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Because of the predominance of the Minnesota Model and its focus on a single outpatient aftercare treatment method, effective complementary treatment methods are even more important than usually understood.
There are hundreds of therapeutic treatments for substance abuse, misuse, and dependence. Many, perhaps most of these treatments do not have clear clinical evidence of efficacy. Only a handful of these predominate across the vast majority of the thousands of treatment facilities worldwide.
The Minnesota Model of addiction treatment
The majority of substance addiction rehabs throughout the world use a Minnesota Model of treatment. First created in the US in the 1950s, it remains the most popular form of treatment. The marketing advantages of the 12-step self-help group model cannot be denied. Essentially free (no dues or fees, all donations are voluntary).
That said, the Minnesota Model is more than the core 12-step programme within it. It first began on the side of the medical community as welcoming in the lay-persons who wanted to share their message and demonstrate the success of a path to recovery for the afflicted. Doctors still lead the hospital and the programmes, but former addicts and alcoholics were invited to work with the patients.
Psychologists and psychiatrists still have their treatment protocols and expertise external to the 12 steps, though over time, and especially in private rehabs, the 12 steps have become the main focus and other psychological treatments such as cognitive behavioural therapy, motivational interviewing, and the like, are seen as useful complementary therapies .
Cognitive Behavioural Therapy (CBT) is another well-documented and well-used treatment method, and in the rare cases that a 12 step programme is not in use, becomes the primary treatment method. In many cases CBT is used in conjunction with the 12 steps.
Importance of effective complementary treatments
It is important to include additional treatment methods in any comprehensive treatment programme for substance addiction, misuse and dependence. We would suggest that those complementary treatments which are very unlike the 12-step programme should be highlighted, while at the same time providing clear understanding of their limitations.
There are two treatment methods which have become increasingly popular over the past several decades. Both are actually most effective when used as a treatment for depression and posttraumatic stress disorder. However, both are increasingly available at innovative substance addiction treatment facilities. These two are: Mindfulness-Based Stress Reduction and Equine-Assisted Therapy.
This is a complementary therapy which has been used in various therapeutic contexts. In Thailand, this treatment is now being used for the first time to help overcome substance addiction and dependence. While research into this treatment is still developing, well-designed studies indicate promising effectiveness.
Inpatient Addiction Treatment at Siam Rehab in Chiang Rai, Northern Thailand now offers equine-assisted therapy as a part of its comprehensive substance addiction treatment programme. Horses are now a part of the journey to recovery at this boutique addiction rehab nestled in the foothills of Northern Thailand. Increasingly popular in North America and Europe, this intriguing complementary therapy is available for the first time in Thailand.
The equine-assisted therapy is not therapeutic riding or grooming activities, but a method called equicoaching. Equine-assisted therapy sessions are conducted by equicoaching expert and educator Eric Van Poucke, who has published four books on the subject. Many clients see real value in the addition of horses to their therapy regimen, and cherish their experience with Eric and the horses as providing meaningful insight which complements the other aspects of the holistic, integrated addiction treatment programme at Siam Rehab in Thailand.
Mindfulness-based stress reduction (MBSR)
This treatment was founded in 1979 by Dr Jon Kabat-Zinn. He has successfully implemented a meditation protocol that has strong evidence for its efficacy for patients with serious medical conditions and who suffered from stress brought on by those situations. MBSR has found to be especially effective in treating posttraumatic stress disorder and depression. This treatment has been extended to substance addiction treatment, though usually only after an extended period of abstinence.
There are are variety of mindfulness and meditation programmes available in substance treatment rehabs in Thailand. As a Buddhist country with a long history of meditation, this practice is common and found throughout the country.
However, as with other treatments, it is important to follow tested and validated treatment protocols with MBSR, which is a set of meditation techniques. Trainers require certification and to adhere to appropriate methods. At the same time, online training is an option, which can provide effective and sufficient support.
Complementary and supplementary treatment protocols
Both Mindfulness and Equine-Assisted Therapy are similar in several ways. First, they are experiential rather than language-based treatments. Both are also task- and goal-oriented, in that there are practical goals to achieve in the practice. And finally, similar to other complementary treatments, they need to have effective integration with core treatments such as the 12 steps/self-help groups, and require validated protocols in order to ensure their effectiveness.
Dennis Relojo-Howell is the world’s first blog psychologist and founder of Psychreg. He writes for the American Psychological Association and for other online publications.
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