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Evidence-Based or Science-Based Addiction Treatment?

First of all, let’s call it science-based therapy (SBT) rather than evidence-based therapy (EBT). The cognitive-behavioral therapy (CBT) psychologists have essentially usurped the term EBT, and they argue that the only solid evidence is quantitative research. This is so pervasive that government officials refer to research as “the numbers.” It’s the most popular form of research because it’s quick and dirty, though the CBT types think that by relying on numbers makes their work “science.”

In medicine and existential-humanistic psychology, the argument is that SB is better than EB because it is a deeper issue, asking about the meaning of “evidence.” If I give a SSRI to a depressed person and she feels less depressed, that is EB. SB goes deeper, asking why this is so: Is a SSRI the best tx? Is a SSRI simply masking a problem? Is low serotonin turnover really what depression is about? etc. Some have even argued that we need EP…evidence proven, not EB.

In medicine and existential-humanistic psychology, the argument is that SBT is better than EBT because it is a deeper issue, asking about the meaning of “evidence”. If I give a SSRI to a depressed person and she feels less depressed, that is EB. SB goes deeper, asking why this is so: Is a SSRI the best treatment? Is a SSRI simply masking a problem? Is low serotonin turnover really what depression is about? Some have even argued that we need EP (evidence proven) not EB.

Science-Based Therapy (SBT)

Science based therapy (SBT) in counseling and clinical psychology means that the therapy a client receives is based on scientific theory and research. For example, if we believe that addiction is a response to living a life that lacks personal meaning, we need scientific evidence that this is an accurate explanation. After we develop a therapy based on this idea, we need to test it to find out if it is effective. It’s not good enough to dream up a theory and go with it. It’s not good enough to conduct a therapy simply because we’ve been doing the same thing for 50 years. It’s not good enough to conduct therapy without studying if and how it works because a lot of things look great on paper but then fall to pieces in real-life situations.

One Size Truly Does not fit all

Part of the healthcare codes of ethics is to provide a client with therapy that will give him or her the best chance of success. How do we know what therapy provides this? After all, there are at least 400 different psychotherapies. The best way is to let research give us the answer. It may turn out that one therapy works well for women and another for men. It may turn out that a therapy works well for youth but not for adults. It may turn out that a therapy works well with Caucasians, but not with Asian clients. It may turn out that a therapy works great for depression, but not so well for addiction. What happens when you use two or more therapies? Etc, etc. Only systematic research can discover such things.

Here’s a way of thinking about why SBT is important. If you were to go to the emergency ward with a heart attack, you’d expect the doctors to be aware of the latest research on the best way to treat a heart attack. You don’t want some doctor, who has a new method she’s just dreamed up, to use you as a guinea pig. You’d expect the doctor to follow a practice that has developed from science and has been studied for effectiveness.

Our Program at SCHC

SCHC’s program is SBT. It is based on a firm theory and has lots of research supporting it. The foundation of SCHC’s program is based on the work of psychologist Paul T. P. Wong. Principles that drive meaning theory and practice have been developed from research studies. And meaning-centered therapy is used with patients suffering from, for example, cancer, heart conditions, and post-traumatic stress disorder. It has also been used to help companies and employees create a more productive workplace. And it’s the basis for occupational therapy.

An Example of Meaning Therapy as SBT

One of the key principles in meaning therapy is that individuals will be healthier and more resilient if they pursue goals that are personally meaningful, rather than pursue goals that others tell them to do. This principle has a great deal support from studies in motivational psychology. This is why SCHC therapists don’t tell clients what to do or think. That would be trying to force clients to make sense of their addiction in the way the therapist wants them to. Although therapists provide guidance, clients will gain most if they can make personal sense of their addiction and recovery. In addition, research has shown that telling a client what to do or think actively creates resistance to treatment in the client.

Example of Studying SCHC Therapy

SCHC conducted a year-long study to discover the real-life effect of meaning therapy on clients. Regardless of what the theory said or what we were expected, this project helped us understand its actual influence on clients. Using many sources of data, including statistical analyses and psychiatric assessments, the data told us that there were three main effects. Clients developed greater self-awareness, better connections with others, and pursued goals that were personally meaningful.

SBT for Addiction

There are several SBTs for addiction. One that is becoming more popular is Steven Hayes’ Acceptance and Commitment Therapy (ACT). Dr. Hayes developed ACT based on a great deal of scientific research in standard clinical psychology and in mindfulness. Systematic studies on its effectiveness have also been conducted.

The Matrix Model of addiction treatment is also SBT. Richard Rawson, a professor at UCLA School of Medicine, laid the foundation for this version of treatment based on scientific research on how stimulant drugs affect the brain. Dr. Rawson and many others have also studied its effectiveness.

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