below are some suggested questions along with their explanations of why they’re important to ask: [1, 5, 6, 7]
Question: Are your practices based on current research or on program outcomes?
Why it’s important: Ideally, a center will utilize EBP as well as consistently evaluate their program to ensure that their implementation of EBP is actually effective.
Question: How do you measure your success rates? Do you measure short-term and long-term outcomes?
Why it’s important: Those centers with strong program evaluation procedures in place will use both quantitative and qualitative data (for example, a valid and reliable substance use assessment along with a client satisfaction survey) both before and after a client has completed a program.
Centers with strong program evaluation procedures will follow-up with their clients both shortly after completing their program, as well as after some time has passed in order to monitor both short-term and long-term outcomes and revise their program accordingly.
Question: What are your research sources?
Why it’s important: You want to ensure that the center is using EBP that have strong research support. This means that the EBP utilized at the center are well-established modalities that have been researched by multiple, well-designed studies conducted by independent investigators that converge to support the EBP’s efficacy.
Question: Do you follow a comprehensive treatment model that is customized to your clients?
Why it’s important: No single treatment is right for everyone. Effective treatment is tailored to the individual and addresses all of the patient’s needs, not just his or her drug use.
This includes any co-occurring mental health disorders. One way a rehab can do this is to create individualized treatment plans with input from multiple providers that are reviewed regularly and modified to fit the patient’s changing needs.
Question: Are your staff/clinicians trained in any evidence-based modalities? If so, which ones?
Why it’s important: In order for EBP to be applied most effectively, clinicians that are implementing services must be trained in the modality. This is especially true for more structured and manualized therapies like Cognitive Behavioral and Dialectical Behavioral Therapies.
Question: Do you provide evidence-based pharmacological interventions?
Why it’s important: Medications are often an important part of SUD treatment, especially when combined with behavioral therapies.
Question: What is the typical length of stay for a client in this program?
Why it’s important: Staying in treatment long enough is critical for recovery. If lengths of stay are short, it may speak to problems with client satisfaction or organizational issues. You want to ensure that the lengths of stay reflect what is average or expected for that type of program.
Rehab and treatment centers can vary in their offerings and approaches to SUD treatment. It is often helpful to visit different centers and see which center may be the best fit for you.
While finding a rehab that utilizes EBP effectively is important, remember that it is also important to find a center that fits your unique recovery needs.
About the Author:
Chelsea Fielder-Jenks is a Licensed Professional Counselor in private practice in Austin, Texas. Chelsea works with individuals, families, and groups primarily from a Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) framework. She has extensive experience working with adolescents, families, and adults who struggle with eating, substance use, and various co-occurring mental health disorders. You can learn more about Chelsea and her private practice at ThriveCounselingAustin.com.
1. Glasner-Edwards, S., & Rawson, R. (2010). Evidence-Based Practices in Addiction Treatment: Review and Recommendations for Public Policy. Health Policy (Amsterdam, Netherlands), 97(2-3), 93–104. http://doi.org/10.1016/j.healthpol.2010.05.013
2. University of Washington Alcohol and Drug Abuse Institute. (2006). Evidence-Based Practices for Treating Substance Use Disorders: Matrix of Interventions. Retrieved from http://adai.washington.edu/ebp/matrix.pdf on June 26, 2018.
3. American Psychological Association, Division 12: Society of Clinical Psychology. (2016). Psychological Treatments. Retrieved from https://www.div12.org/treatments/ on 2018, June 28.
4. NIDA. (2018, January 17). Treatment Approaches for Drug Addiction. Retrieved from https://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction on 2018, June 28.
5. NIDA. (2018, January 17). Principles of Drug Addiction Treatment: A Research-Based Guide (Third Edition). Retrieved from https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition on 2018, June 28
6. American Psychological Association, Division 12: Society of Clinical Psychology. (2016). FAQ. Retrieved from https://www.div12.org/psychological-treatments/frequently-asked-questions/#support on 2018, June 28.
7. Rush, Brian. (2003). The evaluation of treatment services and systems for substance use disorders. Revista de Psiquiatria do Rio Grande do Sul, 25(3), 393-411. https://dx.doi.org/10.1590/S0101-81082003000300002
The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.
We at Addiction Hope understand that addictions result from a combination of environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.
Published on August 1, 2018
Reviewed by Jacquelyn Ekern, MS, LPC on August 1, 2018
Published on AddictionHope.com